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InFocus

Leave it to the locum – 2

MARION McCULLAGH continues her series on locum veterinary surgeons with a look at locum agencies and how they operate, and the valuable service they provide to the profession

LOCUM agencies have proliferated over the years.

Once there were one or two, now a look at the back pages of a journal such as the Veterinary Record shows nine separate agencies vying for business.

The pioneer was probably Rowena Paxton; Angela Wright and CPL are also among the early agencies. Julie Frost of the Northern Locum Agency started off in her back bedroom in 1978 and has been going strong ever since. Now she handles about 2,000 clients. Over the years some of her practice-based vets have become locums and some vets who were locums now own practices.

She feels strongly that her initial career as a veterinary nurse has put her agency on a good foundation. Her aim to match the needs of locums with those of the practices has an end point in wanting to provide the best possible care for the animals.

So why does the profession need locum agencies? How do they differ from each other and how do they work? How do you tell a good one?

Locuming is all about change: a practice finds itself understaffed through accident, illness, pregnancy, unplanned staff changes or planned holidays. Many practices can cover their own shortfall even if it means overworking their existing staff, but others, especially smaller practices and the single-handed ones, need help, sometimes at very short notice.

The agencies have potential locums on their books, ready to work, so the practice has a selection of candidates waiting to fill its needs. The definition of a “locum” indicates a replacement of the same competence, so having more people to choose from can increase the chances of a good match.

This works equally from the side of a vet wanting locum work: the agencies give a choice of practices rather than relying on a single advertisement. Also, as the practices pay the agency fees, a locum can sign up with all available agencies and so have a wide client base. Agencies do the footwork; they make the contacts, arrange the terms and check out the small print.

The efficiency of agencies varies, some are very personal, very caring and very competent. They are thorough in their screening of potential locums. They require the locum to submit RCVS number, passport, qualifications, CPD records, CV and references from previous work assignments. These are objective assessments and may even include a statement from the potential locum of competence in all the tasks that may be required.

A little daunting

Several pages of boxes to be ticked may seem a little daunting but the essence of a good match is knowing the strengths and weaknesses of both parties – locum and practice may have blind spots and problems which are better not concealed.

Some positions need an experienced veterinarian, others make a good proving ground for new, or relatively new, graduates who wish to test the waters of practice and find out which sort of practice suits them before making a long-term choice.

The locum scene used to be full of antipodeans who did the grand tour, some months locuming here before a trip around Europe, but their numbers have declined as the pay back home is much better than they can get here.

Good work by the agency means that both locum and practice benefit. Good agencies avoid the temptation of gaining their fee regardless, they respect the needs of both locum and practice. The locum can have a personal crisis just as much as the practice can and the agency needs not to bully them into taking on work that they do not want.

In one case the vet’s grandmother had died, the vet needed to go to the funeral and so declined to take on the booking that was offered. Her wishes were not respected. If the locum is not suitable for the work, for example someone with little large animal experience being put forward for a full-on mixed practice, nobody benefits.

The practice can be shaky too, as where a veterinarian was expected to do out-of-hours emergency surgery without the right equipment or sufficient nursing support. The most gruesome tale is the practice unfortunate enough to take on a “veterinary surgeon” who, many months later, was disclosed as a trader in human body parts.

Some agencies run a payroll system, they charge the practice a fee that includes commission and the locum’s pay and then pay the locum. This is fine as long as the locum is paid a fair salary and paid on time.

Most of the agencies will negotiate the fee, brokering between practice and locum, and leave the practice to pay the locum directly. Prompt payment is necessary as locuming is by nature a bit stop and go: the locum’s bank balance may well need topping up after a gap in the bookings.

So how do practices see the locum agencies? Again, this varies. The practice may have a list of six agencies pinned to the notice board, they may request help from several agencies simultaneously, or may have had a bad experience with an agency and prefer to use individual advertisements and personal contacts.

From the locum’s point of view, agencies may take a very close contact, advertising the outline of a piece of work and waiting for the locum’s response before disclosing the details of the practice, or their e-mail may give the practice details and rely on the locum to report on the progress. Most of the agencies are very friendly and work hard to find out just what the locum needs and will negotiate to fine tune a situation where either party needs to change an aspect of the booking.

Overall, agencies provide a valuable service to the profession, helping to avoid the pitfalls of trying to fit square pegs into round holes, and generally helping practices to smooth out potentially difficult situations.

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