A locum, or locum tenens, is a person who temporarily fulfills the duties of another; the term is especially used for physicians or clergy. [1] For example, a locum tenens physician is a physician who works in the place of the regular physician.
Locum tenens is a Latin phrase meaning "place holding", akin to the French lieutenant .
In the United Kingdom, the NHS on average has 3,500 locum doctors working in hospitals on any given day, [2] with another 17,000 locum general practitioners (GPs). [3]
On the other hand, GP locums (freelance GPs) mostly work independently from locum agencies, either as self-employed or via freelance GP chambers based on the NASGP's Sessional GP Support Team (SGPST) model. Some GPs have been employed by the primary care trusts (PCTs) to provide locum cover. However, PCTs were abolished in 2013 and replaced by the clinical commissioning groups (CCGs). [4]
Locums provide a ready means for organizations to fill positions that are temporarily vacant or for which no long-term funding is available. Working as a locum allows a professional to gain experience in a variety of work environments or specialties. [5] [6]
Some locum recruitment agencies offer pre-employment training to foreign medical graduates before their first professional experience in the primary care system. [7]
However, reliance on locums has some disadvantages:
A general practitioner (GP) or family physician is a doctor who is a consultant in general practice.
General practice is personal, family, and community-orientated comprehensive primary care that includes diagnosis, continues over time and is anticipatory as well as responsive.
Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.
Within the National Health Service, resident doctors are qualified medical practitioners working whilst engaged in postgraduate training. The period of being a resident doctor starts when they qualify as a medical practitioner following graduation with a Bachelor of Medicine, Bachelor of Surgery degree and start the UK Foundation Programme. It culminates in a post as a consultant, a general practitioner (GP), or becoming a SAS Doctor, such as a specialty doctor or Specialist post.
Medical education in Australia includes the educational activities involved in the initial and ongoing training of Medical Practitioners. In Australia, medical education begins in Medical School; upon graduation it is followed by a period of pre-vocational training including Internship and Residency; thereafter, enrolment into a specialist-vocational training program as a Registrar eventually leads to fellowship qualification and recognition as a fully qualified Specialist Medical Practitioner. Medical education in Australia is facilitated by Medical Schools and the Medical Specialty Colleges, and is regulated by the Australian Medical Council (AMC) and Australian Health Practitioner Regulation Agency (AHPRA) of which includes the Medical Board of Australia where medical practitioners are registered nationally.
Polyclinics in England were intended to offer a greater range of services than were offered by current general practitioner (GP) practices and local health centres. In addition to traditional GP services they would offer extended urgent care, healthy living services, community mental health services and social care, whilst being more accessible and less medicalised than hospitals. A variety of models were proposed, ranging from networks of existing clinics to larger premises with several colocated general practitioner (GP) practices, more extensive facilities and additional services provided by allied healthcare professionals.
The Royal College of General Practitioners (RCGP) is the professional body for general (medical) practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with over 54,000 members. The RCGP was founded in 1952 in London, England and is a registered charity. Its motto is Cum Scientia Caritas – "Compassion [empowered] with Knowledge."
In the United Kingdom, Ireland, and parts of the Commonwealth, consultant is the title of a senior hospital-based physician or surgeon who has completed all of their specialist training and been placed on the specialist register in their chosen speciality.
General medical services (GMS) is the range of healthcare that is provided by general practitioners as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. Today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. In 2013 60% of practices had a GMS contract as their principal contract. The contract has sub-sections and not all are compulsory. The other forms of contract are the Personal Medical Services or Alternative Provider Medical Services contracts. They are designed to encourage practices to offer services over and above the standard contract. Alternative Provider Medical Services contracts, unlike the other contracts, can be awarded to anyone, not just GPs, don't specify standard essential services, and are time limited. A new contract is issued each year.
Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May 2011, they also provided community health services directly. Collectively PCTs were responsible for spending around 80 per cent of the total NHS budget. Primary care trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012, with their work taken over by clinical commissioning groups.
A virtual ward allows patients to get the care they need at home safely and conveniently, rather than being in hospital.
Practice-Based Commissioning (PBC) was a United Kingdom Department of Health initiative introduced in 2005 to improve primary care services by enabling healthcare professionals to decide how services are funded to meet the needs of the local population. PBC was designed to give healthcare staff, usually general medical practitioners (GPs), the resources and support to become directly involved in decisions on commissioning health services.
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).
Healthcare in England is mainly provided by the National Health Service (NHS), a public body that provides healthcare to all permanent residents in England, that is free at the point of use. The body is one of four forming the UK National Health Service, as health is a devolved matter; there are differences with the provisions for healthcare elsewhere in the United Kingdom, and in England it is overseen by NHS England. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing and able to pay.
A sessional GP is an umbrella term for general practitioners (GPs) whose work is organised on a sessional basis, as opposed to GP partners whose contract is generally for 24-hour care. The term was first coined by the National Association of Sessional GPs (NASGP), who at the time were called the National Association of Non-Principals (NANP). After consultation with their membership, it was perceived that the term 'non-principal' was a term that defined these GPs using a negative definition rather than a positive one.
The Health and Social Care Act 2012 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date. It removed responsibility for the health of citizens from the Secretary of State for Health, which the post had carried since the inception of the NHS in 1948. It abolished primary care trusts (PCTs) and strategic health authorities (SHAs) and transferred between £60 billion and £80 billion of "commissioning", or healthcare funds, from the abolished PCTs to several hundred clinical commissioning groups, partly run by the general practitioners (GPs) in England. A new executive agency of the Department of Health, Public Health England, was established under the act on 1 April 2013.
Michael Alexander Leary Pringle CBE is a British physician and academic. He is the emeritus professor of general practice (GP) at the University of Nottingham, a past president of the Royal College of General Practitioners (RCGP), best known for his primary care research on clinical audit, significant event audit, revalidation, quality improvement programmes and his contributions to health informatics services and health politics. He is a writer of medicine and fiction, with a number of publications including articles, books, chapters, forewords and guidelines.
Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the practice is closed for educational sessions.
GP Federations became popular among English general practitioners after 2010 as a means to exploit the opportunities—or mitigate the threats—posed by the Five Year Forward View proposals in the English NHS which envisaged delivering primary care at a larger scale than the traditional GP list. It is widely believed that ‘Practices cannot survive on their own – they have to look at ways of making themselves stronger.’ 15 sites were selected in December 2015 to test new enhanced primary care models serving populations of 30,000 to 50,000 patients. Some, but by no means all, clinical commissioning groups have given financial support to encourage the formation of federations.