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You may have heard something about this but as part of the non-contractual elements of the General Medical Services Contract 2016/17, ‘NHS England will set a maximum indicative rate based on a set of rates (which may have some degree of regional variation) for locum doctors’ pay. NHS England will amend the electronic declaration system to include recording on the number of instances where a practice pays a locum doctor more than the maximum indicative rate’.
So what is the impact of this upon freelance/locum GPs and the practice(s) they work for?
There is little doubt that the number of sessional GPs within the general practice workforce is increasing, and perhaps it is worthwhile considering for a moment why GPs are choosing to work as sessional GPs, and in particular have opted for the locum route of practice. This could be either as GPs within their first five years of practice, or as ex-partners coming out of partnership, and continuing to work as a sessional GP. Many will cite that this way of working gives them flexibility as regards childcare and/or family reasons, including caring responsibilities. It also provides them with flexible ways of working and portfolio career development. But perhaps the most important one cited is being able to manage workload and manage risk, being able to practice safely and achieve a work-life balance that also means being able to look after personal health.
The Government may set a maximum indicative rate, but this is for a rate irrespective of the type of services the GP locum might provide in practice. I don’t need to say that what a locum provides will vary from practice to practice, from agreement to agreement, from isolated practices in deepest rural Cumbria, where they might be the only GP in the practice and cover it all, to a locum GP in London, where they might be faced with completely different challenges dictated by the environment in which they practice. Therefore it is important that locums and practices still discuss and negotiate the fee for the work done. You can use the BMA locum calculator to help with this.
Even though reporting the rate paid over the indicative rate by the practice will be a non-contractual requirement, this is of little comfort to practices and GP locums alike. The risk is that the outcome will be to cap rates, and this completely fails to recognise the variability of the jobs that we do and the various workload pressures we work under. It indicates that the Government feels that it can ‘fix’ market prices, and rather than valuing general practice, this could be viewed as yet another way in which general practice is devalued as a whole.
The Government needs to demonstrate a ‘real’ commitment to investment in general practice and nuture an environment of stability, rather than the current piecemeal fashion of imposed changes that we have to put up with. If/when that occurs then you will see recruitment go up, and the failure to retain GPs a problem of the past.
Link to BMA Calculator doesn't seem to work
Apologies Anonymous - will look into that broken link now
Practices should simply boycott this nonsense!
As a locum I will not be dictated to by the government... I will not drop my hourly rate. I have just passed the Canada licensing exam and will readily pursue over seas work. I am a very experienced GP and will happily move overseas if necessary.
I also will not be dictated to by government. ( Welsh Assembly in my case), as a retired GP of over 35 years experience , the practices are paying for an experienced GP who can run the whole show and doesn't need hand holding! I will stick to my daily rate.
Is the Government's action not a clear breach of anti-competition laws in the UK? What are the BMA doing on a legal front to protect their freelance, self-employed members as well as the practices and businesses or organisations they work for from Governments actions? The NHS and businesses that contract with it should not be held to financial ransom, that is for sure, but in the longer term the actions that stem from this change could cause serious difficulties in arranging appropriate resources for the services that need to be provided. My opinion is that Government realises this...
I checked back to confirm that I had correctly understood the legal advice we had received on this, and apparently a rate can be set because it is an 'indicative' rate. Certainly we have made our feelings clear on this matter, and the reporting is in the non-contractual part of the 2016/17 agreement. Vicky Weeks
we will not be dictated and humiliated in this way. The government forgets that middle-east would gladly welcome us and no TAX!!. Keep all your earnings and PERKS on top
How many more nails will this Government be hammering into the NHS's coffin? There seems to be a clear agenda to destroy the Service by attrition of its staff, so that when it further fails patients and collapses, it can be claimed there was no direct political cause for its demise. We owe it to ALL our patients to stand united and tell Government that enough is enough, not just on this matter, but the many that erode the quality and timeliness of services delivered. Not a week goes by now, without me seeing the failing service causing further morbidity, distress, or disadvantage to the people that I am trying to look after. Frankly this is just wrong, and not what we became Doctors to support or condone surely?
I am currently freelance, but neither in nor out of hours do I personally use the 'sellers market' to drive up rates. Neverthelss, govt hypocrisy grates. It is firmly capitalist, and for decades has extolled getting leaders of public services from the private sector, demanding pay far higher than historic levels (the SECoast AmbuanceSerice chief suspended over alleged fiddling of response times was on £160,000, although many examples are much higher). Somehow the only exception seems be frontline healthcare workers, working with much clearer risk, responsibility and accountability, who are expected to work for much less than both market rates and what their level of intelligence/qualificaton/responsibility would merit.
I would use the BMA calculator if I could access it
I'm a retired GP.... doing locums.. if the renumeration is too low then no problem... I'll call it a day... do not need to work but still feel I have some ting to contribute and indeed enjoy medicine. Remember within the fee for work is the mushrooming cost on indemnity.... at present 75 pound a day.... locums are considered high risk. Then there is the hours spent on appraisal / revalidation. Utter waste of time and of no value at all to those we look after in terms of reassurance on how we are performing. Then the fees to BMA, GMC etc. Finally there is no support for GP's let alone locums... and certainly no post grad education. You know.... perhaps its time to move on? John
For goodness sake, get a grip. There's no way I'll charge less that I decide because HMG might get upset about it. Market forces are currently heavily in favour of sessional GPs: they need us more than we need them. If anyone tells you you should charge less just walk away and work elsewhere,
It's hilarious, from the party of "supply and demand".
There was a similar out-cry over bank-nurses pay from the same hypocrites before.
Zero-hours, zero-security work comes at a price, however suitable for some.
I have been a locum for 14 years and a principal for 14 years before that. Like my Welsh colleague people leave their practice in my hands knowing that it will not be an absolute disaster when they return. Even though I moved from Yorkshire to Cumbria I am turning more work away than I can do. I was 55 in December and drew my pension before the BMA allowed it to be cut further.
I will not work for rates any lower than i am currently charging. The Cumbrian fells call every morning. I will quit.
The problem with the GPC is it keeps allowing this sort of thing to happen.
At the end of the day there will be no GPs locally when I get ill
I have worked recently as a Locum GP myself in several surgeries and was shocked to hear how one Locum GP bartered their hours of work to the highest bidder and seemed to enjoy seeing regular Surgery staff struggling to meet staffing needs and costs of employing a Locum. This sort of behaviour only serves to strengthen the Government's position and is utterly immoral. Pay should reflect work done / skills needed, not the desperation of regular staff to plug the gaps. https://www.garciniacambogiareviewed.co/brands/true-trim-forskolin/