General Practice Locum Improvement Tool.

An improvement culture is required in the NHS. Staff members who move from one place of work to another are often best placed to see alternative methods of working that at times are more efficient - locum general practitioners (GPs) tend to be in this category. A tool was developed specifically to obtain quality improvement suggestions to the general practice from the locum GP and vice versa in a time efficient manner. A pilot study was performed in one general practice in Tayside (Grove Health Centre) in December 2013 to assess if this was possible. During this month a general practice partner provided feedback to the locum GP by completing a drop down tick box survey while reviewing three cases dealt with by the locum. The locum GP was emailed after their session with a one question survey enquiring about improvement suggestions for that practice. Five different locum GPs provided clinical cover during the month studied - of these, one opted out from the study. The other four locums performed their clinical session and completed the survey. Feedback from the practice to locums included specific clinical guidance, suggestions for improving documentation, and ways to optimise referrals; of note, unique feedback was given to each locum and this was generated using this tool. Themes from the locum suggestions to the practice included more physical resources (such as cameras in each room), different ways of handling prescriptions, and a suggestion about identifying complex patients. As a direct result of this pilot a locum box has been implemented in this practice and plans are to rerun this tool periodically. The authors would recommend utilising this tool periodically in other general practices as it has the potential to identify improvement suggestions unique for that particular practice.