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7) fitting a square peg
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locum gps do not fit into the traditional
B
partner model. few practices know how
to make the most of them and deliver a
good continuity of care. Most practices
are not akin to their particular needs.
Solution – develop realistic
expectations by explaining what your job
as a locum entails and what you need
to do your job well. cultivating good
communication with other gps and
practices will make this easier to achieve.
8) risky tasks
do’s and don’ts of
practices often expect locum gps
to perform tasks, such as signing
repeat prescriptions, which are risky emailing patients
if you don’t know the patient.
Solution – speak to the practice
manager. if he or she thinks you are being
difficult, explain that repeat prescribing electronic communication can provide a
is a common source of medical error,
and it’s a risk for the patients and the useful alternate point of access for patients.
practice. explain that if you are going
to do it, you need more time because Dr Richard Stacey explores the pros and cons
you have to check each patient’s notes.
the practice has to understand this and
pay for it. it’s in their interest. Before do don’t
you agree to sign repeats, make sure
you know how the practice reviews ■ ask to have sight of the practice ■ forget that email exchanges are an
repeat prescriptions. if the system is email communication policy important part of a patient’s medical
unsafe, say no. and consider who ■ ensure that the policy incorporates records and should be saved therein
needs to know that there is a problem. appropriate safeguards in order to ■ be tempted to use email to respond
preserve patient confidentiality to complicated or difficult problems;
9) A clash of beliefs ■ confirm that the patient is content to if you feel that a consultation would
a locum may hold a conscientious receive a response by way of email be more appropriate then make
objection to a particular treatment or ■ remember that when corresponding the necessary arrangements to
procedure, eg, abortion. it is important by email, many of the non-verbal see or telephone the patient
that patients do not get stuck in the clues and nuances, which would ■ be afraid to either involve one of
middle of a moral debate. nor should be apparent in a face-to-face the partners or to ask that they
everyone’s time be wasted because consultation, or to a lesser extent respond if you feel uncomfortable
patients are booked for procedures in a telephone conversation, will responding to the patient’s request
you aren’t qualified to perform. not be apparent, and this problem ■ forget that responding to email
Solution – Make clear before you start may be amplified because you enquiries may take some considerable
what you will and won’t do, and what you might have had no previous time. You should ensure that if you are
can and can’t do. use a nasgp booking contact with the patient to be expected to respond to email
form so the practice knows in advance ■ remember to respond in a queries, you should be alerted to this in
that you don’t refer for termination or professional manner and advance of taking up a locum position
that you are skilled at injecting joints. avoid “text–speak” and that you should be appropriately
■ respond in a timely way. remunerated for the same.
10) limited practice feedback
“am i any good?” every locum
wonders this now and again, and
appraisal requires an answer. useful links
Solution – performance feedback
is essential for good risk management, ■ car, J and sheikh, a. email consultations in Healthcare, BMJ (2004) www.
and locums should demand it. Working bmj.com/cgi/reprint/329/7463/439
in chambers or through a locum support ■ Guidelines for Clinical Use of Electronic Mail Patients american Medical
team makes this easier. appraisers must informatics association (1998) www.amia.org
take account of a locum gp’s working ■ Evaluating Internet Health Information: A Tutorial from the National Library
life, and locums’ personal development of Medicine www.nlm.nih.gov
plans (pdp) should reflect this.
sessional gp | voluMe 1 | 2009 www.mps.org.uk 21
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