Robbie Coull

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GP Magazine, February 2002

Does this sound familiar? It's the middle of a busy Thursday morning surgery and you say to your practice manager "Oh, by the way, I've got to go to [insert vital appointment here] . Any chance you could find a locum for the Friday evening surgery?".

Result: much employee gnashing of teeth and wailing.

Why is finding locum cover so dreaded by otherwise unflappable staff? It's all got to do with how practices and locums communicate. Unless you are willing to spend a lot of money to get a locum agency to do all the hard work for you, you will need to get out your list of locums and start phoning around. This can mean hours spent on the phone leaving messages on answering machines etc.. Sometimes, the time spent on finding a locum can be greater than the actual length of the locum cover itself.

The ideal system for contacting locums would have the following features:

- ease of use

- low cost

- rapid communication

- always up to date

- practices ability to select which locums they want to use

- locum ability to decide where and when they want to work

- locums ability to decide how and when they are contacted

Six months ago I set out to create a website that would meet all of these requirements.

I decided that SMS (Short Messaging Service) text messaging was the perfect medium for contacting locums. Like a phone call, the message is delivered to the locum's mobile phone immediately. But, like email, locums can control when they receive and reply to those messages.

500 programming hours later, and more than one threat of finding myself single again, the result was

Locums register online selecting what types of work they are willing to do, and which parts of the country they are willing to work in. They can change their settings online at any time, so the list keeps itself constantly up to date.

When a practice needs locum cover, they visit the site and enter the dates they need cover for. All the locums that match their requirements are then instantly sent an SMS and email message. Locums then phone the practice just as they would if they had been contacted directly.

The system is automated, so running costs are low, and practices only have to pay for the cost of any SMS messages they send. Practices can be either invoiced or pay online by credit card. Online payment is handled securely by a company called Netbanx.

The site was launched last month and in the first four weeks 119 locums joined the list and 48 requests were sent. The main pilot area is Inverness where 96% of active locums are registered with the system.

Feedback from practices and locums has been very positive. The ease of use of the system is the main positive comment. Another is the speed of SMS messaging. One GP emailed me to say "your system worked like a charm and I had a locum within 5 minutes of leaving the computer".

The only problems encountered have been with practices and locums that find the use of the internet difficult. Mis-spelling of long NHS email addresses by practices also causes some problems. This has been less of a problem than was expected, and should disappear as practices become more familiar with the internet.

Future developments include an approach to the National Association of Non-Principals inviting them to use the system for communication between practices and local non-principal groups that are already established around the country. This has the potential to revolutionise how practices and NHS trusts find locum cover. Across the NHS, the potential savings are huge.

Robbie Coull

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