View from the Ground, by Dr Richard Fieldhouse
When a Cornish town resorts to a music video to attract a salaried GP,1 it's clear that general practice is facing desperate times. Rural communities, often overlooked when discussing health access, are grappling with their own unique challenges. The workforce crisis has hit general practice hard, especially in remote and rural locations.
Demand for appointments is up across the UK, with GP practices delivering 29.6 million appointments in January 2023 alone.2 Meanwhile, the GP workforce is dwindling, with 898 fewer fully qualified full-time-equivalent GPs in May 2023 than in May 2019.3 Consequently, some GPs are now responsible for more than 2500 patients.3 The strain is evident, with 474 surgeries closing in the past 9 years.4
Seven in 10 of the appointments delivered in January 2023 were face to face—a 6% rise compared with the previous 2 years.2 This may reflect the fact that, following the pandemic, patients are more open to remote sessions and the use of technology in their care. Some GP partners and practice managers worry that remote sessions give practices less control at a greater cost, but there are solutions that address these concerns.
One such solution is access to remote-working locum GPs through booking platforms such as LocumDeck.5 Created by the National Association of Sessional GPs, LocumDeck allows a practice to book directly with a locum GP, paying no fee to do so,5 and giving the locum secure and instant access to the practice’s clinical software.6 With access to a patient’s notes, correspondence, and investigations, as well as the ability to request pathology tests and prescribe, remote locum GPs can do pretty much anything a regular GP can do except for physical examinations.
Remote working has been transformative for many locum GPs. It has improved their work–life balance and increased their motivation and engagement. According to one locum GP, ‘Remote working has massively improved my work life balance. It’s so much easier to see my children more.'6 Another stated that they are now able to work an extra day a week on average thanks to the flexibility of remote working.6 In addition, remote locum work has the potential to enhance the quality of patient care. One locum GP said that they received flowers from a patient after a remote session—a testament to the positive difference they were able to make, even from afar.6
LocumDeck has recently been upgraded, making it even easier for practices to access the support they need. Now, any practice in England that uses Egton Medical Information Systems (EMIS) software can immediately log into LocumDeck, accept some simple terms, and start booking remote locum cover.6 In future, there will be further opportunities to improve and increase the use of remote-working locum GPs: by taking these steps, we can ensure that all communities, rural or otherwise, have access to the care they need.
Guidelines Live is partnering with the NASGP
At Guidelines Live 2023, the NASGP will present an afternoon of practical advice and support for sessional GPs, and GPs thinking of expanding their portfolio to include more locum work. Special offer for NASGP members—visit bit.ly/3Uun3Uq to register to attend Guidelines Live 2023 for just £29.