I have been a locum GP for ten years now, something I can’t see changing any time soon.
I recently reflected on what I’ve learned over this time about the craft, and what advice I would give to my younger self, just starting out on her locum career, having relocated to a different part of England with no knowledge of the local practices and systems.
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Patients are patients; the medicine doesn’t change
I remember worrying about how I would cope not being in the same room everyday, with my folder of notes, without the clinical system shortcuts set up how I like them, and familiar equipment. ‘How will I know who to refer to when working in a new area?’ for example.
It turns out that those years of GP training were still just as relevant in an urban practice down on the South Coast, than the rural North Norfolk practice I’d done my clinical work in until that point. The patients are the same; they inhabit a human body. Moving to a vet med practice would have proved more of a challenge and was the scale of change I was expecting when transitioning to a locum career – I was glad my worries were unfounded.
Sure, there are adaptations to be made: I have a well-stocked bag including things such as a Snellen Chart and stickers for kids, a library of internet browser tabs, a full coffee flask, a little book with useful numbers and door codes in, and I wear plenty of layers. However, the consulting room in Average Medical Practice generally has what’s required in it, thanks to the many previous occupiers.
In short, change, and constant change in the form of very ad hoc locum work, isn’t particularly scary and in time it feels quite run of the mill.
Give every practice a chance
Although the grapevine is helpful and very much worth listening to, I would like to encourage my former self to acknowledge rumours and then verify (or not) for myself what’s going on under the chatter. I have, for example, had lovely experiences at practices with terrible national reputations or practices that are well-known locally to value their salaried GPs poorly. On the latter point, that particular practice treats me well as a locum, however were they to ever ask me to become a salaried GP, I would politely decline because I know I would struggle to feel valued.
It’s also true that we are a diverse bunch of people, so a favorite practice of mine may be on someone else’s black list. The worst case scenario of ending up at a practice that is a poor fit for you as a GP locum, is that you’re stuck there for the few number of sessions you’ve been booked for, so it’s not the end of the world to finish those off and then commit to never going back.
I can honestly say that I have learnt something from every practice I have worked at, even the ones I never wish to return to.
You don’t have to be perfect
In my experience, locum GPs are given a degree of leeway in practices, as staff are familiar with the concept that each practice has a different set up, and therefore a locum will not get it right, no matter how many years’ experience they may have in their career. If a locum GP is practicing safely, communicating something sensible with someone, then it is unlikely to matter if a task is sent to ‘reception’ instead of ‘admin’; the team members will sort out any slightly off-piste requests. The patients have been seen, the clinical work has been covered, and that’s primarily why the locum was engaged by the practice in the first place.
Be flexible, understanding, and responsive
There is some competition out there between locum GPs, and we have to work to stand out from the crowd and be the first choice when a practice needs a session filling. I try hard to accommodate last minute changes e.g. to session times, or branch surgery visits, or supervising a GP registrar where I can – sometimes the flexible request is one that works better for me anyway. Equally if a clinic is looking unfilled, and I am working in a familiar practice, I may offer to do some path filing in empty slot so my time is not wasted. This tends to go down well and buys a bit of goodwill, but this particular example also gives me a bit of variety to my day and keeps me feeling fresh.
I also try to be understanding when a mistake with booking has been made. For example, a practice may book me for a half day but on the clinical system I have been given a full day of patients. Sometimes I just have not been able to stay and do that extra session as I need to immediately head off to something else, but occasionally I can offer to see a couple of the patients at the end of the morning or make a few phone calls to help out.
Mistakes are inevitable – and on my part too – so the hope is that by being understanding, I will be afforded the same when I double book or have a request to move my clinic start time.
Another way to stand out from the competition is to be as responsive as possible to booking and availability requests. A locum GP who is known to be extremely responsive to emails may well be the first person called upon for a next day requirement.
Keep the paperwork tight
I was lucky to have already had it drummed into me the importance of solid T&Cs with every practice. It is fair to say that I have needed to refer to them several times, and am glad that they were robust enough to help me out with late payments and cancellations.
I would also recommend adding extra details to them whenever a slightly awkward issue happens, so that when the next time inevitably comes round, the situation has been anticipated in the T&Cs and there is a pre-agreed way to work through it.
Do not be afraid to value yourself
Locum rates do not need to be an elephant in the room, and the BMA has confirmed that locum GPs are free to discuss their rates among themselves as long as they do not agree as a group to work for no less than a certain amount within a specific locality or setting.
If you feel what you provide is worth more than what you know someone else is providing, then it’s absolutely reasonable to charge more.
I was also anxious initially about increasing my rate from time to time. However, having done it, I am able to say that it has not affected my ability to get paid work, although I appreciate this may be easier to achieve once the locum GP is known to be reliable and responsible. Ultimately, practices pay more each year to their suppliers of goods and services, and are therefore familiar with rate rises being ‘normal’.
How NASGP can help
In summary therefore, I would tell myself to not sweat the ‘on the job’ small stuff, but instead focus on reach, reputation, and responsiveness whilst investing some time in getting the administrative parts of being a locum, such as T&Cs, right.
NASGP has various tools for its members to help achieve this – CV builders, reference tools, oven-ready T&Cs that can be flexed for each practice.
LocumDeck can also be used to achieve the ‘reach’ and ‘responsiveness’ with practices looking for sessions to be covered, and the ability for them to instantly book a locum.
Try our 2025/26 GP handbook, free for members.
