First-day checklist for locums at a new practice

Starting your first day at a new practice can feel like stepping onto a moving train. The phones are ringing, triage lists are busy, and every member of staff is already operating at full speed. As a locum, you are walking into that pace with none of the context the team has built up over the week.

A simple, structured first-day routine changes everything. It reduces stress, protects your clinical safety and makes the practice far more likely to rebook you. This guide breaks the day down into calm, practical steps.

1. Arrive 10–15 minutes early

Those extra minutes remove the sense of rushing and give you time to orient yourself. Whether you are on site or logging in remotely, use that time to settle in:

• Introduce yourself to reception and clinical leads
• Find your consulting room or remote access details
• Check where toilets, breakout areas and emergency exits are
• Ask who the duty clinician or on-call lead is for the day

A calm arrival sets the tone for a calm clinic.

2. Confirm your logins before the first patient

Nothing increases early stress like broken logins or missing permissions when patients are already waiting. Before the session begins:

• Log into the clinical system (EMIS, SystmOne, Vision, PharmOutcomes, Sonar, etc.)
• Check you can issue prescriptions and access tasks and documents
• Confirm your smartcard or token is working if required
• Make sure your professional details and signature appear correctly

If anything fails, flag it immediately. It is far easier to resolve at 08:45 than at 09:15 with three patients already waiting.

3. Ask for a quick “session at a glance” briefing

Every practice has its own rhythm. A short, focused briefing gives you most of what you need in under a minute. Ask:

• How many patients are booked, and in what format (F2F, telephone, video, home visits)?
• How on-the-day triage is handled and who is responsible for it
• Where results, tasks and repeat prescriptions appear in the system
• Any specific clinics, high-risk patients or practice “hot spots” to be aware of

4. Clarify support, escalation and clinical safety routes

As a locum, you may not know the practice’s usual patterns or shortcuts. One of the most protective things you can do is understand where support sits:

• Who should you speak to if you are worried about a patient?
• How are urgent referrals handled?
• Where should you record safety-netting or escalation notes?
• Who is the safeguarding lead if concerns arise?

A brief conversation here prevents confusion later when the clinic is busy.

5. Set up your consulting space so it works for you

You do not need to redesign the room. You simply need it to be workable and safe:

• Adjust chair and screen height so you can work comfortably
• Check that gloves, sanitiser and wipes are within reach
• Confirm that the phone and video camera work if you are using them
• Clear obvious clutter from your working surface

These tiny adjustments reduce physical strain and cognitive load through the day.

6. Skim your list before the first consultation

Even a quick scan of today’s appointments can help you pace the session:

• Look for complex, multi-morbidity patients who may need more time
• Notice frequent attenders or those with recent safeguarding concerns
• Identify any home visits or unusual appointment types

You do not need to pre-read every set of notes. You just need a sense of the shape of the day.

7. Use clear, consistent safety-netting

Locums often carry more clinical uncertainty because they do not know patients’ baseline in the same way permanent staff do. Clean safety-netting helps protect everyone.

A simple pattern works well:

“If symptoms worsen, fail to improve over the next few days, or if you develop [specific red-flag symptoms], please seek urgent review or call NHS 111 / 999.”

Documenting this clearly in the notes also helps colleagues who see the patient later.

8. Understand how prescribing works in this practice

Each organisation has its own prescription processes and preferences. Early clarity avoids awkward moments at the end of a consultation:

• Confirm that your prescriber details are set up correctly on the system
• Ask if any drugs are normally “consult and sign” with another GP
• Clarify how controlled drugs are issued and who handles queries
• Check whether there is a clinical pharmacist available for medicines advice

9. Know the end-of-session expectations

Many frustrations arise late in the day when assumptions don’t match. Before you start the list, ask:

• Are you expected to clear all tasks, results and repeats before leaving?
• Should you leave a short summary for the duty doctor?
• Is there a particular time they prefer you to finish consulting?

This avoids the feeling that you have “vanished” at the end of the session.

10. Leave a clean handover

Handover does not have to be long; it just needs to be clear. Before you log off:

• Flag any patients needing follow-up or review
• Note any investigations ordered where results may need chasing
• Highlight urgent tasks you have escalated
• Make sure no prescriptions are left half-completed

This is one of the fastest ways to build trust with a new practice.

11. Send a short thank-you message

A simple expression of appreciation goes a long way in busy primary care environments. A quick note such as:

“Thank you for the warm welcome today – I’ve completed my notes and cleared my inbox. Happy to support again anytime.”

builds your reputation as a thoughtful, professional locum and makes it more likely that you will be invited back.

Final thoughts

Your first day at a new practice does not need to feel like a stress test. With a calm, structured approach, you can protect your own wellbeing, support the team and provide excellent care for patients.

A settled start leads to a settled session – and that benefits everyone in the building.