Creation of an ‘On-Boarding Pack’  for Locum Doctors

Introduction

Many NHS hospitals are dependent on short term locum doctors, due to staff shortages, which can impact on patient safety. ‘External’ locums are often required at short notice to fill these gaps.  

For external locums, it can be challenging to work in a new environment as it  takes extra time to be acquainted with new IT systems, knowledge of the hospital’s processes and local guidelines. Also, locum doctors  relative lack of team awareness  may impede their request for support and escalation in emergency cases. 

Locum doctors’ involvement in several incidents in our Trust, highlighted these issues and identified some supervising consultant’s unawareness of their competencies.

Our project ’On-Boarding Pack’ started in 2021 and aimed to support locum doctors. It’s importance is reflected by the RCOG publication of Certificate of Eligibility for Short Term Locums in Feb 2023.

Design / Methods

We identified key processes and information that a new doctor needed and used these to create a concise pocket-size document.

The ‘Onboarding pack’ created both as a physical pocket-size and a softcopy document sent to locums via email in advance, has been used for all external locums since its implementation in late 2021.

Results

Key information shared were:

1) Emergency phone numbers and escalation pathway, including how and when to involve the supervising consultant.

2) Easy-to-follow flow charts of how to document on Trust systems (Care-flow in Gynaecology and paperless K2 systems in Obstetrics), admission and discharge pathways and accessing hospital guidelines were demonstrated. 

3) How to obtain IT logins and identification badges  including  stepwise directions to the temporary staff offices.

4) A list of core competencies for SHO and Registrar levels to guide initial discussion between consultants and the locum doctor, who then must provide supporting  evidence of their competencies prior  to performing those procedures unsupervised.

Conclusions

The onboarding pack was piloted on new locum doctors and reviewed by O&G consultants and the labour ward forum before final approval.

It was  found to be excellent for obtaining quick information, speeding up the initial process of starting work by ensuring the locum knew how to collect ID badges and access the IT systems.

It has facilitated a quick orientation to our processes and supported effective task completion.

Additionally, it has enabled the consultants to provide an appropriate level of supervision to the locums by assessing their competencies prior to working in the department and ensuring patient safety. Some comments received are below. 

“Innovative project that has helped orientate new doctors and make patient safety better”

“The ‘how to’ guides were very helpful for someone who has never worked here before”