The British journal of general practice : the journal of the Royal College of General Practitioners
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There is evidence of dissatisfaction with locum doctors' performance, but little is known about doctors who work as locums in general practice or about their experiences of this work. ⋯ Locum doctors in general practice are a heterogeneous group that includes those who have chosen this type of work. The doctors who intend to continue as locums indefinitely represent a useful resource in primary care whose ability to provide short-term cover could be maximized. The need to control the quality of 'freelance' doctors should not overshadow the need to control the quality of their working environments.
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For nurse practitioners (NPs) in general practice to substitute for general practitioners (GPs) in consultations, their educational needs require specification, and their effectiveness and acceptability to patients must be determined. There is limited evidence in the United Kingdom about training requirements or how NPs compare with GPs. ⋯ Early in their training, TNPs made good diagnostic and treatment decisions, while their high level of patient transfers to GPs indicated residual uncertainty. In independent practice, their GP mentors judged them to be offering an effective service, with acceptable transfer and patient return rates. They were liked by patients and more so by patients with previous TNP experience. TNPs are a valuable substitute for GPs for patients wishing for a same-day consultation, and for younger and female patients who prefer a female TNP over a male GP. Limited authority to prescribe and refer to secondary care reduces NP efficiency.