It's ironic that in NHS England's new plan to "stabilise and transform general practice" (General Practice Forward View, April 2016), the first mention of GP locums is 'excluding locums', and is in the context of GP workforce numbers.
The plan, "backed by a multi-billion pound investment", and developed in partnership with the RCGP, lacks any real acknowledgement of the contribution of the estimated 17,000 GPs, one in four of the GP workforce, working as locums.
So what is their plan regarding GP locums, many of whom have made the positive choice to work as locum GPs? It's no less than "...to improve the relative attractiveness of partner and salaried positions..."; and the plan goes on to clarify "...to create an alternative to day-by-day or week-by-week locuming for those...who need more flexibility."
It's actually bewildering what the 'plan' lacks for this 25% of the GP workforce, who work across multiple settings, often at short notice, sometimes in over-stretched and even desperate practices. For example, where's the plan for:
- training and induction?
- safety and quality awareness?
- access to practice-specific standardised practice information portals so that these GPs can hit the ground running?
- professional support via locum chambers or groups?
- proper clinical governance structures?
Instead, proposals mentioned in the plan include the setting of indicative rates and benefits that will come with working 'at scale' in much larger practices.
Without doubt, practices are struggling and we desperately do need more partners and more salaried GPs in well-supported GP practices. But just ignoring the issues faced by locum GPs and implying they are part of the problem rather than part of the solution, is just burying our heads in the sand. It's a step backwards and a missed opportunity.
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