Learning from Locums

What are the aims of NASGP?

The National Association of Sessional GPs (NASGP) was founded 21 years ago by a group of GP locums. Their approach to the way they support sessional GPs is that working as a GP locum or a salaried GP is a positive career choice, and one that should make absolutely no difference to the patient or the care they give.

They believe that every patient has the right to expect the same level of care from every GP encounter, whether they’re seeing their regular GP or a GP that they’ve never met before. Therefore all GPs need to be equally recognised and enabled to deliver this.

NASGP has worked hard since its inception to raise the recognition and professional status of GP locums. They initiated the campaign to extend NHS pensions to GP locums and developed the concept of GP locum chambers.

RACHEL BIRCH (RB): Hi Richard,can you tell us more about what drives the work that NASGP does?

RICHARD FIELDHOUSE (RF): We see a real passion from locum GPs wanting to make changes to improve patient safety and give their patient the best experience they can, despite often never having previously met the patient. GP locums have direct experience of many different practices and extensive knowledge of the kind of difficulties and obstacles that can be faced.We work on turning our GP members’ experiences into positive ideas, resources and practical tools that will assist them in engaging well with practices and providing the biggest benefits to patients. Sessional GPs are an invaluable part of the GP workforce.

RB: Tell us about your latest innovation

RF: For the last five years, we at NASGP have been incredibly busy developing a system that aims to fully unlock the potential of the sessional GP workforce across the UK. This is achieved through a decentralised web platform called Practeus that comes as part of NASGP membership.

We created Practeus to be a single point of call for locum GPs, and potentially all other healthcare professionals and staff working in primary care.

Practeus consists of three time-saving and quality-driven components that work together in harmony through all three stages of the locum workforce cycle: Spip, LocumDeck and AppraisalAid.

Although the whole enterprise of developing Practeus sounds very bold, the needs and the untapped potential of the GP locum workforce are very real. Bold solutions are needed, and yet this bold solution rests on tackling many of the small,marginal gains that are currently being missed in engaging the locum workforce.

With so much talk of workforce planning – without any actual real results and with such a huge number of GPs working as locums in multiple practices – this is the strategy that will enhance both the psychological safety and positive affect within which we hope GPs and practices using our system will thrive.

RB: Can you explain to us what Spip is?

RF: One of the first things that NASGP did 21 years ago was create a paper-based locum pack template. This was designed to assist practices in putting all the important information that a locum GP needed in one place. Not only did it save time, but it was designed with patient safety in mind.

Six years ago we decided to take the template further and use the internet to create NASGP’s Standardised practice information portal (Spip). This is an extensive online locum induction pack, with the aim that GP locums have all necessary information about the practice and primary care network at their fingertips.

Spip allows every practice to store, share and retrieve all those ever-changing practice-specific phone numbers, email addresses,contact details, policies, guidelines, soft intelligence and service changes in one easy-to-find place.

It also allows local networks (such as a GP federations, CCGs,practice hubs etc) to support practices by instantly supplying relevant information upstream in a dedicated, centralised and updatable directory that practices can synchronise with and customise with their own practice-specific information.

A typical locum can work in up to 30 different practices in a year, maybe five or six different practices a month, in all sorts of different consulting rooms. It would be most unusual for a locum to be able to know the most up-to-date information about policies, services, procedures that are going on in all these different practices. Having access to Spip is an invaluable resource for locum GPs, and the feedback we have received has been very positive, both from locums and practice managers alike.

RB: Could Spip be useful for everyone in the practice?

RF: Yes. A clear benefit of Spip is that it is best used as a central resource where all the important practice information is stored. It can be easily updated when new policies or procedures come into place. Its standardised format makes it easy to locate information and practices can arrange for it to be accessible by all members of the practice team within just three clicks.

It can be of particular benefit for new and visiting clinicians and administrative members of the team. When all the relevant information has been entered onto Spip, it will give a comprehensive overview of how the practice operates.Established clinicians may also find it helpful, when looking for new guidelines or policies.

RB: What do you like in particular about Spip?

RF: It is interactive and dynamic, allowing practice and staff to ‘crowd share’ relevant information, whilst also allowing synchronisation with any information provided by their federation, CCG or practice hub. It is designed so that there is no duplication of information and everything is where it should be.

When treating a patient, often the information required is a  composite of multiple bits of information from disparate sources.For example, when managing a patient with a suspected DVT, the local CCG guideline may be useful. However, the locum GP will also need to know where to find an ultrasound referral form, the practice-specific location of a near patient D-dimer testing kit,and the out of hours pharmacy details for accessing same-day anti-coagulants. If all that information is entered on Spip, then it saves time for both the doctor and the patient.

Spip also includes a suite of reporting and communication tools for the locum to document issues with any providers that need to be escalated to the practice manager.

RB: So, what is LocumDeck?

RF: This application allows practices to easily and clearly arrange work with GP locums. It provides a way for practices and locum GPs to transparently share booking information, avoiding stressful and potentially risky booking misunderstandings and the time consuming,sometimes error-prone process of toing and froing in negotiating work. Practices can customise their request and outline what they expect of the locum. The locum can publish their availability to individual practices and have their terms of work automatically attached. This clarity can help build constructive relationships between locums and practices.It has an easy to use, standardised way of making and confirming bookings, so everyone is clear about what’s been agreed. There is an audit trail to prove this, protecting both the practice and the locum GP.

This ability to instantly book has been described as a ‘paradigm shift’ in locum booking, giving locum GPs the confidence and security to pre-define all their booking conditions, so that practices can book multiple sessions in just a few seconds. One locum recently commented “you have to use it to truly appreciate it. Practices are also very appreciative of how easy it is to make bookings and how greatly this eases their workload compared to using traditional systems or having to send out booking requests and wait for responses.

LocumDeck also enables GP locums to automatically generate invoices and paperless pension forms, and display all these transactions into an inbuilt accounts package. This is also clearly displayed for the practice manager and their team too, and allows practice managers to easily keep track of all their locum work. Again, practices really value the ease and convenience with which they can track invoices, inform the locum of payment and paperlessly manage the pension forms.

RB: Tell us about AppraisalAid

RF: Whilst currently in the development phase, AppraisalAid will help both the practice’s team and the locum to exchange feedback. Even when the locum has left the practice, they will be able to share their experience with the practice, and the practice will be able to share feedback with the locum, so that both parties can contribute positively to each other’s learning and professional development.

RB: And finally, how can practices access Practeus?

RF: As part of NASGP’s commitment to fostering good working relationships between practices and GP locums, we are delighted to welcome practices as NASGP members too. Practeus is free to be used by all NASGP members.

For further information, visit nasgp.org.uk