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Locum GPs highlight physician associate role as a leading work concern

by Rima Evans
27 November 2023

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Almost a third of GP locums say the increasing number of advanced practitioners and physician associates is the biggest challenge they face today, according to a survey.

The National Association of Sessional GPs (NASGP) 2023 survey, which received 799 responses, revealed that 29% highlighted these roles as being a leading concern for them in their ‘locuming’ work.

The only two issues rated by more locums as being their main challenge were ‘professional isolation and ‘not knowing the practice’, both of which were cited by 30% of respondents.

Dr Richard Fieldhouse, chairman of the NASGP, said there is a worry that physician associate (PA) and advanced practitioner (AP) roles were competing with locums in terms of work, but there is also a patient safety aspect because PAs are unregulated professionally.

He acknowledged that the timing of the survey had coincided with media stories about problems with PAs, and concerns raised by the BMA, which has now called for an immediate pause on their recruitment until ‘appropriately safe regulatory processes are in place’.

‘Locums GPs are picking up on errors since PAs can’t manage risk they way we can,’ Dr Fieldhouse told Management in Practice.

He added: ‘These jobs have also created uncertainty. Practices have a budget to spend to employ people in these roles. But now they have been warned they need to be more careful about the use of PAs, for example. And the bubble is starting to burst since PA appointments are fully booked and GP partners are finding they have to spend more of their time supervising. So, in some cases we are actually seeing work picking up for locums again so they can take on the supervision work.’

Other survey findings revealed that for locums, fair terms and having a safe workload are much more important than pay when it comes to deciding which surgeries to work at.

A total of 37% prioritised fair terms and workload whereas just 8% said ‘good rates pay’ were the main factor.

Meanwhile, 42% said finding work was the main issue they needed support with on a day-to-day basis.

Dr Fieldhouse said that they have heard from locums in some areas struggling to find work or having to apply for shifts posted on jobs boards where they knew they were competing with 20 or more other doctors, which he described as being demoralising and ‘creating a lot of anxiety’.

He added that this ‘kind of scrum’ can be avoided by using the organisation’s platform LocumDeck, which supports GPs in finding work on their own terms and rates.

However, he also went on to explain that separate feedback from practice managers and locums showed that where locums are happy in their work and feel supported by a practice, they are ‘charging effectively half the hourly rate than locums working at practices that don’t acknowledge them’.

‘It’s not just about the rates,’ Dr Fieldhouse said. ‘Locums working at the really nice practices tend to bend over backwards to do extra work for them or stay a bit late. So providing that support is worth it.’

He outlined five tips practices can take to help locums work more closely with them and prevent feelings of isolation:

  • Provide a simple induction pack if possible or at least provide information on important contact numbers and practice processes and routines. It means locums dont have to keep bothering everyone with questions, which can be lead them to feel devalued.
  • Pay on time. This removes a lot of stress for locums and recognises they have their bills to pay too.
  • Make human contact. Invite your locum to join in coffee breaks or knock on their door to say hello and check in on them. It helps foster inclusion.
  • Ask your locum for feedback. Ask about what they think the practice can improve on or what other innovations they have seen in other surgeries. Also, it’s important to let them know if there has been a patient complaint about them.
  • Tell your locum about any opportunities for partner/salaried roles or leadership type roles within the PCN. This reinforces a sense of them being part of the general practice community.