MPS

MPS GP Conference: Balancing the Risks

NASGP

Professionalism
GP locums are fully qualified GPs – period. No one has ever forced a GP locum to work as a locum – it’s a positive choice, whether or not some of us would actually prefer to be a partner or in another substantive post. We have to conduct ourselves in a manner worthy of our profession, whether that’s in our dress, our demeanour or our behaviour as clinicians. Locuming is not an excuse to become complacent, to not take the job seriously or avoid responsibility. Which also means that we have to be treated with the same respect as other GPs – not as the poor second-cousin that all too often pervades. The NASGP provides a Code of Good practice for GPs and practices alike to create a professional ethos for us to thrive as members of the primary care team.

Ownership
Locums do not get paid to keep the other GP’s seat warm. As far as the patient ins concerned, they’ve booked to see a fully qualified GP who should have all the necessary clinical and non-clinical information at their fingertips to deal with that patients concerns at the moment they present – not to be told to wait until their normal GP arrives back from skiing. But so often us GP locums are placed in this position of professional ‘learned helplessness’ through a simple collusion of ignorance from the practice – as GPs, we have ten’s of thousands of ‘bits’ of information in our brains, ready to be translated into instant wisdom in the form of a patient’s management plan. Yet so often this process is arrested through very simple oversight – non-clinical information is so often not provided in an easily accessible format so that, for example, a locum can clinch the diagnosis of a DVT within literally seconds yet be completely scuppered by not knowing the fast-access DVT clinic at the local unit, leading potentially to the patient being managed inappropriately. The NASGP has developed a Standardised Practice Induction Pack in conjunction with the MPS to help circumvent these issues.

Teamwork
The DoH refers to us as DOMOs – Doctors Outside Managed Organizations. And we are – and often very proud of it! Independent, freelance, self-governed – all potentially very positive aspects of working as a GP. But this can also cause issues. The paradox of being both an empathic clinician and hard nosed businessman; working for a day here and a day there, choosing whether to accept or decline practices but subject to periods of redundancy; choosing how and when to respond to our concerns of our personal clinical governance. All very well, but working as an independent GP locum will require a lot of convincing when it comes to recertification. So that’s why the NASGP came up with two new ways for GO locums to work within a managed organization yet remain self-employed. The Sessional GP Support Team concept provides a team environment within which GP locums work as a team within inbuilt clinical governance, peer-review, education, support – all very much within a managed organisation. And the NASGP’s affiliate Freelance GP Scheme – a package that facilitates individual locum GPs in working very closely with one practice for mutual support.

Working as a GP locum need not involve any more risk than working as any other type of GP; indeed, not only may it be safer but may – as a second pair of eyes – very much reduce risk inherent an ongoing contiguous doctor-patient relationship.