Dr Catherine Steven
Role Locum GP and lead doctor for the Islington branch of Pallant Medical Chambers
Location Islington, north London
I start my day with a stiff cup of coffee and the morning news before my daughter wakes up and has her breakfast. After getting her dressed and having our breakfast together I jump into the shower, get dressed and we both wish my husband a good day at work. We go the child-minder and I drop my daughter off.
Today I’m fully booked with locum work, but I expect to do a bit of work to keep the locum chambers in good order. I am the lead for the Islington locum chambers, which is the latest in an expanding network of groups that provide support to sessional GPs.
Like other chambers leaders, I help member GPs to meet up regularly for business and social support and chair the monthly meetings. I can also help members find resources – for example, when collecting evidence for clinical governance – through the wider Pallant network (of which our group in Islington is one branch). Pallant managers and staff cover the admin side of our work.
I arrive at my first job today in a leafy part of north London. The workload is varied but not too taxing, as you would expect for the population of a generally affluent suburb.
But as with most of London there are always a few challenging patients such as the immigrant lady who has just arrived in the country and immediately signed on for disability living allowance, who has an urgent appointment this morning.
The rest of my list includes everything from a young man wondering if his scrotal oedema could be a side effect of his antipsychotics, to the young lady with an overriding worry about her persistent microscopic haematuria (despite my and other GPs’ reassurance that it’s likely to be benign).
I only manage to see one patient on the ‘emergency’ list (who would like antibiotics for her sore throat before she goes on holiday…) before I leave for my second job of the day.
I dash to East London, stopping at a petrol station to grab a sandwich, having stupidly forgotten to pick up a proper deli sandwich before leaving Islington.
Before starting my second surgery I check my e-mails. We’ve had two new applicants to the locum chambers who are keen to join, so I fire off a couple of e-mails to see when they are free to meet up for a chat. I’ve already spoken to one of them on the phone, but the point of being in a chambers is to feel supported and know who you’re relying on both from a personal and professional point of view, so the meeting is very important. It’s their opportunity to put a face to the GPs that will be supporting them, and our chance to make a quick assessment of whether the applicant is someone you can rely on to step in and contribute to chambers meetings.
Our monthly meetings give us an opportunity to update each other on best practice and trouble any problems we may be having in the chambers – most recently a practice that booked a member for eight hours’ work, and then told them on the day their work was cancelled. This is where the chamber’s membership is invaluable – they were able to explain if the member is booked, part of the terms and conditions of the booking says they must be paid for committing to the session.
I arrive at my afternoon job in East London just in time to log on and make a few quick calls to a couple of patients I met during from my last surgery here. The population is generally more deprived here than at the practice I work in this morning and although my surgery almost always overruns I find it rewarding. Tasks range from helping people appeal the removal of their disability living allowance to referring a young couple who have been trying to conceive unsuccessfully for further investigation. They are all genuinely grateful for the time taken to explain what you are doing, why and what they should expect to happen.
I get away to collect my daughter from my parents-in-law, who often help out by collecting my daughter from the child-minder. She’s had a busy afternoon rearranging their fridge magnets and exploring the garden, but we must be off to get dinner ready.
My husband arrives home and we all have dinner together – I spend most of the meal trying to persuade our daughter to eat a few vegetables with her fish fingers.
After I put my daughter to bed, it’s time for me catch up with my husband. He works at a local hospital – we swap stories of successful treatment and challenging patients at the surgery.
Then I catch up on my e-mails – I have more than usual as we’ve only just set up the new chambers in Islington. We’ve had plenty of interest, both from practice managers looking for locums, and GPs wishing to do locum work with the support of a chambers. A few practice managers have ‘favorited’ me for future work with them – including one I’ve only locumed with once, two weeks ago.
When I worked as a salaried GP, although I would get the odd thank you letter from patients I never got the same amount of positive feedback as I have as a locum. Perhaps the work is more rewarding, or perhaps practices like to show more appreciation for GPs who have a choice as to whether to return or not. As the chambers manager does most of my admin for me, this is really the only admin I do out of surgery – which leaves plenty of time for curling up on the sofa to watch Family Guy/Here Comes Honey Boo Boo (depending on whether my husband or I win the coin toss over the remote control).