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Long-term locums cost practices £100k

The GP recruitment crisis is increasingly forcing practices to employ locums on long-term contracts at a cost of up to £100,000 a year, a Pulse

investigation has found.

Practices bringing in a locum GP to do regular

sessions are also facing further reductions in income of up to £25,000 through lost GMS grants and allowances.

But the GPs feel they have no option because recruiting a new partner has proved virtually impossible and their practice cannot cope with demand and offer any continuity to staff or patients otherwise.

The scale of the recruitment problem was revealed in Department of Health statistics released last month.

More than 100 practices have had vacancies for partners for more than a year, double the figure for the previous year. The total number of unfilled vacancies also doubled.

The department this month introduced payments of up to £12,000 for locums who return to partnerships or salaried GP roles in an effort to stem the crisis. But with such strong demand for their time and a variety of short- and long-term work available, the scheme looks set to have little effect.

David Barr, Kent LMC clerk, said GPs at a practice in the county which has been unable to recruit for over a year have had to take a £10,000 pay cut because of the costs of employing a long-term locum.

As well as paying the locum rates, practices with long-term cover rather than a partner cannot claim the basic practice allowance, out-of-hours allowance, seniority payment, and postgraduate educational allowance. They may also lose out if the locum is not on child health surveillance or minor ops lists.

'What you can no longer get adds up to £20,000-£25,000 over a year,' said Mr Barr. 'Locums are costing up to £200 a session around here. You can end up spending the best part of £100,000 a year ­ and you then lose £25,000 of practice income. The economics of doing it are horrendous.'

Primary care organisations in Gwent, south Wales, and Newcastle-upon-Tyne, both GP recruitment blackspots, are directly funding long-term locums in practices. Kathryn Duggan of Newcastle PCT said the trust employed several locums to fill in at practices that were operating one or more partners down.

Gwent health authority is paying for cover in five formerly singlehanded practices. A spokeswoman said locums were asking for almost double the suggested BMA rate because of the demand. 'They can pretty much name their price,' she said.

However, GPC non-principals sub-committee chair Dr Victoria Weeks said there are drawbacks for locums if they take long-term contracts.

The Inland Revenue may view the locum as employed, denying them the tax benefits of self-employment. The NHS Pensions Agency may also not class the GP as a locum, which could mean they cannot make pension contributions on other locum income.

Long-term locums are also unlikely to get employment benefits or access to postgraduate education.

Locums also cost practices £25,000 a year through lost GMS grants and allowances~

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