Having been a sessional GP for 12 years, working at over twenty practices in my local area, I have found that the ‘first impressions’ I get from a visit to a new practice tell me a lot about how much I’m going to enjoy working there, how well the practice is run, and what its CQC rating is likely to be.
Some of these insights may be helped by the fact that I have an LMC background, mediate partnership disputes, and co-founded a company that offered CQC compliance support to practices, but nonetheless, sessional GPs have all sorts of additional areas of interest and expertise that form part of their ‘first impression’ radar when they go into a practice.
I can’t impress enough how important the early contact is, even that which happens before the sessional colleague sets foot in a practice. The practices that create a positive first impression with me will drop me an email before my session with some general housekeeping business such as checking how I would like surgeries to be structured, what the parking arrangements are, who to present myself to before the first session and how to access the staff entrance. It is a small gesture, but it makes such a difference, and ultimately then does not create a lot of work for a stretched member of the admin team on the morning of arrival. It also makes the morning run smoother and to time from a patient point of view, and limit complaints which of course take a disproportionate amount of time to respond to from a senior team member.
The physical welcome is equally important. To illustrate this, I’ve mashed together some difficult – but completely genuine – experiences I’ve had on a first day, into one amusingly hell-ish start to a day, which fellow clinicians of all contractual status may be able to relate to, to paint a picture:
I arrive with plenty of time to spare (or so I think) at a new surgery and park in the patient car park as it is not clear if there is staff parking and whether I am permitted to use it – I am British and would not want to park in someone’s ‘space’ because I am not aware of the parking etiquette! Little do I know that when I return to my car at lunchtime, it will have a ding on the door from an unknown carpark user and the CCTV is of no help. I think we all have a carpark horror story! I head to the entrance and walk past the queue of patients at the locked door and press the buzzer. The person who responds understandably assumes I am a patient who does not want to queue in the cold, but after explaining, I am let in and receive an apology for not knowing to expect a locum today and I’m told the code to use the back door in future.‘You’re in room 3’ is what I am told, and of course I have no idea where that is, so after asking how to locate room 3, I receive hand signals in the general direction while the front door is formally opened to the public. Arriving at room 3, it is unfortunately locked, so back to reception, where there is now sadly a queue, I go. Room 3 then gets unlocked and the receptionist quickly heads back to tend to the growing queue.Room 3 is cold with the heater off, there is used couch roll in a crumpled pile on the bed, a urine sample left on the side and an edamame bean neatly resting between the delete and enter buttons on the keyboard. The light for the examination couch is broken, so I pray I have no gynae examinations to do, and the printer is flashing as it’s out of toner.I go to turn on the computer, and realise there is no laptop plugged in to the dock, so it is back to the only place I know – the reception queue – where this time someone from the admin team in the back office is summoned to assist me and locate a spare laptop.The computer is finally up and running after the mega-slow ‘initialising your settings’ thing that it does to every new user – this is inevitable and one of the reasons I always try to be very early on my first day – but I then have to wait for someone senior in the practice to enable my smartcard at this surgery, which a lot of practices now do in advance using the smartcard details I give when the session is booked. When I get into the system I see that unfortunately my clinic times are wrong, so I am already half an hour late, and ironically those patients I was standing in the queue with at reception could have been complaining about being made to wait to see me.But alas I am saved by the first two slots being telephone calls, except…there is no phone in the room. I reach out to my personal trouble-shooter – who is surprised that I do not have an account with the practice-specific voice software provider. After a search of consulting rooms, I am brought a phone to plug in myself, and the session can finally begin…
I hope the above example illustrates the practical first time experience at a new practice, and equally provides some useful pointers for practices who wish to get it right and make their first impression count. Ultimately, an email in advance with some basic practicalities, and then an organised welcome on arrival can make a huge difference, enough of a difference to guarantee that the same locum will return the next time a gap on the rota needs filling, and will inform their peer network that your practice is a good one to work for.
Dr Clare Sieber is the National Association of Sessional GPs’s sessional GP workforce advocate.
