The well-publicised GP shortage, rising stresses and strains of the job leading to increased absenteeism and an ever-growing demand for GP services means that locums are becoming an increasingly essential component of any GP practice’s workforce. But how can you make sure you’re selecting a locum that fits in well in your practice and how can you make sure you’re not chucking practice cash at unnecessarily expensive locums?
Finding the right locum
There is no shortage of locum doctors (unlike the situation with salaried) which means practices can, to a degree anyway, afford to be choosy when hiring a locum. Therefore the questions to ask yourself are what specific skills they need to have, whether you want them to have worked in a similar-sized or type of practice to yours, and so on. This should help you source a suitable locum and also help the locum to fit in.
Most locums are experienced, both in terms of settling quickly into a new environment so as to start adding value straight away, and the range of skills that they are able to offer. Whether you recruit directly or through an agency, via a local medical committee or by way of local sessional GP groups, ask for a detailed CV and do your background checks – we’ll talk about this in more detail later.
Locums can be extremely beneficial and some practice managers would argue they come into their own when there is an urgent demand for a professional with very specific skills. The process of interviewing and recruiting a permanent replacement is usually a slow one, so bringing a locum with specific, proven skills can be welcome. Don’t be afraid to ask for certain capabilities and experience – there are plenty of locums out there with lots to offer.
There’s no getting away from the fact that locums can be expensive – there has been plenty of media focus on it in recent times for sure. However, when properly implemented, there’s no reason why hiring a locum, especially for longer-term coverage on occasions of maternity leave, sabbaticals etc, should be any more expensive than long term staff, particularly when you take into account that there is no need to cover costs such as training, benefits, holiday, sick pay or National Insurance.
Even without those costs, locum fees can be high, so how can practices reduce their locum costs? The answer here is by employing a system and procedure that ensures better planning. These include:
- Booking locums in advance to avoid higher short-term costs
- Establishing good working relationships with regular locums
- Working with other practices or CCGs to source locums directly
Hopefully the recent bluster from Jeremy Hunt about controlling locum fees will help too – but we’ll wait to see on that point.
Fit and proper
The fit and proper test concept that requires all staff employed in the GP practice to be able to carry out their duties adequately extends to locums – with responsibility for ensuring this is the case falling on practices. Where a practice hires a locum directly, it must check that the locum is a GP registered with the GMC and that he or she has medical indemnity and is on the performers list.
The details that need to be checked are specified in Regulation 19 schedule 3 of the Health and Social Care Act 2008, which are:
- Proof of identity
- Evidence of previous employment and conduct in the provision of health/social care and to children or vulnerable adults
- Documented evidence of qualifications
- Employment history
Responsibility for the above, when hiring from an agency is a grey area. The responsibility to ensure the fitness of a locum will always remain with the GP practice. However, a practice manager can reasonably assume that where the locum is supplied by an agency, then the agency should be responsible, as a locum agency is required by law to check that its temporary workers are suitable for the positions for which it puts them forward. In a nutshell, that means the agency should be able to provide the information a practice needs to confirm the locum as being fit and proper.
Finally, a written agreement needs to be put in place to protect both practice and locum. A handy place to turn for advice here is the BMA, which has published a guide to written locum agreements – click here for more. This guidance is for locum GPs and the practices that engage them, with the aim of helping locum GPs to put together written agreements with the practices for which they work; it will also be of interest to practices that engage locums.
Have you hired a locum recently? What advice can you share with your fellow Practice Managers when it comes to hiring them? Please comment below or in the forum here.
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