Starting out as a locum back in 1995, I soon came across all sorts of obvious hurdles and barriers, and plenty of not-so-obvious ones as well.
I’d not been trained for the complexities of locum work; I had no idea or experience of practices being all so inexplicably varied and complex; at that time, us locums were not entitled to access the NHS pension scheme, and I had no idea how to manage all my bookings and tax.
I also realised how incredibly isolating it was working from practice to practice, sometimes not meeting another GP for days on end, and having absolutely no one to turn to for support, leading me to quickly set up a local support group for my locum friends.
GPs as paratroopers
When Major Dick Winters, leading a regiment of US paratroopers called ‘Easy Company’ during the second world war – made famous by the TV series Band of Brothers – was told that he was surrounded by enemies, he simply replied, “We’re paratroopers, we’re supposed to be surrounded”.
As GP locums, in each practice, we’re surrounded by practice-specific, highly complex, usually complicated, sometimes sophisticated, and often chaotic processes, policies and guidelines. But unlike Easy Company, this isn’t a war, (although it sometimes feels like it); this is general practice, and there’s an awful lot we could, and should, be doing to mitigate that chaos and complexity.
I’ve put together a short video for newly-qualified GP or GPs in training who are thinking of working as a GP locum, and for any GP locums who are just starting out.
We need to be prepared for the job, so it’s important to think of ourselves not as victims, but as professionals who have agency and control over how we work; we can make a real difference to support practices, especially if they’re struggling, especially if they don’t even know they’re struggling.