We ask the question, ‘can you be a locum forever?’
No-one really knows how many GPs are locums right now but The National Association of Sessional GPs estimates that there are 17,000 locum GPs.
The rise and rise of locuming has also seen a proliferation in spin-offs: agencies, online platforms like Network Locum (now Lantum) that allow you to negotiate directly with practices and pension your work, GP chambers and courses tailored directly to locums such as the BMA masterclass.
Is being a locum a long term option for a career?
But while locums often report that they’re happier and feel more in control of their workload, are they planning be a locum for life?
There’s no limit to how long you can be a locum. Even though takes a certain type of personality to deal with the long term uncertainties about filling your diary; it can be more hassle to gather material for appraisal and the fact that some of your colleagues still look down on you, many are starting to see it as a positive long term choice.
Clare De Mortimer Griffin has been a locum for 10 years. “I can’t see why I would want to work in any other way,” she says.
“I choose to work for who I want to work for. I get to arrive welcomed - be cheerful, avoid politics and do the clinical job that I trained for - not bean counting."
“On a personal level- it's allowed me to travel, become quite good at Argentine tango, and go a fine arts degree part time and relocate. “
Locuming has its downsides as well
In spite of the many attractions, not everyone is drawn to the life. Lack of continuity of care, lack of benefits such as sick and maternity pay and the story of Dr Helen Sanderson, a GP locum for whom NHS Pensions refused to pay out on death in service benefit to her family because she died on Christmas Eve when she was not technically at work.
“I have never wanted to be a long term locum. I don't like the insecurity of not knowing what the future holds,” said GP Tayo Idowu. “ I don't see long term locuming as a positive career. It's a stop gap while you work out where you are going to be due to say family, maternity leave etc.”
Do patients want to see locum GPs?
With locums one of the main tools in the battle to improve access, what about continuity and the patient relationship? Is the rise of the locum contributing to the decline of general practice; the loss of the value of getting to know the whole family and looking after patients from cradle to grave?
Tayo feels that patients are not always necessarily pleased to see a locum. “I think that many patients I see don't like locums. I feel they want to have that relationship with their doctor and get frustrated and tired of explaining and building rapport.”
But one long term locum who wished to remain anonymous, disagrees. “Working as a locum GP, I make a difference to people's lives if that is what is used to define 'real'. I certainly have less administrative responsibilities working as a locum but that does not make me 'unreal'.”
Sometimes patients can even benefit from seeing a locum. Recent evidence suggests that locums are more likely to diagnose cancer as they see the patient with a fresh eye. Locums also benefit from seeing how different practices work and may even be the only witness and reporting unsafe practice.
Are locums in general a good thing?
While locums are also benefiting from increased networking opportunities and expanding their portfolio roles and gaining from a range of experiences with practices, are they good for the future of primary care?
Tayo Idowu disagrees.
"I feel this is contributing to the detriment of how gp's are viewed in society by public and other health professionals,", he says. "This makes it harder to recruit new blood, making it harder for all in the trade. We need less locums."
But with partnership profits spiralling downwards with some practices no longer viable, rocketing workload and many practices report difficulties in recruiting for salaried posts at any price, more and more GPs will still be turning to the locum life.
Read Sonia Hutton-Taylor on why you need a career plan as a locum