When a GP takes sick, annual or parental leave, locum GPs have traditionally been utilised to ensure practice capacity is maintained as much as possible. Locums have also been drafted in during times of high demand such as the busy winter period.
But the general practice landscape is changing. We’re currently short of around 4,200 full-time equivalent (FTE) GPs.
GP practice appointment bookings reached a record high of 36 million in October 2022. And in the six months to August 2023, GP practices delivered 150,000 more appointments per day than they did during the same period in 2019.
Now, faced with the ongoing NHS workforce shortage and increasing demand for care, it’s not just about short-term or ad hoc staffing gaps. GP practices often have longer-term clinician vacancies to fill.
Locum GPs are still a crucial lifeline, and a necessary thread in the tapestry of healthcare staffing. But they are now part of a growing number of available solutions designed to address complex staffing issues. With the rise of virtual healthcare services, there’s now an innovative alternative for short-staffed GP practices.
Here, we explore why your practice might choose a locum GP over virtual care – and vice versa – helping you find the best solution for your organisation.
What is a virtual healthcare service?
Most GP practices are familiar with locum GPs and how they work. But what exactly is a virtual healthcare service?
A virtual healthcare service runs remotely alongside your practice, usually and ideally in close partnership. The type of practice activity a virtual care service supports depends upon the partner and the package you choose.
Generally, practices direct a designated sub-section of patients to a service, where they receive a particular form of care relating to their requirements. Be it virtual appointments with experienced clinical staff over telephone or video consultation, or the provision of digital tools that help them engage with and improve their health in a proactive and ongoing manner. Or both. There are of course many other methods of delivering virtual care across primary and secondary care, covering a wide range of conditions and requirements.
Like a locum GP, a virtual healthcare service can help to plug staffing gaps, reduce pressure on GP practices and free up GP time for the patients who need them most.
Locum GPs vs. Virtual healthcare service
Let’s take a look at how locum GPs and a virtual healthcare service compare across a range of practice priorities.
A locum GP who is familiar with your local area can boast a good understanding of your patient population and their unique needs and challenges. This helps them to provide high quality, personalised care.
Virtual clinicians can be based anywhere in the country. So, certainly at the start of a partnership, they’re unlikely to have the same affinity with your patients.
However, is also one of the benefits of virtual care. Because a virtual healthcare service operates remotely, it can care for patients over a much wider geographical area, creating a borderless digital capacity mechanism.
Imagine a PCN searching for additional clinical support across their network area. It could involve recruiting multiple locum GPs to cover all practice locations. In contrast, deploying a virtual care service involves one solitary partnership, with a bank of clinicians working virtually across all practices in which they are required.
A virtual care service helps practices build capacity and service resilience across a whole region. This is especially useful in areas with a low GP-to-patient ratio. And in places, like rural and deprived areas, where recruiting permanent GPs is known to be more difficult. Virtual care services can therefore provide the additional benefit of increasing patient access to quality care, as well as reducing care inequalities that exist due to locality or a deprivation of resources.
There’s a widely held belief that the number of locums is growing. But according to the BMA, the number of locum GPs has remained relatively low and stable over recent years. If anything, the number of available locums is shrinking.
Many practices are struggling to recruit locum GPs. Two thirds of GP partners responding to a GPonline poll said that they had been unable to recruit a locum at least once over the previous six months. And half of GP partners said it was difficult to recruit locums.
This makes it hard to fill staffing gaps, particularly at short notice. And it makes planning ahead very tricky.
In contrast, a virtual care service provides ongoing support. You have consistent and often additional resource available at all times, so it’s easier to pick up the slack when another clinician takes a few days off sick or decides to book a holiday. Furthermore, the clinicians utilised may well be consistent, offering the same benefits as a local clinician. And even if clinicians change, the partnership itself remains constant, a continuous relationship and thread of understanding that continues even if those carrying out the care change over time.
This makes it easier to forecast, plan ahead and have a longer term approach to resource deployment and workforce management in the ever-present pursuit of greater efficiency.
Length of contract
When you hire a short-term locum GP they may only work at your practice for a day, a week or a month. Longer-term locum contracts and virtual healthcare services are available for your practice for a much longer period.
Longer contracts are preferable because they’re more efficient. You don’t have to keep searching for locum cover. And you don’t have to repeatedly introduce new clinicians to your practice, its computer systems and your ways of working.
Longer-term arrangements also make staff planning much easier. You get peace of mind, knowing you’ve secured clinical support for a set period of time.
Another benefit of long-term contracts? Clinical support staff gain a deeper understanding of your practice and its patients. They can then provide a better standard of care and play their part in helping your practice meet local and national targets.
Each locum sets their own terms of work. So when you recruit a new locum, you can’t count on them fulfilling all of the duties you had in mind.
For example, some locums aren’t happy signing repeat prescriptions in a practice they’re not familiar with as it increases their clinical risk. And while all locums complete administrative work associated with patient appointments, they don’t generally tackle wider practice administration.
When you partner with a virtual care service, you decide the terms of the contract upfront. You know exactly what remote-working clinicians will take responsibility for going forward. This makes it easier to plan GP workload across a practice or PCN. Administrative tasks can also be undertaken by the digital healthcare partner, further reducing pressure on the practice.
Locums see patients on site at your practice so they use existing practice computer systems. This has its benefits. Patient notes are updated in the usual way with all relevant QOF and IIF codes, so all members of the team can see changes.
When you work with a virtual care service, you need to first integrate your systems with theirs. This allows for secure and seamless sharing of patient information.
Once systems are in place, clinicians working as part of your virtual care service can make fully coded changes to patient notes, in a seamless manner.
Locum GPs generally earn more per day than salaried GPs. According to GPonline, many GP partners say that rising locum costs are putting pressure on practice finances.
The cost of hiring a locum GP depends on your location, with the highest rates in Devon and Cornwall, and some of the lowest rates in the City of London and Greater London. The average daily rate ranges from £600 to £900.
So how does this compare to a virtual healthcare service? Costs vary depending on the provider and service package you choose. But virtual care can be much more cost-effective over the long term, particularly when a service is designed to improve patient health outcomes and the meeting of QOF and IIF targets.
Continuity of care
Continuity of care leads to better patient outcomes and improved patient satisfaction. It also makes care more cost-effective.
Although locums have no obligation to a particular practice, many do remain connected to a particular selection of practices. Therefore, positive continuity of care is certainly possible, in addition to the local knowledge discussed earlier in the article. The temporary nature of the arrangement naturally means that this is not always the case, however.
High quality virtual healthcare services address this issue. They prioritise the patient experience and make it easy for patients to book appointments with their clinician of choice. Appointments can also be longer so it becomes easier for patients to develop a relationship with their clinician.
Also, most services provide a virtual care app, where patients get to see their healthcare history and get healthcare advice via the same user-friendly portal, whenever and wherever they need it.
Quality of care
GPs have a lot on their plate. There are currently 2,286 patients for every fully qualified FTE GP in England – that’s 27% over the suggested safe limit.
By increasing the capacity of your practice, both locums and a virtual healthcare service support a practice to operate within safe limits. They lighten existing GP workload and help you to retain general practice clinicians. This all contributes to a better quality of care, as well as practice staff wellbeing.
However, there are some additional factors to consider.
Locum GPs may not be familiar with prescribing policies or the competencies of other practice staff. Furthermore busy practice teams can’t always provide a thorough induction for new locums. And supporting locum GPs can stretch overworked practice staff even further.
A virtual care service faces some of these same issues at the start of a partnership. But because contracts tend to last longer, virtual care clinicians - and at the very least, the partner in particular - soon get to know and understand the practice and its ways of working.
There’s an added benefit to virtual care, too. By giving patients access to digital healthcare tools, you stand to improve patient engagement and self-care.
You also provide easy and convenient access to clinicians and health advice digitally, either via an app or designated webpage, which means patients are more likely to use the support available to them.
Of course, regardless of who you hire, you need to do your due diligence. You can ensure the best possible quality of care for patients by completing all pre-employment checks for locums. And by confirming that a virtual care service is CQC-rated.
Recruiting a locum used to be the only option for GP practices looking to increase their capacity over the short or long term. They remain a vital option for practices across the country. The increase in options and choices for practices in how to solve short, medium and long-term workforce issues can only be seen as a positive, especially as recruitment becomes more difficult and costly. Virtual healthcare services present another way to solve staffing issues efficiently and effectively.
The solution you choose will depend upon a range of factors, including the needs of your practice, the length of contract you wish to put in place and the responsibilities you want additional staff to fulfil.
But at a time when demand is high and GP numbers are low, it’s worth exploring all possible options to provide patients with consistent, safe, high quality care.
If you’re interested in learning more about how a virtual healthcare service could benefit your practice, get in touch with Suvera. We provide bespoke packages for our practice partners, helping them to increase capacity and provide a top quality patient experience.