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North-East Employed and Locum GPs

<< Information for Practice Managers

Do you have a locum induction pack?

It is considered good practice to have an induction pack which is specific to the practice. This is recommended as part of practice risk management, good practice in personnel management and is recommended by the MDU (medical defence union). It is also one of the parameters contributing to assessments of quality made during inspections by the Commission for Health Improvement (CHI).

Enquiries into major critical incidents consistently highlight poor communication and teamwork as causal factors. Induction pack therefore have a major role to play in preventing critical incidents. They will also increase job satisfaction for locums and most importantly ensure that the service your patients receive from a locum can be as good as that provided by permanent doctors within the practice.

The induction pack will help to ensure that your locum:

• will use "in house" services appropriately and follow correct procedures e.g. bloods, dietician, contraception (IUDs), minor surgery
• will use external local services appropriately e.g. local cancer pathways, chest pain clinics, and any services which are peculiar to your area (e.g. hospital appointments booked by patients)
• will refer acute admissions to the correct service/hospital without undue delay or confusion
• will work effectively with the primary care team
• will communicate with the right person for each problem in a timely fashion
• follows practice protocols (e.g. repeat prescribing protocols)
• documents care in a format which will fit with quality measurements/targets in the practice
• follows the practice prescribing incentive scheme
• knows where in the practice they can access information (local guidelines, recent urgent public health alerts or cascades
  
  A blank induction pack that can be customised to the needs of your practice can be downloaded below:)

Locum induction pack

Locum induction- BMJ careers article

Locum induction guidance

What does a locum need to know in order to provide a good service to your practice and your patients?

Welcome Drill:
The following are useful to demonstrate to your locum at the start of their session.

1. Show locum to room. If they have never worked with you before they won't know where room 6 is!
2. Code numbers to any keypad operated doors which the locum will need to use (coffee room, consulting room, etc)
3. Location of panic button, fire exits, toilets and source of beverages, and where other staff can be found.
4. In the consulting room show the locum:
   1. How do you call patients in
   2. How to obtain an outside line.
   3. Login in to computer (windows and clinical system) and show where surgeries can be found.
   4. the practice directory of phone numbers (reception, secretary, consulting rooms, nurses etc).
   5. how to use practice intra-net
   6. how to print a prescription (is there a "dummy"/"play" patient to test printer is correctly loaded
5. In the consulting room show the locum where they can find:
   1. stationary: sick notes, FP10 pad and computer script supplies, letterhead, envelopes, blood forms, x-ray forms
   2. referral forms are kept (ideally in a file)
   3. maps of any new estates which are not included in commercially available A to Z
   4. essential equipment : BP machine, peak flow meter, msu bottles
   5. Dictaphone and tape
   6. The locum induction file.

Tip - Wait till locum has everything they need or take a list of missing items to be provided prior to start of surgery. This will mean the locum will not need to make multiple phone calls throughout the session to reception staff to request missing items- thus allowing him/her to run to time, appear organised with patients, and avoid adding to receptionist phone calls.

Locum induction file:
This file provides essential information about how the practice works, what services are available and how different team members refer to each other and ensures that everything runs smoothly.

1. telephone numbers: Internal extensions and external numbers and how to obtain an outside line
2. referral forms to local services including fast track services
3. How to organize investigations (routine and urgent):
   1. within the practice, are there specific forms to complete, or do they just request at reception, is an appointment needed or do they just take a seat : bloods, ECG, pregnancy test, paeds urines, spirometry
   2. outside the practice (forms required, open access or through appointments): X-rays, USS, pregnancy scans, cardiac echo, echo, carotid,
4. What services are available within the practice (e.g. counselling, IUDs, depo contraception, implants, minor surgery, smoking cessation, midwife, chiropody, physio, district nurse, health visitors, etc) and how to access them (book in reception, dictate letter or form)
5. Local community or hospital services which are peculiar to your area: direct booking by patient of hospital appointments, falls clinic,
6. Practice procedures/protocols:
   1. repeat prescribing
   2. appointments (advanced access, how to pre-book)
   3. internal messaging, etc.
   4. Who to report adverse/significant events to
   5. Referral letters: is there a practice log for these or are they entered as READ codes by the doctors.

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