When I (Dr Pooja Arora) completed GP training I spent my initial years as a Locum GP with the aim of getting a feel of local practices. Overall I thoroughly enjoyed the flexibility and networking opportunities Locum GP work offered me, especially with a 6 month old baby at home. Over the years I developed my own systems and methods to make my life simple and enjoyable. In this blog I will share with you 10 things about working as Locum GP I wish someone had told me when I first started.
1) Get organised
Locum General Practice requires a lot of organisation. This came as a bit of a shock to me, as naturally I’m not a very organised person! For example as a Locum GP you have to:
- send out a set of documents every time you start working in a new place
- keep track of the shifts you booked
- send out invoices for your shifts (noting how many hours of work you have done and how many visits you have completed at each practice if you don’t have a daily rate)
- ensure invoices are paid on time and if not send a reminder to practices
- stay on top of pension forms and submit these on time if you choose to contribute to the NHS pension
This can all get quite messy and complicated, especially if you work full time in a number of different practices and you don’t stay on top of things.
Make sure you develop your own system that you can rely on to work for you.
2) Ask for your own login details
When I first started working, quite a few surgeries asked me to sign in using generic login details – for example ‘Dr Locum’. Whilst this was practical and time saving for the practice, in reality this could lead to huge governance issues. Imagine signing in as ‘Dr Locum’, alongside numerous other locum colleagues, and 3 years down the line a complaint comes in. How will you a) be able to ascertain if you made that consultation entry saved as ‘Dr Locum’ and b) be confident that no-one else has altered the notes at some point?
Please always ask for your own login details – not only is it good governance but it also protects you!
3) Confirm your shifts in writing
Fortunately all practices I’ve worked with have never let me down with respect to locum work. However I have known friends and colleagues who have confirmed shifts over the phone and turned up only to be told ‘Oh sorry we don’t need you to work today anymore’ or ‘we didn’t know we booked you in for today’. By confirming your shift in writing there is no room for confusion in regard to shifts booked, types of appointments agreed, number of appointments or rates paid.
Unfortunately as with all important things, without it being confirmed in writing things are open to interpretation – potentially resulting in you missing out on work and pay.
Have you ever thought about what would happen if you are too unwell to do a shift or if a practice does not pay you on time? Setting your terms and conditions makes it easier for both sides to understand the commitments agreed, as well as the consequences for not carrying out those commitments. Although it may seem odd to charge an interest rate for late payments or offer to work a shift free of charge if you are unable to complete a shift, it can make things less stressful if unexpected things happen. The BMA have come up with a draft set of terms of conditions, which you may find useful to refer to.
Please create your terms and conditions before doing shifts, and have them agreed in writing by Practices in advance. Our Post CCT Max Online Course covers everything you need to cover in your terms and conditions.
5) Limited Company vs sole trader?
You may often hear suggestions to work as a Limited Company as it is ‘may be more tax efficient’. However, this does not hold true for everyone and in my case after receiving financial advice from my accountant I decided that it was not for me.
Also Limited Company set up may come with other disadvantages as well, for example not being able to contribute locum earnings towards your NHS pension.
Before making this decision for yourself it is important to get financial advice from an accountant familiar with your circumstances, who can advise you appropriately.
6) Don’t get caught out by your tax bill!
Working as a Locum GP means you will now be self-employed. Unlike in your training years where you receive an income with your tax already deducted for you, you now have to pay your own tax bills separately. I would suggest putting a set amount aside from each shift to ensure you have enough funds to pay your tax when it is due. This reduces unnecessary stress, as you often have to pay tax in advance based on your previous year’s income, which can potentially result in a large initial bill – something that I know several colleagues were caught out by.
As always if this is something that you’re not sure about seek appropriate professional financial advice.
7) Stay polite and stay in touch
The GP world can be a very small world – important to bear this in mind when working in multiple practices. Nobody likes a Locum GP who speaks ill of other practices in front of colleagues and I assure you word will eventually get back to the practice. If you remain courteous, polite and professional not only does this increase your chances of being called back but it can also help with your multi-source feedback forms for your appraisal. If you don’t like a practice, then don’t work there again – it’s great to have that choice.
I found working as a Locum GP a great way to network – often before or after surgery I would spend a little time thanking reception staff, and if a GP partner was free, to introduce myself. This led me to getting to know staff members and indirectly feeling part of teams when I came back to do regular locums.
It is so easy to go in, do your shift and leave – sometimes putting in a little extra effort can make a huge amount of difference.
8) Try to have a folder of useful resources
During training you become familiar with the various leaflets available to hand out to patients, but this is not always the case when you work as a Locum. I found it useful having a dropbox folder with useful links, patient leaflets eg back pain exercises, that I could download or refer to in the middle of a consultation to enhance the care I provided. This saved time trying to find a MIMS book (for the HRT/Contraception tables) or looking for any leaflets the practice may have in stock. After clinic I would also always ask the practice if there are any leaflets I could use in the future and how to access them.
During your time as a Locum GP you may find when you turn up for a shift that the room is empty, meaning you start the shift with a rapid equipment hunt. This may be because the room isn’t often used by a clinician, or the practice may simply be too busy to pay attention to equipment supplies in every room.
Personally, I would check my medical bag on a weekly basis ensuring I had the necessary stationary, spare batteries, BP cuffs etc to reduce the stress I could face when presented with a room with no medical equipment.
The stress of having no BP machine when patients are building up certainly isn’t worth it.
10) Locum agencies – keep an open mind and read the fine print
I was very lucky to find a small agency who offered me good support and great jobs when I started as a Locum GP. However not all agencies are great, and some may for example offer you shifts that are not in line with your expectations or take a commission if you end up taking up a salaried role in a practice that they introduced you to. Some may not even support you when you are not being paid by practice.
It is therefore vital for you to read the terms and conditions for an agency to ensure you understand your rights and are aware of what you are signing up to. Agencies can be a great way to find work but there can be disadvantages such as IR35 or not having direct contact with the practice manager.
Keep an open mind when looking at agency work and only accept work that you are comfortable with.
There are so many things to think about when working as a Locum GP and it is hard to condense it into 10 recommendations. Use the information around you, speak to your colleagues and always be clear of what your terms and conditions are. If you follow these steps hopefully you will find Locum work as fulfilling as I did.
As always wishing you all every success in your journeys.
Dr Pooja Arora
Dr Pooja Arora is a portfolio GP based in Birmingham. She has held local and national roles in her Medico-Political background fighting for GP trainee and GP rights. Her roles have included:
– Vice Chair Birmingham LMC
– BMA council member
– BMA General Practitioners Committee elected representative
– BMA Sessional GP committee elected representative
– BMA National Deputy Policy lead working at scale
– HEE GP ambassador
– HEE GP stage 3 assessor
– RCGP Midland Faculty AiT representative
* Blogs written by Dr Aman and Dr Pooja Arora are not for professional, financial or medical advice. Please seek appropriate professional, legal or financial advice where appropriate *