NASGP has been campaigning for 15 years to enable sessional GPs to become more involved in the structures and processes of the NHS across the UK. The recent changes to the NHS in England have started the ball rolling and help to set the scene for other UK countries to follow.
The number of GPs in your area working as sessional GPs will account for up to half the workforce, with the number of locums being nearly double the number of salaried GPs. With GP commissioning now an incontrovertible reality, it's time to take a serious look at the role of sessional GPs in clinical commissioning, and their greater involvement in the NHS.
Why would you want to be involved?
- Work closely with other GPs to improve health in your area, allowing you to use purely clinical expertise or wider management and leadership skills.
- Perfect opportunity to ensure that sessional GPs are kept informed of all local clinical developments.
- Gives a fascinating perspective on health needs and resources.
- Challenges and develops leadership skills.
- All part of a portfolio career.
So how should you get started?
For Freelance GPs
- Take the initiative
- If you want to work within commissioning, you're going to have to do a lot of the legwork yourself, especially if you're going to be involved in a clinical leadership role. There is the potential for a lot of autonomy and creativity in this role, and using initiative to contact the local commissioners and find out what sort of skills are needed will be part of this.
- Expose yourself
- You won't be surprised that many commissioners just won't have a clue who their local freelance GPs are. If you're a member of a chambers or well-organised locum group you should be on their radar already, but just check with your chambers lead partner or group leader that contact has been established with the Clinical Commissioning Group (CCG) in which you're interested.
- If you work independently, drop your local CCG chairperson a very brief email stating your interest, how you'd like to be involved and suggest some dates that you can pop along to the HQ to talk to them. And don't take no for an answer!
- Spread the Word
- You're a locum, and you're working with your CCG? Let your colleagues know what you're up to, and use your unique experience of working in lots of practices to help shape the way you work with the CCG.
- Chin up, broad shoulders
- Bizarrely, some GPs may think you're mad to be involved, and are somehow letting the side down. Don't ignore them - that's how they feel. But it’s a great opportunity to reinforce your CCG's message in lots of different practices, and your own personal convictions about GPs leading the commissioning of services. You will be a human GP face of their CCG, can show them how we're all in this together, and how we've all been moaning for years about how distanced the PCT was from real life, so now's our chance to make a difference!
For Salaried GPs
- As well as the above, you've got your employers to think about - you don't want to make life difficult for yourself. Discuss with them the different roles you could take on, from practice representative, locality lead, clinical lead, project or programme lead or even an executive director and chairman. Will you do this in your own time - on your days off - or will the CCG be paying for your time? But do your research before you start mentioning it at a practice meeting!
- A well-informed, up-to-date group of locum GPs or salaried GPs is good for general practice. Spreading best practice, with ownership of everything health-related that goes on in their area, everyone's going to be a winner. Wherever you can, keep your Sessional GPs in the loop (trust us - they would love to be more informed!).
- Sessional GPs tend to have more time and flexibility when it comes to taking on extra roles, so support them and they'll no doubt be able to keep you more in the loop too.
- This really, really is a no brainer. You know how incredibly busy your GPs are and, for all the right reasons, you're making them busier. Sessional GPs are the flux in the system, the cement that holds the bricks of the NHS together, the capacity that you need to make your CCG work. They work in all your practices, in every area - and they have intimate knowledge of how the other CCGs and acute trusts work too. They have little or no financial or local conflicts of interests, and have the time and flexibility to be an integral part of the clinical leadership of your CCG.
- Don't think of locums as just backfill - think of us as supporting commissioning.
- Want to improve the quality of prescribing? Make sure your locum GPs know what important prescribing messages need delivering.
- Think that locums may be responsible for increased referrals? Make sure that you've actually told them about up-to-date referral pathways, and ensure that if they have referred inappropriately, you have systems in place to feed that back to them.
Clinical commissioning is not only a fantastic opportunity for general practice, it’s also the perfect opportunity for sessional GPs to put themselves at the centre of general practice – or, at least, precisely where we need to be: as respected, vital components of the delivery of NHS primary care.