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New locum prescribing study needs context, GPs advise

25th March 2022 by NASGP

New locum prescribing study needs context, GPs advise

A new study in the BJGP about GP antibiotic prescribing ignores two key factors, GP locums have told NASGP.

The study, which found that GP locums contribute to higher antibiotic prescribing compared with their peers, was discussed by NASGP members in a GP-only forum.

One GP commented: “Two factors not mentioned: (i) locums see a different subsection of patients – more often used to immediate access and demands; (ii) the prior prescribing patterns of different practices affects patient behaviours.

“To be a valid comparison you’d need to compare the locum v partner outcomes on the same patient group with the same presenting complaints.”

Another GP supported this comment: “As a newer doctor, I tend to be more stringent with my antibiotic prescriptions than those who have been practising for many years and this is something I see with other newly-qualified and salaried GPs.

“It would be interesting to see a breakdown by years working, given that a lot of senior doctors switch to locuming for a few years before retiring.”

In full the authors concluded: “Locums contribute to higher antibiotic prescribing compared with their peers. They experience challenges but also opportunities for contributing to AMS , which should be better addressed. With an increasing proportion of locums in general practice, they have an important role in antibiotic optimisation and AMS.”

Dr Richard Fieldhouse, NASGP chair, said: “As we highlighted last week, GP locums are often poorly understood and misrepresented, despite providing a significant amount of patient care. Very little research has been performed into the complexities of how we work.

“This paper raises many questions, and together with insightful feedback from our members goes to show that more research needs to be done on this subject.

“As well as publishing regular clinical updates from Dr Louise Hudman, NASGP provides regular forums for members to discuss clinical topics like antibiotic prescribing and share best practice. This usually happens in face-to-face NASGP Locum Chambers meetings, but we also discuss clinical topics in our GP-only members forum and Facebook group.

“Lastly, don’t miss our very popular download for locums to review their own prescribing with a colleague.”

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"I fell into a salaried role post-CCT, so faced with an unexpected relocation to a completely new area of the country the thought of GP locuming was incredibly daunting.

The assistance I have received from NASGP has been invaluable. I have received excellent and patient admin support when setting up my LocumDeck account. I have enjoyed the monthly chambers meetings I have attended: this made locuming feel far less isolating.

I have easily found plentiful work and am grateful for the invoicing and pension forms being taken care of – this gives me time to focus on the clinical work or make the most of precious days off.

With the support of NASGP Locum Chambers I have filled my diary working in a variety of practices in my new area, and have now joined one practice I enjoyed locuming at on a salaried basis while I continue to do some locum work on top using LocumDeck."

Dr Joanne Wright, GP, Essex

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