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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)

  • Bob Hodges

    Firstly, how will they know if you DON'T inform them?

    Secondly, a private provider would regard this information as 'commercial in confidence' surely.

    Anyone fancy some pro-bono legal work?

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  • Do we live in Stalinist Russia?
    This conservative government is using a state monopoly to destroy market forces in health care. Ironic. Is it even legal? Do they think they can control the market?? The law of unintended consequences will, with out doubt, exert itself = fewer GPs locums at a time of GP recruitment crisis, leading to ever increasing demand, and ever reducing supply. Fools

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  • If we stand together as a profession - and even more so if we stand with teachers and workers in social care - we have the power to bring this government down. The question is simply having the will and co-ordinating the profession. I'm up for the fight - who else is?

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  • It amazes me just how naive so many views expressed here are. Of cause governments control markets. That's what they do. Or try to do where they can. Ever heard of customs and taxes? They exist exactly to control market forces. And they control Partners income indirectly through practice funding. As they do all over the globe. The names of payment arrangements vary, but the gist is that doctors are paid roughly what societies expect us to be paid.
    You, locums, had an easy ride for few years. Walked away from any position of responsibility and in doing so lost any voice in any decision-making. So don't complain when decisions are made not in your favour and you haven't been consulted. It's your own freely made choices that got you here.
    Judging by the speed the "efficiency savings" are being introduced elsewhere, I predict another 12-24 months of locum bananza, after which you lot will be named and shamed. And when you disappear, no one will really notice.

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  • Took Early Retirement

    I am not clear how this info can be helpful; even to NHSE.

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  • What the GOV are doing is clear. They can't make salaried jobs and partnership attractive so their solution is to make locumming unattractive. @ssholes!

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  • I walked away from partnership after a decade to preserve my sanity. There is non-NHS, non-clinical work out there which will become increasingly attractive as indemnity rises and pension tax relief goes. If work as a salaried GP or partner was sustainable in the UK, I would do it. Having 70 patient contacts in a day, working 15 hour days, is unsafe for patients and a risk for mental ill-health in GPs. Along with junior doctor contract imposition, this will do nothing for increasing GP trainee numbers.

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  • This is the works of one character - Mr Hunt whose manipulative activities- along with his type of politics and ideology is the end of the NHS as we know. This will be very slow but inevitable painful transition to part-to full privatisation of GP practices/Hospitals with us workers bearing the pain. At the moment the poor juniors are in the middle of it and for BMA it will get guts/determination to fight this man. Watch this space.

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  • Sessional/Locum GP - 21 Feb 2016 1:53am

    And don't forget IR35. As a locum pharmacist who was targeted as I was deemed to be working as an employee rather than a locum (even though I worked in three pharmacies), I think they will attack locums even more.

    This in turn will give them even greater control over the workforce.

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  • The way things are going, only a fool would become a doctor. The Goodies are ready to fill the void as shown here. The Goodies become doctors in the National Health Service; their methods of curing the nations ills causes conflict with the minister of health

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