Sessional GPs - including salaried, freelance and locum GPs – make up an increasingly large part of the workforce, yet sessionals are often under-represented on LMCs (local medical committees).
Given the funding and workforce crisis in general practice, and the expanding role of LMCs in responding to local challenges, it is now more important than ever that there is good communication and engagement between sessional GPs and LMCs.
As a sessional GP, becoming a member of an LMC will give you access to all the services that the committee can offer, including, among others:
- employer mediation
- networking opportunities
- career development.
Our guidance provides practical solutions to addressing the barriers to engagement that sessional GPs and LMCs have reported to us.
It can sometimes be difficult for an LMC to obtain accurate details for the sessional GPs in their area. To get in touch with sessional GPs LMCs could:
- ask the area team, commissioning support unit or local service agency (or equivalent body in the devolved administrations) to pass contact details of GPs on the performers list to the LMC. PCOs may wish to include an option on their performers list registration forms, for both new applicants and when checking details of those already on the performers list, allowing GPs to give permission for the sharing of their contact details with the LMC
- alternatively, ask the area team or PCO to forward a mailshot about the LMC to GPs on the performers list in their area. LMCs could use this to publicise details of their open meetings more widely.
There are a number of mutual benefits for sessional GPs and LMCs engaging.
What LMCs can offer sessional GPs:
- provision of up-to-date information and support on any changes that affect the way GPs work
- help to mediate between employers and salaried GPs
- support and advice on performers list issues
- education and career development opportunities
- networking opportunities
- giving voice to the concerns of sessional GPs arising from their clinical practice and taking up issues directly with relevant organisations
- providing a supportive and pastoral role if a GP has difficulties with their CCG or area team
- providing the opportunity to undertake GP leadership roles.
What sessional GPs can offer LMCs:
- for locum GPs, experience of working in many different practices, thus the ability to offer advice or opinion on issues that face many GPs across their area
- sessional GPs may work part-time or hours that are different to practice hours, or have a special interest in a particular area, and therefore be best placed to attend meetings on behalf of the LMC
- sessional GPs may be able to take on an office bearer’s role because of flexible working, whereas GP principals find it difficult because of practice or other commitments
- this may lead to sessional GPs undertaking local and national roles such as representing their LMC on GPC.
Many LMCs have told us that sessional GPs are often reluctant to get involved with the LMC, due to a number of barriers to engagement. Our advice includes possible areas of improvement to encourage sessional GP involvement:
- if the membership of the LMC is not covered by working in a levy paying practice (for both salaried and locum GPs), then set the levy at an affordable and reasonable rate or consider removing it altogether
- publicise the services the LMC can offer to sessional GPs. For example, ensure you disseminate the LMC newsletter to as many sessional GPs as possible. Advertise, well in advance, the dates for the open meetings of the LMC and ensure that sessional GPs understand that all GPs can attend these meetings. Publicise elections as widely as possible and make clear that sessional GPs are entitled to stand and vote
- set up a visitor scheme to allow sessional GPs who might be interested in getting involved to attend an LMC meeting as an observer - this is a good way of creating a better understanding of how the LMC works. Alternatively, the LMC could hold an 'open day' meeting for sessional GPs, to introduce them to the LMC
- often a personal approach goes a long way - LMC officers could encourage sessional GPs they know to stand for election
- LMCs can include sessional GP-specific items in newsletters and have a sessional GP area on the LMC website
- set up mentoring for sessional GPs who are new to the committee, or who might want to consider running for officer roles.
GPs can be reluctant to stand for election against incumbents. LMCs should consider setting limits on the number of years that one individual can stand for an elected post.
Look at when the LMC holds its meetings. Sessional GPs can find it difficult to attend LMC meetings, especially when they are held during working hours, either because of difficulty in persuading their employers to give them leave to attend, or because of concerns about loss of income. LMCs could hold meetings outside of office hours to make it easier for sessional GPs to attend.
Representing sessional and partner GPs
One reason that some sessional GPs may not be involved with their LMC is the perception that LMCs only represent GP partners, or that they are unconcerned with sessional GP issues.
To counter this perception:
- make sure that you have a protocol in place to make sure that whenever the LMC is representing two different LMC constituents (especially when the two constituents are an employer and employee) the cases are dealt with independently by two different LMC staff members. If this is not practical, LMCs can consider asking a neighbouring LMC to represent one party throughout the dispute
- consider reserving seats on the committee specifically for sessional GPs
- consider setting up a sessional GPs subcommittee
- adopt a checklist when considering key agenda items, so that you consider the impact on all different groups of GPs, for example: GMS contractors, PMS contractors, APMS contractors, salaried GPs, locum GPs, etc
- reserve space on the agenda for issues specific to sessional GPs to be considered by the committee. This option should be used with caution though, as there is a tendency for standing items to be addressed perfunctorily in meetings, especially if they are placed late in the agenda. Placing them higher up may encourage greater discussion and consideration.