www.mddus.com


Set terms It is important that both you and the practice understand what work will be undertaken. When I first started as a locum I put together a contract setting out my terms and sent this to PMs. This stated the amount I expected to be paid and included the number of patients I expected to see in a routine surgery, how I wanted my surgery arranged regarding breaks and catch-ups, and the number of telephone calls and home visits included in my fee.


I also included a clause regarding cancelling work and the amount of


notice I would give/expect to be given by practices. These terms and conditions help to protect me and the practice and ensure each party’s expectations are clear. When it comes to agreeing a fee, I often ask practices what rate they


usually pay and negotiate from there. Ensure you clarify if this rate is inclusive of your pension contribution.


On the day Locum work in unfamiliar practices comes with its own risks. Ensure you arrive early to get set up in your room. Introduce yourself to key staff and get their extension numbers so you can access their advice quickly. If it has not already been sent to you, ask for the locum pack which will have key information, from login details to local prescribing protocols and referral pathways. Note down who you can speak to during clinic should you need a second opinion or other advice.


Useful questions to ask include: • What is the extension number for reception?


• Where is the panic button? • How do I call patients in?


• How do I request blood tests and where are these done (on site or local hospital)?


• How do I order X-rays and ultrasounds?


• How do I refer for physiotherapy and counselling? • Where are MED3, MATB1 and maternity exemption forms kept? • Do I dictate or type referrals?


Mutual support The patients you see as a locum are your patients and you have a duty of care to them and your colleagues. Do not be tempted to “pass the buck”, even if you won’t be working at the practice again. Clear documentation when arranging investigations and reviewing test results are extremely important from both a clinical and medico-legal point of view. Before starting your clinic, confirm who in the practice can act as a chaperone if needed, noting their full name and title. Working across a regular group of practices can make continuity of


care and patient review easier. But if you are changing practices regularly and won’t have the chance to follow-up a patient, don’t forget to do a comprehensive handover to your colleagues. You should also note down a clear plan so the patient’s regular doctor has all the relevant information they may need. Clearly document red flags, safety-netting advice and follow-up arrangements discussed with your patients. Try to keep up-to-date about prescribing polices and referral guidelines. One useful free online resource is the Red Whale GP Update Locum Essentials Guide. I often discuss any queries I have with the practice’s regular doctors and make a point of submitting any referrals before I leave for the day.


Returning to practices The key to locum success is being invited back by practices. It pays to be flexible in helping to meet the surgery’s needs, be punctual, organised, and be equipped with the necessary equipment. Developing a good working relationship with practices will help you access regular work, support and continuity and become a valued member of the wider team.


Dr Surina Chibber is co-founder of MyLocumManager.com – the cloud-based locum business toolkit


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