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Dr Grant Ingrams: Why we stopped using locums

Dr Grant Ingrams on why his practice has stopped using locums routinely in his practice to cut costs

We stopped using locums last year to save on costs. It is a combination: the cost of locums is going up as practice income goes down. You think: ‘Well where can you save money?’

There are two of us here, and what we are basically doing is that when one is off the other one is covering. So we do more time ourselves and employ fewer locums.

That is mainly on financial grounds but, without upsetting some of my locum colleagues, it is also on quality grounds. Because obviously if you only go into a practice occasionally, you don’t really know how that practice runs and how they like to do things. We are able to have more control if it is only the partners running it.

It is actually more about the practice income going down. Like every practice we have seen how general expenses are increasing and income, through the contract, is going down and that just puts a squeeze on all costs and you look around and say: ‘What can we save?’

We actually booked a locum for this Thursday morning, but that was the first time we have employed one for over a year. Occasional needs must and we book a locum for a session but otherwise we have just been more coordinated in-house to make sure that we can cover each other.

Dr Grant Ingrams is a GP in Coventry

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Readers' comments (13)

  • Hazel Drury

    Same here. Can hardly ever afford to use locums - which is a pisser when you're single handed :-(

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  • Will all those GPs threatening to retire early increase
    supply in the loum market in the near future?

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  • 2 points-
    1) Its two way traffic - Some of the " quality" from partners is not always what it should be- " those in lass houses" comes to mind !
    2) Partners profits are sacrosanct !
    I have noticed that a lot of partners only do 7-8 clinical sessions a week- with a day off - They wouldnt get away with this in the private sector. Also a pension thrown in aswell.As a Locum I work 10 sessions a week for 44 weeks of the year - and still do not earn as much as most partners- They have still got it quite good !

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  • Sorry " Glass houses "

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  • Eight clinical sessions in a week is enough to qualify as a full time week when you are a partner. These equate to four 11 hours days.

    On top of that you will have all the other things a partner will have to deal with which will easily fill two admin sessions.

    Eight sessions a week is certainly not slacking. Our newest recruit, male and in his 30s has done it for a year. He is now considering reducing his sessions to be 3/4 time. Even youngsters are getting burnt out .

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  • Not these old chestnuts ! This is part of the problem- cramming in 11-12 hour days instead of a more steady approach- GPs can tend to bring on burn out theirselves cranning their work and h poorly arranged systems.Reliance on telephone consultations instead of proper eye to eye contact medicine- etc etc etc.QOF QOF QOF etc etc etc.

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  • In answer to Anonymous at 2:33

    I would love to stop concentrating on QOF but it pays for the practice expenses, so we have no choice but to carry on.

    In addition to the four days of consulting the 5th day is used to catch up and do the administrative tasks of running the practice. As full time GPs are working 50 hours a week I cannot see how we can have a more ‘steady approach’ . Perhaps you think we should spread the work over 7 days instead of 5 ? And never see our families.

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  • For the locum that works ten sessions a week for 44 weeks of the year. Our locums charge 550 pounds per day so that's 121,000 which is actually more that I earn and much less hours involved. If we all packet it in and took on locum positions who would pay us and run the practices.

    I would love to cut our locum usage as feel that it's also more difficult for them to manage chronic diseases. Unfortunately we have had two retirements and no new doctors in the area so no one applied for the position.

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