FEATURE
“I want to see
a real doctor”
Locums and practices need to work together, but
Gone are the days when
organising a referral just meant
this doesn’t always happen, and locums can feel
dictating a letter. Care pathways
and clinical referral systems vary
like a spare part. Dr Judith Harvey asks readers to widely. Partners only need to
put themselves in a locum’s shoes
know one system on a day-to-
day basis. In the course of a
month’s work, locums may be
dealing with 4 PCOs and 24
secondary care trusts. Telling a
“I want to see a real doctor” ThE locUm in A local information that doctors locum that all the information and
is a typical response to the FoREign lAnd need to do their job. Locums forms are “on the computer” is
all too common receptionist’s In a consultation it is important can help their fellow locums by unhelpful. If a locum has to run
explanation: “I’m afraid Dr that a patient and a doctor contributing additional notes. searches to find documents,
Jones is on holiday; it’s only have an open mind about each which can be shrouded under
a locum today.” This is not other. It is worth remembering If the practice computer system an uninformative alias, their time
a great start to any locum’s that patients do not all place a is accessed using a Smart will be directed away from seeing
consultation. high value on continuity of care, Card, unless a locum has this patients.
many are happy as long as a card he/she will have to practise
A locum can feel like an oily rag. competent doctor is available. without patient records and Similarly, while any good locum
In an emergency everybody And regular patients can write paper notes. It is helpful will endeavour to support the
needs one to keep the wheels sometimes benefit from a fresh if practices have someone on practice’s work on the QOF,
turning, but then it is forgotten eye that picks up problems that hand, who can get the locum enhanced services and local
till the next breakdown. familiarity has rendered invisible. up and running without delay. incentive schemes, they will
Practices don’t get the best Some locums provide practices not always know the computer
out of their investment in with a brief biography so that ThE locUm codes. Templates incorporated
locums. Locums may be sitting patients will know a bit about compUTER TEchiE into the clinical software make
in a partner’s chair, seeing a them before their consultation. When a locum starts they it much easier for doctors new
partner’s patients; they are Practices can promote this: immediately need to ask, to a practice to contribute
not the partner, but nor are why not ask each locum for a and practices need to tell to practice targets – and,
they a second-rate substitute. biography with a photograph? them, what clinical software hopefully, to patient health.
They are flexible, highly-trained system the practice uses.
professionals who can bring Most practices claim to have a Experienced locums will be Some practices still log in
special skills and insights to locum induction pack. Efforts familiar with widely-used all locums as “Dr Locum”.
practices that are disposed are made to keep the pack systems and new locums can This is unacceptable. It is a
to take advantage of them. up-to-date, but I’ve visited familiarise themselves with the requirement of good practice
If locum GPs practise in an practices where the information most common systems, but that every consulter have his
environment of “enforced covering the hospital pathology a practice with a homespun, or her own username and
underperformance”, they, the services over the festive period off-brand system will be difficult password, so that a proper
practice, and the patients will was two years out-of-date. to navigate even for the most audit trail exists and no-one can
pay a high price. Practices should provide the IT-literate visitor. falsify another doctor’s notes.
6 YOUR PRACTICE VOL. 3 NO. 1, 2009 www.mps.org.uk
YP07 pp06-08 real doctor.indd 6 29/1/09 10:56:48
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