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Ex-partners form bulk of locums' chambers, says locums chief

The majority of GPs joining medical chambers are partners who have decided to sell up, according to the chief of a locum organisation.

Dr Richard Fieldhouse, lead partner at Pallant Medical Chambers and chief executive of the National Association for Sessional GPs, told Pulse over half of new members at his chambers were GP partners who were quitting because they were ‘miserable’.

Speaking at the Pulse Live conference in London, Dr Fieldhouse said: ‘Over 50% of all the new GPs joining our chambers are currently partners.They’re resigning - leaving their partnerships to join chambers.’

‘This has been a phenomenon we’ve noticed over the past 18 months. It’s a big deal for them but they do it – they are now happy doctors but they were miserable.’

Speaking at a Pulse Live session, Dr Fieldhouse told delegates: ‘We asked members who were ex-partners, “are you happier as a GP now or before?”.’

‘They said they are happier working as a chambers locum than when they were working as a partner.’

Dr Fieldhouse said locum GPs will form a major part of the general practice workforce in future, but he stressed this would not be to the detriment of continuity of care.

He said locum GPs offer a counterbalance to some of the extra demand that can result from patients seeing the same GP, as well as bringing a valuable second opinion, or ‘pair of fresh eyes’ to a case.

Dr Fieldhouse said: ‘Doctors will see patients with chronic conditions, 50-80% of the time. But there are plenty of situations where you need the diversity and flexibility of freelance GPs, if they are organised well. We need symbiotic relationships between federations of practices and GPs working in chambers.’

Readers' comments (14)

  • It may not be detriment to patient care (though I'm afraid I disagree with that point as it will not provide the continuity of care) but it certainly will be detriment to affordability of primary care in Britain. You cannot have large part of work force commanding almost twice the income of the rest without affecting the whole market price of a GP.

    e.g. if a Locum costs £90/hour and is (say) 30% of work force and Partners/Salaried GPs costing £40/hour, average cost would be £55/hour.
    If a locum is (say) 5% of the work force at same price as above, average price of GP would be £42.50/hour. As the money spent for primary care is fairy static, more expensive GP cost/hour = less GPs in primary care!

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  • John Glasspool

    Another Good News Story. I am leaving and am 90% sure I will not be back, but locums are, in my experience, very good doctors, and I am grateful for them. When I am made aware that we have on in, I like to go and say "Hello" to him/her, tell them where I am in the building if they need help, check they are OK, tell them where the coffee is, etc. they are the future of GP as the service gently implodes. If the money is right, I might be tempted back, but it would need to be a very big "bung" indeed at current punitive tax rates.
    Mr (C) hunt take note!

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  • these are the blood sucking 'partners' who after ensuring a golden pension,ownership of practice property now want 'more'.they r too greedy for words

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  • Anonymous 3:34pm
    Locums dont cost £90/hr - its more like £70/hr in my part of the world. That has to include all their training cost, professional indemnity insurance etc and the work is highly variable and there is no guarantee of work - unlike a practice partner. Get your facts straight.
    Locums are the future of general practice the ways things are going. Their cost simply reflects a market - I feel for partners who are being shafted by the government and tax payers by proxy - however we are all the same profession and I think both you and Anonymous 7:28pm are falling into a trap blaming one another.
    In my view everyone should resign and become Locums - only then will the population at large realise our true value and wake up to how badly the Government has been treating us.

    Read the comments section after the article about 'seven GPs elected to the BMA' and the discussion about a ballot to resign from the NHS contract en mass. We should be doing this rather than attacking each other.

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  • 7:28pm Don't be so ridiculous!

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  • @7.28
    I find your comments outrageous.
    You are free to apply to chambers if you like.
    The facts are that the rate that applies is less than an agency locum and the doctor pays 10% of their earnings to the chambers for administration. There is no sick pay, maternity pay, guarantee of work or annual leave.
    However, there is flexibility, support for education and appraisal and more control over how you work. There is an opportunity to practice good quality medicine without the distractions of partnership, commissioning and management.
    Chambers are recognised by the defence organisations as demonstrating good practice by a reduction in fees of 10%.
    7.28..... I expect there are plenty of partnerships available to you at the moment. Your choice!

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  • to 3:34pm
    Can I also add that you seem aggrieved that locums might be earning more than partners..and yet as a partner I bet you employ a salaried GP - (If you don't most do) and I can guarantee that over the last 10 years you've earned significantly more than they did. How does that fit with your discomfort with a 'large part of work force commanding almost twice the income of the rest'...thats exactly what has been happening with the current partner/salaried GP model. Now the boot is on the other foot here you are bleating. You wouldn't get me taking a partnership for love nor money today - five years ago I might have done when I was working my back side off doing a partners job on a salary but I wasn't offered one because it didn't suit the finances of the partners I was with. We do need to stick together but there is so much about your posting that winds me up I couldnt let it go unchallenged

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  • Sorry guys, you clearly have no idea. Have a think on why many ex partners are becoming locums.

    1. Partners do not earn more then BMA salaried GPs do per hour. Yes, partners do earn more annually but that just reflects the amount of hours partner is working. Learn to read beyond the head lines - partner has a lot more expense (employer pension contribution alone costs 12k for me).

    2. Good on you if you can get a locum for £70/hr. I've not seen that kind of rate for a few years.

    3. No, I don't employ any salaried GP. In fact, when my partners were considering this, I showed them they will earn more per hour and all agreed we could not afford one.

    4. Majority of the partners do not earn the kind of money salaried GPs thinks a partner does. Only 2.5% of the partners earn around 250k/year. Do a bit of research and Google average income of a partners for last 10 years.

    5. As I've been a partner for only 4 years, I have not earned like some of the green eyed monsters thinks I do. Have you considered the possibilities that young partners exists?

    6. Reading your post, 3:34 I'd imagine the reason you were not offered a partnership reflects your ignorance of the position rather then just finance. Partnership job isn't just about clinical work (often that's the easiest party of Or job). Most viable partnerships I know have al ways look out for GPs who understands what it takes to run the practice, not purely based on finance out clinical skill. I've interviewed several frustrated salaried GPs like yourself who had been qualified for years but hasn't grasped the concept of business side of general practice and it was all too easy to see. You just can't offer a position to GPs who cannot add to the partnership. It doesn't mean you are not a good clinician though so please don't be too upset.

    7. We actively avoid locums to ensure continuity so I'm not really aggravated by locums. I do think current locum rate is unsustainable over long term and will eventually will have to adjust the rate or surgeries will not be able to afford them.

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  • I left my partnership because I was not prepared to continue to work 14 hours a day, flat out, without a break and go home worried about the things I had not done.
    I will earn less in chambers but have more control over my work.
    The choice is there.... Partner, salaried, locum, portfolio, chambers.... Exercise it to suit your own personal preference.

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  • 10:53am
    Google it and you get average salaried GP pay of around £71,000 full time - and average GP partner pay of around £105,000 full time - thats an average and its £30,000 different. Plenty of practices round me expect to pay £65/hr for their Locums - if you haven't seen £70/hr for several years then I suggest you get out more - apparently you don't use Locums anyway so what do you know?

    You've misread my post if you think I'm frustrated to get a partnership - I don't - partnerships are terrible these days - but 5-10 years ago you were raking it, if you weren't employing salaried GPs congratulations but plenty of you peers were. Drs go to medical school to train to be Drs - its the Doctoring bit thats worth all the money - you don't need a 5 year medical degree and years of post graduate training to administrate and manage - if you find it really so difficult and stressful maybe thats because you were never actually specifically trained to do it and its not really something you should be doing - leave that to the practice manager - they're probably better at it, find it less stressful and cost less.

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