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GPs go forth

GP practices forced to tell NHS England if they pay over 'maximum rate' for locums

GP practices will be given an 'indicative maximum rate' for locums, which will see them reporting any breaches to NHS England once a national rate is determined.

The scheme – which is to be introduced by NHS England against the wishes of GP leaders – will mean that GP practices will have to report their locum spend for the first time to the NHS.

It is unclear what this information will be used for and when it will be introduced, and there is no indication as to what the rate will be.

But a statement says that practices will have to 'record annually the number of instances where a practice pays a locum doctor more than an indicative maximum rate, as set out by NHS England.’

Although the measure is part of the 2016/17 GP contract deal, the GPC told Pulse it had not agreed to it, and it comes six weeks after a cap on spending on locum agency doctors and nurses was rolled out to hospitals in England.

NHS England has not detailed what will happen to practices breaching this maximum rate.

NHS Employer's guide to the new contract states: 'NHS England propose setting 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’.

But GPC chair Dr Chaand Nagpaul said NHS England had 'said they intend to do this unilaterally', despite concerns from the GPC, including 'how the rates will be comparable for locums who fill variable roles at different pay'.

He told Pulse: 'NHS England informed us they intend to do this. There’s no detail, we do not support it and we do not believe it us meaningful or possible. This is fraught with problems.'

He further stressed that the measure would not solve the real issue of 'making general practice more attractive so that dctors want to work as GPs in a permanent capacity'.

He said: 'That is the problem, and the other point is that locums are an extremely valuable resource that allows many practices to have flexibility.’

Meanwhile, National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse branded the scheme ‘a knee-jerk, cock-eyed, half-witted reaction’ that failed to understand the root cause of growing locum demand.

He told Pulse that locums, who are rising in numbers because GPs cannot cope with partnership, will continue to 'decide what rates they will charge' or leave general practice altogether.

He said: 'Over the last year, we’ve been recruiting partners when they hit a wall. They don’t want to be salaried GPs, that’s what they have been fighting against.

‘It’s another short-sighted exercise in control from the Government. They are not thinking about why there are 17,000 locums out there. It’s a knee-jerk, cock-eyed, half-witted reaction.

‘Our members decide what rates they will charge and it is very difficult to get them to put up their fees because they are nice people and they understand the pressure that practices are under. This is not going to work. I feel sorry for isolated locums.’

Please note this article was amended at 9:35 on Monday 22 February 2016 to reflect that there has been no indication when this scheme will be introduced.

Does capping locum pay work?

The left-field proposal comes six week's after a cap was set for hospitals in England for spending on locum agency staff, preventing them from paying locum nurses and doctors more than 55% than a permanent staff member would receive, in a bid to save £1bn per year.

It also comes on the same day that The Telegraph revealed nine out of ten hospitals have breached the spending cap on doctor and nurse agency staff to date (the paper's report said 194 (85%) out of 228 NHS are non-compliant, with 20,000 shifts a week being filled by locum staff).

With one one in ten training posts going unfilled last year and a third of GPs planning to retire in the next five years the Government will be fighting an uphill battle to make this target effective.

Amid the ongoing strain under which general practice is creaking, some locum agencies noted a 20% surge in members last year and a Pulse survey showed that just 6% of GP registrars want to take on partnership roles, while 49% intended to become locums.


Readers' comments (71)

  • we knew this would happen - the monitor guide though does not specify GP locum rates unless i've missed it. It mentions consultant and junior doctors. It will be interesting what rate they set bearing in mind our high defense fees. This may push those retired but locum GPs and OOH GPs to quit and totally destroy staffing in primary care.

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  • What is NHS England's maximum daily GP locum rate?

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  • please Chaand do us a favor and retire and let one of the juniors take over ?

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  • ".... and then they came for the locums, but still I did not speak"

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  • not sure how easy it is to enforce this.,

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  • Canute tried to stop the tide,the ancient name for Canute is Cnut an anagram of the health secretaries surname,didn't work then won't work now. Market forces dear boy

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  • It's really turning big brother now. We really need to fight the increasing Control NHS England is trying to exert. We need to be more independant.
    If they want locums to take on permenant jobs they need to reduce workload and stress

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  • It seems that GPs must inform NHS England if they pay a locum above some yet to be defined rate. So what will NHS England do about it? (SFA they can do I imagine.)

    GP partners pay for locums out their own pockets. Perhaps it has not occurred to Mr H that these partners might try and minimise these costs.

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  • Honestly, I dont't understand you dear colleagues. Why are you moaning so much. You know well that nothing will change. Its the end of NHS and GP. There will be no NHS left in the next 20-30 years and GPs will be extinct. If it's so bad , why don't you just leave and let this **nt bite his elbows. I have just applied for a post abroad and hope to leave ASAP.

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  • How is this allowed to happen?!!! Is the NHS becoming a nazi state!

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  • So if GPC haven't agreed to this, doesn't this constitute imposition just as much as the threatened imposition of the Junior Doctors contract?
    This sets a very dangerous precedent, as it gives NHSE a window to interfere in how a practice delivers the contract, what staff it employs and how much it pays them, i.e. the crack in the independent contractor status which may be subsequently wedged further and further open until all practices are merely delivery agencies of the DH.

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  • Yes our Government is becoming more like Nazi Germany or Stalinist Russia. This has happened since the end of the coalition government, now that the Tories have full control. We have another four years of this.

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  • But the silence from the labour politicians is also deafening! Bith as bad as each other.
    Every day now there seems to be another headline about more burdens for gps or doctors. The government are really serious about killing the NHS. They are working flat out to kill it before they are out of power now.

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  • They like market forces when it suits them and try to strangle them when it doesn't. The BMA are hopelessly outmanoeuvred.

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  • Was at a dinner party last night with an ex partner of one of the major accountancy/ management accountancy firms. Her suggestion for sorting out the junior doctors' dispute was to send the army in.
    No, I am not joking and no, she had not had too much wine!

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  • @10:54 I agree

    As a locum this is worrying. What next? Locums having to publish their rates?
    I will be making a complaint to the competition and markets authority as this is anti competitive and the nhs is a monopoly employer - but I don't think it will get anywhere.

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  • locums have been sacrificed at the altar as it was thought that new contract was a sweet deal .
    Time for fresh blood !

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  • First make life sh!t for partners and salaried GP's and then target Locums. Before the solution was to locum, migrate or retire. Now the only way is to migrate or retire. Pretty sad.

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  • Locum caps are very high for hospital consultants, around £1500 a day if I am not mistaken. The issue was with the £3500 a day some consultants were being paid. mind you it must have been that amount or patients died. Tories would rather have patients die than to pay over the odds. Tight b@stards.
    Having said all that, a £1000 /day cap would suit me just fine.

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  • Why is this information of any of their concern?

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