The number of locum practice managers is on the rise. Michael Wright, now Chief Executive of Nottinghamshire LMC, used to be a locum practice manager and he shares his tips on locum life
Most people have heard of a locum doctor. Perhaps you’re even familiar with a locum cleric. But what about a locum practice manager (PM)?
The word ‘locum’ generally refers to a person who stands in temporarily for someone else of the same profession. And that’s exactly what a locum practice manager will do. It’s not a regulated role, but it is normally a person with practice manager experience who can work in different settings, often on short-term assignments.
For practices, there is value in recruiting temporary expertise. This might be to help with an assignment or to cover absence. For the locum PM, it’s an alternative to being employed at one practice. And it’s becoming an increasingly popular common career option, with the number of locum PMs rising over the years. They come to the role for a variety of reasons and at different stages of their career.
So, what do you need to know about being a locum PM?
If you’re interested in becoming a locum PM, the first thing to know is that there are pros and cons. That’s like anything in life, of course, but it is advisable to go into it with your eyes open. There are also certain skills that a locum PM requires, both for the assignment itself and to find jobs.
One of the big advantages is the flexibility of where to work, when and how. It’s your business and you get to choose. As a contractor, you have control over your future without getting bogged down by the 9-5 (or 8-8!).
Being a locum PM also gives you more freedom in your working relationships. For example, you can be honest with GP partners without concern for your own job. This works well for the practice too because a fresh perspective can be transformative for the team.
And the work can be very enriching for your CV. Working across a range of practices in a variety of assignments gives you a unique vantage point that most employed practice managers don’t have. It provides multiple opportunities to learn and gives you a valuable understanding.
So, there are plenty of positives – what about the downsides?
You’re not embedded in a team in the same way as an employee and, for some, this can feel isolating. After all, you’ve been brought in to do a job. To hit the ground running, you need to get to know your new team as quickly as possible. There is an imperative to win their trust so as not to be seen as an unpopular ‘supply teacher’! That requires honesty and candour in your dealings with team members. It is worth accessing coaching and peer support to help you hone relationship-building skills.
The flip side to the freedom and flexibility of being a locum is the lack of employee status. You lose employee benefits such as sick pay, paid holidays, security, and pension. However, there are steps you can take to mitigate this. By setting fees appropriately, you can offset this. What do you need to earn to make it worthwhile to work as a contractor? You get to decide – providing the practice agrees. So, negotiating skills are required.
There is also the burden of admin, though you can outsource some of this. Get help, if it’s needed, with filing tax returns and invoicing practices and so on.
When you find a good team, it can be hard to emotionally detach from a practice. The answer is to find a sounding board and move on to new projects promptly.
There may be jobs that are frustrating. This can happen when you’re engaged for a limited number of hours or the scope of the role. You can suggest changes to the scope of the engagement during the job if it could provide better results.
Skills and requirements to be a locum PM
Unsurprisingly, people skills are essential. Without them, you won’t get far. These skills come into play as soon as you start. To work out how best to fulfil any assignment, you first need to understand the culture of the practice. That means listening to GPs and staff to get to the root of what’s going on.
Locum PMs must also have the ability to adapt to meet the differing needs of all sorts of practices. This requires a flexible approach. It also needs a technical knowledge of the PM role as well as a high level of organisational skill. And negotiating is a must – both in securing contracts and for the role inside a practice.
Obviously, you have to be able to run a business and find work. This includes the ability to meet the legal requirements of a self-employed person/company.
It’s also a good idea to think about what you enjoy most about the job and what you don’t like. It may be that you can play to your strengths and delegate (responsibly) those aspects that are less enjoyable.
And, finally, a good sense of humour really helps.
Getting work and making the most of being a locum PM
To get assignments, the pricing needs to be right – for you and the practice. Charge a fee that values you sufficiently but doesn’t alienate anyone from hiring you.
As a locum PM you are a businessperson and, as such, you need to have a pipeline of work. There are various ways to achieve this.
An obvious one is to look out for potential assignments by checking practice manager vacancies. It’s also a good idea to build relationships with those who have intelligence about practices, such as the local LMC, ICB contracting team, and GP federations. Using social media networks (e.g. Facebook/WhatsApp groups for practices/GPs/managers) may open further doors as GPs and others discuss difficulties they are experiencing in their practices.
Consider how to build your profile and create a ‘brand’. By that, I mean getting known for specialist skills such as IT or project management. If you want to be a generalist then that’s fine too.
Going online is also a wise move. Get on trade websites and add your details to a list of managers who are up for new roles such as First Practice Management and Practice Index. And make use of social media – Facebook, Twitter, and LinkedIn – to promote your services.
Make sure you keep an up-to-date CV and ask for feedback and testimonials from every assignment. Learn from constructive criticism and accentuate the good bits.
Finally, once you’re approached to do a job, visit the practice before accepting the assignment. Be prepared to ask why you’re needed.
How practices can make the most of their locum PM
In my current role leading Nottinghamshire LMC, I used my experience as a locum PM to persuade the CCG to fund a ‘roving PM’ scheme in September 2019. We advertised for practice managers who met certain criteria. They needed to have capacity to do more work and availability to be deployed for variable periods of time. We wanted our recruits to support practices in need. By taking on assignments, the roving PMs could boost resilience across a number of practices.
Essentially, we have built a cohort of locum practice managers, which is run by our workforce arm, the GP Phoenix Programme.
Here are my tips for practices:
- The partners should set out a clear brief/job plan much like they do with a new salaried GP.
- Set SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) objectives. What will the practice get for their money and what outcomes are required for the PM to achieve?
- What are you prepared to pay? This is likely to be more than you paid your last employed practice manager. Locums charge more because they must pay their own costs such as tax, NI, and pension.
- Think about the parameters of the job. Do you want to pay for the time involved? Or will you set a target and agree on a price for the project upon its successful achievement? That might be a practice merger or hiring a manager.
- Nominate a partner to work closely with the Roving PM to provide them support but also ensure that they are on track to achieve what you want from them.
Michael Wright is Chief Executive of Nottinghamshire Local Medical Committee
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