AppraisalAid | How patients can adversely affect locum feedback.

Patient variables

Your session was booked weeks ago.

  • So you’re expected at least. The absent GP will be on holiday, educational or maternity leave, so likely to be at least a well run practice. Indeed, if it’s to cover an appraiser, educational lead or for educational events this suggests it may be an above average practice.
  • Patients may be generally healthier, so will present with less ‘pathology’ and because of good contemporaneous notes you will be less stressed and will get better feedback…
  • Oh…but remember too that they’ll have much higher expectations, and likely that there will be more worried well – so be prepared for some critical comments too.
  • If the practice doesn’t often use locums, be prepared to see more than your usual dose of chronic and untreatable conditions, and probably every heartsink in the district. The longer you stay, the faster word will get round that there’s a new GP in town. Drug addicts usually come out when you’ve been there over 3 days, with heartsinks after a week.
  • Feedback will be affected either way. Some will see you as their second opinion, valuing your different approach to their problems. You don’t necessarily have to do anything differently, but just offering a different opinion, reinforcing previous advice, or simply speaking in a different tone can all have a new effect on your patient. But similarly, having had high expectations of you as their fresh new GP who may not have heard it all before, their hopes of a different therapy or a radical cure, may be dashed.

Booked within the last 24 hours?

  • It’s unlikely that your patients will have been told that they’re seeing ‘just a locum’ before they arrive at the surgery. Obviously this may delight them, but equally they could be very disappointed.
  • They may have waited weeks to see their usual GP – and now they’re seeing you. If the receptionist isn’t up to speed, and you’re presented as ‘the locum’, they may not even know that you’re a GP.
  • In these days of electronic check-in, the first they know that it’s not their GP will be as they enter the room which can lead to an uphill battle to establish rapport....


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