"Do the Locum GPs continue to be
self-employed, but with more organised support from the SGPLO and
mentor?"
Yes - it's a form of "soft management". As
you know, GP principals are technically self-employed. Employing all the
SGPs would be fraught with problems - a bridge too far perhaps for some
Locum GPs and/or PCTs.
"In what sense are the Locum GPs 'fully
enfranchised members of the PCT' beyond their existing role of working
in the area?"
Because they will formally be involved in clinical
governance; be represented at PCT/LMC level; opportunities to actually
help develop and lead in primary care development. For example, at the
SGPST weekly/monthly management meeting, it transpires that there is a
huge variation in the delivery of diabetic care - some good and some bad
- across the PCT. So it is suggested by one or two of the SGPST members
that they set up a peripatetic diabetic clinic, with the same two
trained GPs (Freelance GPs) working regularly in every practice seeing every
diabetic in the PCT, feeding back into the clinical governance
mechanisms, building up a wealth of data, knowledge, experience and
measurable outcomes.
"Are the Locum GPs funded to participate in
education/ clinical governance?"
No less so and no more so than any other GP in the
PCT.
"Would you expect all local practices to go via
the SGPLO to set up any Locum GP cover required?
It would make sense! Some Locum GPs may hate the idea of
this, and so they could/should be left to their own devices. But as the
system unfolds and those Locum GPs being booked by the SGPLO start to
receive greater benefit, I would expect that those initially dissenting
Locum GPs may finally give it a go. It would be wrong to force any
SGP to
something they don't want to - the trick is to develop a service,
highlight its benefits for all concerned, and then invite people to join
in.
"What about Out of Hours work?"
A lot of Locum GPs can't be bothered - why should they?
But, as a member of a SGPST , as they gained greater ownership of their
PCT and the PCT/OOH co-op greater ownership of their Locum GPs, I believe
that greater synergy would develop and Locum GPs would be far more willing
to do OOH than they are now.
"Most of our Locum GPs here work in several
PCTs - how do you envisage this working?"
The idea is each SGP would be a member of only one PCT.
But two or more PCTs could share meetings, running costs etc. or hold
away days together. In terms of booking Locum GPs, SGPLOs from different
PCTs could easily "borrow/share" Locum GPs.
Many thanks to Clare Mitchison, Clinical Governance
Facilitator for Brighton and Hove City PCT, for posing these questions. |