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Sourcing a suitable GP locum

Research your options carefully when considering how to recruit locums, advises Dr Sara Chambers

With independent locum GPs you will need to negotiate the pay rate, terms and conditions when making bookings (Image: Science Photo Library)
With independent locum GPs you will need to negotiate the pay rate, terms and conditions when making bookings (Image: Science Photo Library)

Estimates suggest 20 per cent of GPs work as locums equating to 15,500 GP locums in the UK. But how do you source a suitable, available locum? There are various options open to practices, each with pros and cons.

Local networks of independent locums

If you are fortunate, you may have an informal network of contacts with trusted local GPs who can step in: the retired ex-partner; the part-time, practice-based GP who wants to take on occasional extra hours; the established local locum; or the ex-GP trainee.

Nurture these contacts if you have them; these networks can be an excellent source of high-quality locum GPs. However, you will need to work at maintaining an up-to-date list of contacts and be prepared to make many phone calls/send out lots of emails when making bookings.

If the locum is managing their own bookings they will be juggling this with their clinical work, which can mean booking is not instant and you are left waiting for responses and confirmation. You will also be responsible for checking these locums’ credentials and will need to negotiate individually with them regarding rates, terms and conditions.

Pros:

  • Often a known entity who comes with a ‘word of mouth’ recommmendation.
  • May have experience of working locally.
  • Flexibility in agreeing terms.

Cons:

  • May be difficult to contact quickly for bookings.
  • Less likely to provide cross-cover if unable to attend through illness.
  • You will be responsible for checking their credentials.
  • Variable rates, terms and conditions; you will need to negotiate, individually, with each locum.

Other points to consider:

  • Independent locums can be isolated, professionally-speaking.
  • What is the clinical governance framework for raising concerns?

 

Locum agencies

It is no surprise that practices short on time, or lacking independent locum GP contacts, turn to locum agencies to source freelance GPs. Agencies are commercial organisations which seek to build large databases of locum doctors, all accessible through one point of contact.

Doctors have to present credentials to sign up to reputable agencies; often GMC registration, performers list inclusion, CV, references, evidence of completed GP training and occupational health checks. Advertisements in the medical press hoping to attract doctors usually focus on the agency’s nationwide coverage, great rates of pay and speed of placements.

No doubt there are many high-quality locums who work through these agencies as they are high profile and have access to many practices and GP work placements. These locums are unlikely to spend time out of work. But bear in mind that you are dealing with an organisation whose primary motive is profit, not necessarily the professional support of their doctor workforce. There are reports of varying quality.

Pros:

  • Ease of access and arranging bookings.
  • Preliminary check of locums’ credentials carried out by the agency.

Cons:

  • Cost: unless they are simply charging a finders fee and acting as a recruitment company, agencies will take a cut of the fee they charge to practices.
  • Quality: locums sourced from large agencies may lack local experience and you will not benefit from ‘word of mouth’ recommendation.

Other points to consider:

  • Locums working through agencies may be professionally isolated
  • What is the clinical governance and quality assurance framework?
  • How would you raise concerns about a doctor’s performance?

Online locum networks

Some areas benefit from a single online portal providing access to a pool of local GPs whose availability can be ascertained and who can be contacted and booked online. These ‘match-making’ services enable practices to seek out a locum who meets their needs or to circulate their requirements and individual locums can do the same.

The online matching systems give ease-of-access to non-agency locums, but lack the peer and management support of the more evolved GP locum chambers.

Pros

  • Potential for ease of access and booking (depending on the sophistication of the online system).
  • Usually supply local locums relying on good local reputation.

Cons

  • Cost: locums using these portals may be charged a fee to do so, which is likely to be reflected in a higher locum rate.
  • Online locum networks are not available in every locality.

Other points to consider:

  • What is the clinical governance and quality assurance framework?

 

GP locum chambers

GP locum chambers are groups of local locum GPs who undertake to work as a team in a ‘virtual practice’ and pool a slice of their income to pay for administrative staff and infrastructure to handle all non-clinical aspects of their work such as booking and invoicing. The GPs meet regularly in ‘practice meetings’ for peer support, sharing information and organising educational events.

GP locum chambers are a relatively recent innovation; the longest established has been running for 10 years. They tend to be set up by locum GPs keen to form a supportive network of peers to avoid professional isolation and thereby improve patient care and build a good reputation with local practices.

To join chambers, a GP has to present references, evidence of training and is interviewed by fellow GP chamber members, rather like joining a practice. It is in the interests of all the GPs in the chamber to build a good reputation so the process is selective.

Practices in areas with a locum chamber tend to value them highly as they offer ease of access and booking to high-quality locums at reasonable rates. Of course, the locum GPs available are only as good as the chamber to which they belong and chambers have not been established in all areas of the UK.

Key features of GP locum chambers

Pros

  • Ease of access and bookings: chambers use online calendars and can book and confirm sessions instantly.
  • Chambers will provide cross-cover if your booked locum is unable to attend at short notice.
  • Terms and conditions are agreed in advance between the chamber and practice.
  • Preliminary checks and interviews are carried out by the chamber as an entry requirement.
  • Locums will be local and relying on their local reputation.
  • They are members of a professionally-supportive peer group and have access to ongoing education, appraisal and revalidation.
  • Clinical governance systems within the chambers provide opportunties to learn from feedback and significant events.

Cons

  • The cost may be higher as rates of chamber-employed locums may factor in administrative costs of running the chamber.
  • Not all areas have locum chambers available.

 

To conclude, there are many high-quality GPs in the marketplace but it can be a challenge to reach them, especially at short notice or at times of high demand; hopefully this article has provided an insight into how locums work and the various methods of accessing them.

Top tips for finding a suitable GP locum:

  • Maintain and nurture a network of independent, freelance GPs, including part-time practice-based GPs; trainees due to qualify; and established local locums with good reputations.
  • Find out if there is an online portal giving access to local locums or a local locum chamber. If there is no chamber, suggest to locums they may benefit from setting one up.
  •  If you are using a locum agency, do your research to ensure it is cost-effective; reliable; and can provide quality assurances.
  • Gain feedback on the locums you use, from staff and patients, to ensure you only employ those that add value.

 

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