I’m just on my way back from giving a talk on ‘Enhanced Appraisal’ for GP locums. When I arrived in the afternoon, I was leapt on by some a few delegates who’d been there for the morning and who reported the general angst about what PCTs should be doing about locums and appraisal.
I gave a half-hour presentation using Maslow’s Hierarchy of Needs as the model we need to be using when we think about planning resources that will actually support locums through revalidation. It’s all very well to look at the higher functions of quality and performance, but when the basic needs of education, work, security and ‘professional community’ are not being met then expecting locums to do audit, Multi Source Feedback etc are pointless.
The solution, as summarised by the conference’s chairman Dr Emyr Jones, was ‘if the problem is because GP locums have to work outside a managed environment, the solution is to create a managed environment for them to work within’. Fortunately examples do exist, and on these occasions I am able to give my own example of working in a Locum Support Team within Pallant Medical Chambers, where 45 locums work within separate local locum chambers. For those unable or unwilling to work in other similar locum teams, the opportunity to work as affiliates to a conventional practice also exist in the form of the affiliate Freelance GP Scheme.
What is clearly not an easy option – a point made very well by those from secondary care – is working in professional isolation. All doctors need to have a certain minimal level of integration with other professionals, and ‘soft’ features relating to communication, behaviour and clinical performance are increasingly being looked at as indicators for concern.