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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)

  • Don not worry. No pay no work

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  • Anonymous @21Feb08:31 is spot on.We are public sector workers.Our ultimate employer is the government (of whatever hue).If you don't like it, try the private sector.
    The locum cap is an idiocy given that,as an earlier post pointed out, we pay for locums out of our pocket.Forget the vacuous drivel about "evil Tory plot",this is simply some NHSE apparatchik who fails to understand how General Practice works.

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  • Surely this is a form of racketeering/price fixing? If I was a locum, I'd get enough locums to form a non BMa group and mount legal challenge to the government.

    We try not to use locums as it is poor value for money. We know average GMS partner earns around £40/hr (before tax, employee pension and expenditures but minus employer pension and locum insurance to make it comparable). Locum earns about £90/hr. I appreciate locums don't get annual leave.

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  • Agency staff cap (including Drs) has been implemented in Acutes. The max agency rate is 55% above the basic equivalent perm staff rate (eg excl pension, hols, sickness etc). I'd assume something similar in GP world.

    So this 55% 'premium' has to cover:
    - Hols
    - Pension
    - Sickness
    - Agency fees
    - Travel and accommodation
    - Professional fees
    - Training and development
    - Risk of being out of work

    start the car...

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  • Why?? If you are a stressed out small practice and need a locum and the only locum decides to charge twice the average rate, surely that's market forces?
    You can decide to pay, which will obviously have a knock on effect with your profits and ultimately pension, or not get a locum.
    What has it got to do with HMG?

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  • Market forces and the control of is simple when it comes to employees that are tied down to their jobs ( for one reason or another ). When it comes to medics, push us hard enough and suddenly those bonds break. Stupid Tories, oh they are in for a nasty surprise.

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  • About time for a GP strike don't you think folks?

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  • mind you, I just did a rough calculations on how much a salaried GP on BMA model will earn/day based on 9k/sessionand actual days worked (no indemnity cover included)

    It's £550/day

    Still less then a locum who earn around £700 for a full day's work but not off 55% limit mentioned about. Much more expensive then a partner.....

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  • Jeremy Hunt is a control freak who could not cope working the hours that GPs and Junior Doctors work. i qualified in the 70,s and it was bad then for doctors hours -my son is doing a hospital GP rotation in Obs & Gynae. he has had no training in suturing, normal deliveries- all he does is run rounfad from ward to ward and has no time for training in the job- the words `'training post``' is a joke

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  • Not sure this story is even feasible. We are independent contractors - how can they even demand to see our books? Surely this is private information between a surgery and their accountant

    But I do agree with some of the comments that this is a plan to squeeze people into salaried positions and then impose 7/7 working.

    The reality is most people will just leave the profession

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