Like many highly skilled professions, a career in general practice can be a journey with obstacles to overcome, barriers to navigate and choices to make. NASGP member Tina Sumner describes how she came to be working as a GP locum and how NASGP has helped her in that journey.
Like most GPs, I entered medical school 'wanting to help people'. I was the first of our family to go to university, so there was no-one in the background advising me on what to really expect throughout training and whilst a fledgling in hospital. I entered general practice after my junior house officer jobs, as I loved every department I had encountered, but wanted continuity, and something of everything. I have never regretted my decision.
As my GP VTS training entered its final months, and with my first baby on the way, I was asked to join the partnership of the course organiser. The surgery was close to my home, in a practice with 2 excellent doctors, so I jumped at the chance and became a partner at the stroke of midnight as we entered a new millennium in January 2000.
The practice was in a deprived urban setting, with many socially challenged patients, but the work was rewarding, and with plenty of chronic health issues to get my teeth into. My partners were great, we worked well together, with an ethos of equality, democracy, workload and list sizes.
Despite all this, I needed some months off after several years due to the spectre of depression, my second episode, this time moderately severe. None of us had seen it coming and my colleagues felt guilty for not recognising the signs, but how could they? When my stress became burnout, and then depression, and all the time I was fooling myself that I was fine.
After recovering, I was able to return to work, reducing my workload from seven to five clinical sessions a week. The practice was expanding rapidly, and we had a new and much larger building built, and after moving took on another and then another partner, making us a five partner team. The practice started training, so I became a mentor to one of our nurses whilst she did the nurse prescribing course. I took on the challenges of an ever evolving primary care role with relish, and slowly found the amount of time spent on administrative tasks and meetings increased enormously. I had also become senior partner. The negative thinking returned, but of course, I said, 'I'm fine'. I wasn't, and hadn't learned from my previous episode, and so perhaps inevitably, depression overcame me again, this time severely, and I ended up requiring hospital admission.
As I recovered it was clear to me that I needed to take action to protect my health in the future. Work was my biggest stressor; initially I was not sure I even wanted to be a doctor anymore. After much pondering, and after compiling a pros and cons list, with admin, meeting and staffing issues being strong negatives, and my love of direct patient care shining a light through the darkness, I resigned from the partnership.
Locum life beckoned. But having recovered from depression, my confidence wasn't quite there, and so I joined a locum chambers. Through the administrative team I got as much work as I wanted, and was protected from all the bookkeeping of a self-employed freelance worker. In addition, each area covered by the chambers had monthly clinical governance meetings with other members, where we could share learning, gossip, and offer and receive support as needed. I'd found my career mojo once more. Without fail, the practices I worked at were welcoming, friendly and helpful. I could do a good job as a clinician, do direct patient administrative tasks then walk away. (Often to return shortly, as many practices made frequent re-bookings). After almost four years with the chambers I was on top form, had the confidence to 'go it alone', and decided to leave them and become freelance in order to save the 14% administrative fee that that particular chambers was charging.
Then I found NASGP and LocumDeck. I can't remember how, possibly intrigued by an online advert whilst reading an article link sent from the local postgraduate centre. I now pay £11 a month to use LocumDeck’s excellent platform for all my bookings and allow all of the practices in my area to 'Instant Book', so I don't have to constantly monitor and reply to enquiring practices.
Some practices do still email, and a couple who have not heard or used LocumDeck have signed up and love it. For some I have popped in to show them the site and the benefits for us both. Win- win! There's no need for negotiations, my terms are set out clearly and easy to use. I can choose what types of self-formatted session I offer to individual practices, and could choose if I wish to charge differing amounts too. Practices can see my availability instantly, book me and be assured with confirmation in a few clicks.
I have set up my own non-principals group, so have not lost out on peer support and learning. My mental health remains good, I feel resilient, have plenty of work and enjoy many repeat short and longer term bookings. Despite several offers of permanent positions, I will remain a locum for the foreseeable future.