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Guidance for negotiating fees for locum services in general practice

• All doctors working in locum positions are required to have the same training and Postgraduate Medical Education and Training Board (PMETB) accreditation certificates as medical providers for whom they work. All doctors must be included on one ‘performer’s list’ in the country in which they practise. Doctors can only be registered on one performer’s list in each country.
• It is in the primary medical services provider’s interest to support appropriately trained and qualified locums so that they are available to cover them for annual, maternity, sick leave or management time. The onus is on locums to ensure they maintain professional standards and their fees should take into account the time and expense of continuing professional development.
• Primary medical services providers are responsible for any negligent acts of locums providing cover for them but only to the extent that these acts are related wholly to the services that are being provided and not something that is outside the remit of what is expected of the locum in the ordinary course of providing those services. Locums are required, in turn, to practise under the GMC guidance Good medical practice’.1 Primary medical services providers, therefore, have some responsibility to support locums engaged by them to maintain their professional skills. It would be fully incumbent on the providers to maintain the appropriate insurance cover for the practice as a whole and that would include the negligence of locums providing contracted services to the practice.
• A high quality locum service must allow for the proper execution of agreed locum contracts. In practical terms, this means allowing reasonable appointment times for consultations and time for the completion of paperwork, such as referral letters and requests for medical tests. The fee must take into account all duties performed by the covering doctor during the ‘session’.
• Self-employed locums have to bear similar professional costs of practice as other GPs, including professional indemnity, General Medical Council (GMC), BMA, NASGP and Royal College of General Practitioners (RCGP) subscriptions.