Appraisal for Locums – Nothing to fear!
The annual appraisal is likely to fill most GPs with dread, especially if you’re a locum. It initially seems that much harder to collect and present the evidence you need, but working as a locum can give you some great opportunities to do this. Plus, you’re in a unique position to work in a variety of different practices and work with a wide range of health care professionals and non clinical colleagues. You will have plenty of access to interesting, complex and challenging cases, which you can record and reflect on in the same way a salaried or GP Partner can.
As a locum, you have the added advantage that you will often access to lots of different patient groups meaning the range of evidence you can provide is often more varied and interesting. You will need to use a tool kit to upload your evidence. Most people use the RCGP tool kit or Clarity but there are other ones on the market you can use.
Multi-source feedback (required once every 5 years)
Think of all the people you work with or come into contact with throughout your locum shifts. You can ask for a multisource feedback from practice managers, nurses, HCA, agency staff, out of hours colleagues and those lovely people at Lantum can write one too. Remember, it’s clinical and non clinical feedback. Maybe you’ve had a lot of dealings with a particular pharmacist, midwife or receptionist? You can include people from ALL the jobs that you do. In-fact, working as a locum means you probably come into contact with more professionals and from a wider range, than those GPs working in small 2 or 3 partner practice.
Are you a member of locum peer group? Or a First 5 group? Have you thought about forming one if you aren’t already a member? These provide not only invaluable support but are a great chance to share cases, ask for advice and discuss practice which you can include in your appraisal. You can also share your learning from a particular educational event and thereby double your CPD credits. Record the minutes of these meetings and you can upload them to your appraisal. You can take it in turn to summarise the latest NICE guidance and present it too. Perhaps network at a local education event or contact other locums via the Facebook page of Lantum or groups like Will and Melissa’s GP Locum group or Tikko’s group to suggest forming one or see if there are existing ones.
Significant Event Audit
Significant events- these don’t always have to be a negative. Did you do something that positively changed your practice? For example, a positive significant event about prompt incidental detection of Atrial Fibrillation might be a great learning point that GPs should check elderly patients pulse opportunistically, regardless of their presenting complaint. You could also share these at one of the peer groups I have mentioned as well as reflecting on it in your learning log.
Have you discovered something adverse while locuming e.g. methotrexate being prescribed on a routine repeat prescription without the relevant blood results? An abnormal blood result that wasn’t followed up on? These are all examples of things you can reflect on in your learning log and discuss in your appraisal.
If you can’t join a significant event meeting at one of the practices, you could always ask for a copy of the minutes to reflect on for in your appraisal. Most practices should be able to provide this.
PSQ (required once every 5 years)
Patients only have to see you once in order to provide feedback for appraisal so being a locum certainly isn’t a barrier to this. You can ask for PSQs across different surgeries and therefore different patient groups, again, providing a real breadth to your evidence. If you can’t befriend a friendly receptionist or practice manager to upload these for you, there are some companies that will do this service for you for a charge which you can find at the following websites;
You could ask one of the regular GPs at the practices you work at if they have any audits they would like an input on. Or, one great idea is to audit your own practice. Good examples include antibiotic prescribing. You could record your antibiotic prescribing over 3 months e.g. for tonsillitis and check you are acting in accordance with the centor criteria. This would be useful if you are doing lots of out of hours as well.
Another idea is to audit your 2 week wait referrals. What proportion of your referrals have a positive cancer diagnosis? You can find this out when you revisit the practice or perhaps ask one of the doctors at that practice if you can follow up a month or so later after you made the referral.
It’s also relatively easy to audit your own notes. Did your document carefully and safety net in each case? Were your notes adequate and include an appropriate plan or referral?
There are loads of great (and often free!) ways locum doctors can demonstrate continuing professional development. Remember, you need to demonstrate 50 CPD hours every year and there are loads of ways you can get these. The key is to provide a range of sources.
Examples include using the internet and reflecting on articles or guidance online. There are often free e-modules you can use on sites like Pulse. Medical journals and podcasts are another great resource plus if you can demonstrate how it has changed your practice, you may be able to claim double credits.
CPD can also include attending peer support groups or discussing cases with another colleague at work.
Attending courses and lectures are a great way to rack up those points and the good news is, there are lots of free ones to attend. It’s worth asking at the practices you locum at if they have any educational events or meetings coming up that you may be able to attend. Many practices will be glad you showed an interest and it also helps demonstrate you are a motivated and up-to-date doctor and can earn you a few brownie points.
Many private hospitals will run free events, such as the London Bridge Hospital, which usually involve a talk by a specialist and a free dinner! Find out about them here http://www.gpseminar.co.uk
Lantum in association with BUPA also run free educational events like the following and these are great way to network with other locums as well as showing you are keeping up to date.
Try to keep your learning log active as you are going along and reflect on interesting cases after each surgery. Think how you would change your practice if you saw a similar patient again.
Good luck! And if you need any advice, please feel free to email me at firstname.lastname@example.org
Dr Susan Brennan