JuditH HArvey
all locums as “dr locum”. high-risk activity and some
this is unacceptable. it is a organisations advise that
legal requirement that every they should not do so. in the
consulter have his or her own real world, both sides need
username and password, to minimise the risks. for the
so that a proper audit trail locum that means checking
exists and no-one can falsify the patients’ notes before
another doctor’s notes. signing for practices that
means allowing the locum
the locum time to do so, and accepting
archaeologist that any locum is justified
a typical gp’s consultation in refusing to sign some
room is a monument to their prescriptions. patients on
individuality. But this can anti-hypertensive or asthma
be difficult for a locum who medication, who haven’t
has to search through a been reviewed for years,
desk full of papers, knick- repeats for benzodiazepines,
knacks and family photos, anti-rheumatoid drugs where
or drawers crammed with no evidence can be found of
drug company freebies, monitoring, can all present
spare spectacles and stale difficulties for the locum.
biscuits, to find a peak-flow
meter or medical certificates. the locum visitor
unearthing the tools of the in a practice it is inevitable
trade can be an exercise in that occasionally someone
office archaeology. untidiness will take the opportunity to
is hard to cure, but it helps to scrump an unattended apple
establish a common system iphone. However careful they
for where equipment and are, locums are vulnerable to
e
g
forms are kept. providing casual theft. You can’t lock
r
e
o
a box of essential bits your belongings in a drawer

g
i
s
and pieces specifically for if the drawer is already
r
H
locums is very handy. in locked and the key is on the

c
©
turn, locums should leave partner’s keyring. You can’t
a consultation room in the lock the consultation room event waiting to happen. skills, but a special degree
state they found it; everything door while you go and hunt Most practice managers of flexibility and an ability
should be left as it was. for the sonicaid if no-one and partners will be glad to judge and manage risk.
knows where the spare to have problems brought locums can only be as good
the locum mind-reader key is. it does not foster a clearly, but diplomatically, to as their skills and abilities,
gps who know their patients good relationship between their attention, and will let but unfortunately all too often
very well (likely in single- a locum and practice if a the locum know what they they are not given a chance
handed practices) may locum discovers that the have changed as a result. to practise at their best.
carry a lot of information small print of a practice practices owe it to their
in their heads. a locum insurance policy excludes the locum and locums, and their patients, not
will not know if Mrs Jones cover for their belongings. the practice to put locums in a position of
usually looks that funny locums and practices need partners work in the same enforced underperformance,
colour, or what “white pills” to consider whether their place, using the same and locums can help
she was prescribed last property is protected, and systems, every day. locums themselves, their colleagues,
week. adequate notes indeed whether they would walk into an unfamiliar and their patients, by using
are essential to maximise have cover if they were building to meet a team of their unique position to
patient safety. all doctors the victim of an assault. strangers with their own way support practices.
need to write notes with the of doing things, knowing Dr Judith Harvey
assumption that the patient the locum management that every patient will be a is a council member
may be a stranger to the consultant “new” patient. this requires of the NASGP, and a
next doctor who sees them. locums are a fresh pair of not only the standard clinical recently-retired locum.
eyes, not only for the patient
the locum prescriber but for the practice. they see
repeat prescriptions are almost every aspect of the further information
a daily practice chore. practice and can spot the
they are also a common things that go unnoticed: out-
■
National Association of Sessional GPs – www.nasgp.org.uk
cause of complaints. for of-date test strips, a wobbly
■
Haynes, K, et al Clinical Risk Management in Primary
locums, signing repeat stool, outdated tfts – any Care. Radcliffe Publishing ISBN 1-85775-869-2 (2005).
prescriptions is a particularly of these are a significant
sessional gp | voluMe 1 | 2009 www.mps.org.uk 29
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