So easily taken for granted, the actual booking process itself is a fundamental part of engaging a locum.
Explain why they're needed
It's really important to let locums know the reason why you're asking for cover as it can make a big difference as to how they prepare themselves to work at your practice.
- Sun and sand
- A practice that books ahead so that the practice has good cover whilst a GP is getting some well-earned rest is a practice that is able to invest in the welfare of its staff. Locums will expect happy staff and well managed patients but also patients that are used to a high level of care.
- Study leave
- Again, a practice that invests in its staff and will no doubt also have a high expectation from all its staff to be up-to-date with both local and national best practice.
- Covering for this GP in this practice may mean your locum GP's support will be even more appreciated; the absent colleague may have been soldiering on on less than full cylinders, and staff as well as patients may be concerned.
- Your locum may be looking for a permanent position, so putting them in-the-know will mean they can make some real effort to get to know you, but also help them understand that some extra support is needed, and patient satisfaction may not be as high as your practice would normally hope.
- Everyone understands that complaints and actions against all doctors are on the rise so please don't not mention a suspension. The locum will appreciate being informed as it offers them the chance to be extra vigilant for shortfalls in care and they will want to support you and your patients.
Confirm in writing
Using the NASGP Terms and Conditions template is of great way of agreeing and confirming terms.
If you're doing any sort of locum work as part of your portfolio career, you'll definitely need your own personalised Terms and Conditions to help protect both you and the practice you're working for. NASGP's model T&Cs has been specifically developed for us by a specialist employment law firm, and allows you to not only fully adopt all its recommendations, but also to add any necessary clauses, and tailor it to suit your personal needs.
LocumDeck's T&Cs generator allows you to
- Set your own cancellation sliding scale from 0 to 100% of your booked fee for 0 to 28 days in advance.
- Include your 14.38% employer's pension contributions
- Legal employment status
- Tax status, IR35 etc
- Duties (on-call, triage etc)
- Private fees (HGV medical etc)
- Cremation fees
- Payment terms (14 days? 28 days?)
- Plus much more.
As an NASGP member, go to your T&Cs generator, choose your settings and then save. You'll then be given a unique link "View my TCs" which will automatically be added to your automated invoices and session request emails, or you can paste the link into your own website.
As an added bonus, you can update your T&Cs as often as you like, with each change being saved in an archive accessible by your practices for extra confidence.
If you have no choice but to cancel a locum, always give as much warning as you possibly can. More than one month's notice would be deemed fair and acceptable, but any less than this and the locum would expect compensation - usually on a sliding scale - if they couldn't find alternative work.
Consider the implications
- The locum may not be able to find alternative work and therefore suffer a crippling reduction in household income.
- It's highly likely that the same locum may never accept work in your practice again.
- There are over 100 locum groups around the UK, where locums meet up on a monthly basis to discuss clinical and work issues; it doesn't take long for the word to get around that you don't honour bookings, and therefore put your practice at risk of getting clinical cover when it's needed.
- In booking a locum GP you have made an 'unconditional' contract of employment, and so breaking that contract could entitle the locum GP to financial compensation should they ultimately end up out-of-pocket if they can't find other work in time.
- Should this be the case, the simplest, cleanest and fairest thing to do is to compensate the locum for all loss of earnings. Otherwise be prepared for the locum to seek financial compensation.
Although this goes without saying, NASGP has heard of instances where the GP has been told by text message! Notifying the GP concerned should always be done by the practice's senior manager or a partner, ideally in person or at the very least by a timely phone call, followed up by a written confirmation.
We've decided the locum is unsuitable and so we want to cancel them
If you have a concern that a GP is unsuitable to practise in your practice for any clinical reason, you have a duty (GMC: Raising and acting on concerns about patient safety (2012) Part 2: Acting on a concern) to raise this with the GP concerned and/or take further steps as appropriate. Although 'simply' cancelling the locum, or making the decision to never book them again, might be the easiest thing to do for you, it robs the locum GP of any chance to learn, reflect and improve the care that gave and simply passes those shortcomings - perceived or real - on to another practice.