Communication communication communication! - Quality fears, locum isolation and misunderstandings are all solved by better and more direct communication.
It is commonly known that many locums report feelings of isolation. We heard from the recent annual GP locum conference that this is still very much an issue.
Isolation is not only unpleasant for locums, but it also creates misunderstandings and risk. Communication is very important. The MPS stated that a breakdown communication, including inadequate medical records are one of the key drivers for complaints and claims against locum doctors. It is crucial that as a locum, or a practice taking on a locum, that you are aware of this risk and that you take steps to reduce it. Melissa Morris founder of Network Locum (now Lantum) states "Locums should be as clued up as they can be about the role and the responsibility of that lies on both the locum and the practice"
"Be open about your need to adjust"
For example, if you are new to a practice, it might take you a little longer to use the systems and perform consultations. A practice manager we spoke to in Manchester told us "If the locum told me before that they might take a little longer, we would give them slightly longer appointment times, if they don't do this, our receptionists will book them back to back appointments of 10 minutes each and patients will be let down when the doctor creates a backlog" It is OK to admit that in a foreign environment you might take a little longer to perform activities safely, but again, communicate with your employer early if there is something they should know about.
"Avoid false expectations and get a good match"
If a locum is not qualified to perform a certain examination this should be made clear at the start, or even before the start - Locums should explain on their application for a role what they will and won't do. It is important not to you do not want to run the risk of either doing something you are not trained to do, or disappointing the practice who thought you would be able to do it. To avoid bad feedback, make sure there are no false expectations Samantha, a Locum in London says "Word travels around so if you have a bad time at one practice, it is likely that neighbouring practices will find out about it - so it is important to get a good match in the first place"
"Be clear and detailed about the job"
Just as locums need to communicate with practices, practices also need to provide as much information as they think is reasonable for someone new coming to the practice. Practices need to be clear about what the job involves. Melissa Morris founder of Network Locum (now Lantum) says "Make sure when you post a job, you explain fully the job that needs to be done, for example if there are home visits involved, you should say so if you don't want a locum turning up without a car"
Practices should also develop a locum information pack (the NASGP has a good standardised induction pack for reference). It can be frustrating when a locum does not understand the various referral pathways, but if you make it easier for them to learn the practice dynamics then you will definitely get the most out of the experience.
"Leave a good impression"
If you want to be invited back to the practice, or even just want good feedback, it is not just about your work and attitude during the session. The work you do leaves a lasting impression and is traceable through your notes. If you leave poor and incomplete notes you can change the practices opinion of you as soon as they revert to them for information. You must communicate to the GPs you may not have even met(those who take on the patients) by leaving good clinical notes which are well written, easy to understand and complete.
"Feedback is a gift!"
Often, while using an agency, feedback does not reach the individual doctor, because communication between doctor and practice is not facilitated or encouraged. Not only does this lead to severe quality worries in the locum market but it also prevents individual doctors from resolving issues.
Feedback is a crucial part of your appraisal and you should be demanding feedback from your practices, and practices should make a habit of giving this to all locums who work with them. The NASGPs report on revalidation suggests that practices should assist locums in evidence collection. GP locums are often not involved in practice meetings where complaints are discussed, Practices should make every effort to contact locums involved in a complaint. If quality and people's perception of it is going to improve, locums should always be involved in the complaint resolution.
No man is an island...
Locums often report feelings of isolation, as there may not be anyone else with whom to share the feelings and frustrations of the day. We recommend that you should join study or support groups, contact your local LMC and see if they have a local locum list, or submit questions on forums.
Network locum is an online tool that enables practices and locums to communicate and find jobs directly, without the need for an agency. Contact Melissa Morris,Melissa.Morris@lantum.com
Find us on www.lantum.com