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Guidance for negotiating fees for locum services in general practice

January 2007

Introduction and background
This guidance has been produced to support all parties involved in negotiating for GP locum services. Agreements are made between two parties and could involve locum GPs, GP practices, primary care organisations (PCOs) and any other alternative providers. The guidance has been developed by the British Medical Association (BMA) (including the general practitioners committee (GPC) and the GPC sessional GPs subcommittee) and the National Association of Sessional GPs (NASGP).

In the past the BMA published a range of ‘suggested fees’ for locums, but in 1999 the Office of Fair Trading (OFT) advised that publication of these fees was anti-competitive in the context of the Competition Act 1998. As a result the fees guidance, which had been published as Fees guidance schedule (FGS) 12: fees for GP non-principals, was withdrawn and guidance issued to BMA staff that no advice could be given to members on suggested fees for sessional GPs.

The publication of a range of fees or even a minimum or maximum level of fees is considered anti-competitive by the OFT. Members of a cartel (an arrangement between two providers not to compete with each other, whether written or verbal, formal or informal) can be fined up to 10 per cent of their UK turnover for up to three years if found to be arranging fees in any way.

The BMA professional fees committee, attended by representatives of the NASGP and the GPC sessional GPs subcommittee (on 17 September 2003) agreed that clear information should be available to locums, practices and other providers on how to calculate and negotiate a reasonable rate for each session of work undertaken. The committee resolved that a short-life, informal joint working group with the NASGP would be convened to review the information and good practice guidance available.

The Working Group was chaired by a consultant member of the professional fees committee. The group agreed the guidance and it has been endorsed by the BMA, the GPC and the NASGP Council.

The BMA and the NASGP agree that locums should be fairly remunerated. Fees could take into account their experience, professional expenses associated with their practice and their continuing professional development. The professional, financial and organisational responsibilities shouldered by GP providers may also be applicable to locums, and may be taken into consideration when setting their fees.

This document is intended to inform GPs and other providers who engage locums of the range of professional expenses incurred by locums, as well as ensuring that locums recognise their true value. Both the BMA and the NASGP hope that this publication will address some of the misconceptions that have developed, and encourage providers, as well as locums, to engage in constructive negotiations. It is intended that both parties forming an agreement will understand how appropriate rates of payment will be, or could be, negotiated and agreed.