Which primary care setting is best for you?

What is primary care? 

Primary care is the first point of contact for patients when they have concerns about their health. They will often build up a relationship with their GP over a longer period and value the understanding of their personal situation.  

However, unless a locum takes on a long-term contract with a surgery, they will not be able to build a strong relationship with patients. Instead, they have to understand a patient’s circumstances quickly and offer them the support they need. They may also feel more comfortable in primary care environments in which they are not expected to manage the continuity of care expected at a GP surgery. Different primary care settings provide different opportunities and challenges. This is your go-to guide for working as a locum in primary care.  

We’re always looking for locums to work in primary care. If you’d like to see our available roles, click here.  

GP surgery 

GP surgeries are the most common primary care setting for locums. It will be their responsibility to provide comfort and reassurance to the patient when their regular GP or nurse isn’t there. They need to be able to step in to understand a patient’s situation and make a positive impact in a limited number of sessions. By bringing new eyes to a situation, they can provide additional advice and suggestions in disease prevention and determining risk factors.  

Remote consultations are also becoming more popular. There is a chance that working with GP surgeries will involve these. It is a good opportunity to develop skills in digital health as the NHS evolves. You can read more about remote consultations here.  

Some locums like to look out for long-term shifts in GP surgeries. These offer patient continuity, a higher level of stability with guaranteed shifts and the ability to build a relationship with other medical professionals which will be valuable in the future.  

Out of hours 

Out of hours work is also popular amongst primary care clinicians. The out-of-hours period is weekday evenings from 6:30pm to 8am, all day at weekends and on bank holidays. It is a varied area of work which takes place in different settings such as:  

-A&E departments 

-Urgent care centres 

-Walk-in centres 

-Minor injury units

-Telephone triage

-Home visits  

Out of Hours is popular because shift times are strictly enforced so you know exactly what times you’re working. Some locums like the challenge of never knowing who is going to walk through the door. It requires you to hone your clinical judgement and think on your feet. Night shifts also encourage solidarity amongst those working together. People who undertake OOH shifts usually enjoy the variety of caring for different sorts of patients and the opportunity to work more with urgent care rather than chronic or long-term illnesses. It also involves identifying the type of care a patient needs with telephone triage and ensuring sharp judgement to accurately diagnose patients who need urgent care. 

However, out-of-hours working usually requires a much higher level of indemnity cover due to the higher level of risk involved in urgent care so check this with your MDO if you are unsure.  

OOH work is a great option if you want to develop your skills in a new environment and challenge yourself.  

Walk–in centre 

Walk-in centres are mainly the domain of nurses, but some do give patients the option of speaking to a GP too. They are an alternative to A&E as they offer urgent medical attention when it isn’t such a high-risk situation. Patients can access treatment and advice for minor illness and injuries without the need to register or book an appointment.  

If you choose to work in a walk-in centre, you may deal with minor infections and rashes, emergency contraception, fractures, lacerations, superficial cuts, and minor burns and strains. It is a good environment for those who want to provide urgent care for patients in need. It may be for you if you enjoy the challenge of thinking on your feet to quickly understand what care is needed, without regularly being under the pressure of a life-threatening situation.  

In particular, many nurses like the walk-in centre environment because they have more responsibility and autonomy in diagnosis and treatment. This experience may allow you to develop the skills which lead to a more advanced practitioner role, if you desire. You can also begin to build this skills which help you advance into management or specialist roles. [1] If you are nurse who prefers working with the presence of a doctor, this may not be the setting for you.  

Covid-19 services 

Covid-19 has expanded primary care’s responsibilities. There are hundreds of GP-led vaccination sites doing an amazing job tackling this mammoth task. Hot hubs have been an important way to manage clinical risks in a new way, such as cross-contamination. This is good opportunity to develop new skills and an understanding of a new clinical setting. You can read more about hot hubs and clinical learning in our Profile of a Locum ANP.  

Primary care networks  

As of May 2020, there are around 1250 Primary Care Networks in England. Bringing general practice together in this way is intended to help manage financial pressures, provide a wider range of services to patients and establish a more integrated health and care system. [2] They allow GP practices to work with pharmacies, mental health services, community and voluntary services to expand the range of care available.  

PCNs will usually provide the opportunity for all staff groups to be represented in decision making processes by joining the board or a sub-group. As a locum, you can provide important insight due to having worked in many settings and locations, and you may have your own needs to be addressed which don’t occur to salaried employees. You should be able to get involved by speaking with a practice you work with.  

Choose the right primary care setting for you  

A benefit of locum working is that you can try lots of different settings to see what works best for you. It may be the case that you enjoy variety and learning new skills, or alternatively you may want to stick with one environment and become an expert in that setting. Locums are not just a replacement to combat staff shortages, they bring a refreshing, diverse set of knowledge to the table from their varied experiences.  

If you would like to find your next primary care shift, see our vacancies or register to be updated with our latest roles.  

 [1] Nursing Times