Any agreement should include details of the fees agreed between the locum and the practice.
This guidance cannot include details of how to set a fee with the practice. Neither the BMA nor the GPC can offer guidance on levels of fees because of competition law.
Read our guidance on the factors to consider when setting fees
However, below is a list of items that both parties should consider including in the agreement. Some items will be more appropriate than others, depending on the structure and type of work that is being carried out for the contractor; not all may be appropriate.
Please note that, as of 1 April 2013, practices in England and Wales are now responsible for the employer's pension contributions for the locums they engage.
The locum should therefore state the employer's contribution (14.3% of 90% of the locum’s fee) separately on any invoices where they intend to pension their income.
Find out more about the pensions changes for sessional GPs
Fees to consider
- The basic fee for each session - standard sessions, based on the model contract for salaried GPs, comprise four hours and 10 minutes of work. The length of a ‘session’ should be clarified and agreed in advance together with the expected consultation rate.
- An hourly rate - for shortened sessions and sessions that overrun.
- An extended hours rate
- A rate for additional work - ie work carried out in addition to that which is defined within the agreement as being expected within a session. This definition is discussed under 'definition of core work’. It may be useful to indicate that additional work will be done subject to the agreement of the locum on the day. Unfamiliarity with systems and other unforeseen circumstances can make time keeping a major challenge for locums so it is not realistic to undertake to agree to an unlimited amount of additional work in advance.
- Details of fee arrangements for private work - for example, whether it will be done in lieu of standard appointments and visits, or in addition to the agreed work (in which case a fee will need to be agreed and set out in the agreement) or not done at all.
- A fee for on-call work
- Arrangements for travel reimbursement
- A cancellation charge - where a session is cancelled by the practice at short notice (see ‘contractor’s responsibilities’ and ‘arrangements for the termination of the agreement’).
Time-based approach to setting a fee
Whereby a set fee is agreed for a specified number of hours’ work.
Where this approach is used, it is important that the locum raises any concerns about the appropriateness of the time period given for the work that they are required to complete. It is also important to ensure that the fee per hour for any additional work is clearly stated in advance.
Workload-based approach to setting a fee
Whereby a fee is agreed for a set number of appointments/visits, regardless of the time worked.
This is the more usual arrangement and the advantage of this approach for the locum is that they can usually manage their time better. This is crucial where they may have a commitment with another practice later in the day or other commitments (eg childcare, teaching, appraisal).
The advantage for the practice is that there is a guarantee of work covered and the practice is not penalised if the locum runs behind (as may occur using a time-based approach to fees).
Under a workload-based fee arrangement, the locum would not normally charge an additional per-hour fee if the agreed workload took much longer than expected, except in exceptional circumstances, such as where a patient is sectioned under the Mental Health Act.
Most locums choose to operate in this way and should ensure that they factor sufficient time into their schedule, especially when they are working in two different practices in one day.
Timescale for payment
The agreement should include details of the time period within which the locum’s fee should be paid. This should usually be within 28 calendar days to allow completion of the locum’s pension forms.
Under late payment legislation, the locum would have the right to charge interest on an overdue account.
Find out more on the government's website