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GP locum notional pay cap set at £80 per hour, says GPC

NHS England has set its ‘indicative rate’ for locums at £80 per hour, as it presses ahead with plans to force practices to report every time they pay over this rate, the GPC has learned.

The chair of GPC’s sessional GP committee, Dr Zoe Norris, said that practices will be asked to submit a mandatory report on how much they have paid locums over the months of July, August and September 2016 ‘in the coming weeks’.

The mandatory report will ask ‘how many times in this period did you pay more than the indicative rate per hour to a locum?’.

Filling it out is compulsory for practices, having been written into the GP contract against the GPC’s wishes earlier this year.

The new national indicative rate of £80.01 has been calculated by NHS England based on the ‘average salaried GP pay range’ though the precise workings are unclear.

NHS England intends to use this information to map out areas of high locum demand, or areas where locums are particularly needed.

Dr Norris said: ‘The next few weeks will see practices being asked to submit data on how much they have paid locums.’

She said that this is part of practice’s ‘mandatory e-reporting’ so practices are contractually obliged to complete it, but stressed that ’it should have no impact on what rate is agreed between locums and practices.T

She said: ’This is not a cap. It is a data collection exercise. It’s important we are clear about that.’

In a blog on the BMA website, she added: ’You’ll forgive my cynicism about what happens next, and how this information gives us any more detailed information compared to what we already have. Needless to say, we will be at the table with NHSE looking at these figures and results.

’We will be reminding them what a significant part of the workforce sessional doctors are, and that in the current precarious position of the NHS, they would do well to remember this.’

The GMS contract for 2016/17 introduced the requirement 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.’

But GPC chair Dr Chaand Nagpaul told Pulse at the time that the clause had been ‘imposed unilaterally’ by NHS England and stressed there is no requirement for practices to set rates at the cap.

And at the Pulse Live conference in London this year Dr Nagpaul urged practices not to take any notice of the ‘indicative rate’, saying we need to ‘just challenge it head-on, and not be affected by anything that is not contractual.’

Pulse has asked NHS England for a comment.

Readers' comments (98)

  • What does the Competition and Markets Authority have to say about capping rates unilaterally? What rights do NHSE have to impose an indicative rate if it is only after information on where locums are needed. The practices are the ones paying so unless NHSE are planning to pay the backfill is it really any of their business?

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  • And what if anything can they do about rates above this?

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  • This open market economy will cripple NHS because of locum GPs and hospital doctors greed. Freshly qualified GPs with little experience are asking for ridiculous rates which range from £85 to £105 per hour + pensions + indemnity. These rates and many salaried rates being asked are unsustainable. A large number of newly qualified GPs go down locum or sessional GP routes and one such GP boasted that he makes £150K by being part-time locum. Both the profession and NHS needs to control this unrestricted rise in GP costs. This can be done by capping NHS pensions contributions to a maximum rate such as £80/hour and restricting locum work for newly qualified GPs to a maximum of 3 months per year. Locums are necessary for essential holidays or sick cover but the long term locums do not bring any continuity of care, improvement or innovation to health care.

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  • I increased my hourly rate to £80 last month. I will have to increase it further in subsequent years to cover the rapidly rising cost of medical indemnity and inflation.

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  • Restricting newly qualified GP's to little/no locum work is depriving them of some valuable experience. All will be used to nice training practices, and it can be a major eye opener. It'll also reduce the locum pool, not a good idea

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  • After indemnity, pension deduction, costs in sometimes travelling long distances to a practice etc I know plumbers, tree fellers and roofers who earn much more per hour.

    I have work booked for next 2 months and if practices don't intend to honour my rate or reduce my rate to £80/ hour I will tell them cancel the booking then. Plenty of work for me above that rate which agencies have guaranteed even after this "cap". Supply and demand.

    Please remember if a locum takes 2 weeks holiday or goes of sick unlike salaried GPs and partners their pay is £0 per hour. We factor this into our rates.

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  • I response to practice manager whom labelled locum GP as greedy . Do you not take any better pay? Do you think you are in the position to judge newly qualified GP ?? Do you not know that they are many newly qualified GPs whom worked in other fields eg A&E for yrs ?? Your comment is an insult ! Btw, you don't have hire locum GP if the surgery you are working has enough GP.

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  • WHY DON'T THEY CAP MDU/MPS FEE. THAT IS WHAT DETERMINES HOURLY RATES. I EXPECT THIS TO BE AS USEFUL EXERCISE AS RECORDING NAMED GP FOR PRACTICE. IT DID NOTHING.THIS IS NOT CAP SO FEEL FREE TO LET THEM KNOW IF YOU PAY OVER £80.YOU MAY HAVE NO CHOICE AS THERE IS SHORTAGE OF LOCUM ALL OVER THE COUNTRY.

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  • You cannot fix the market.The powers that be have to increase the supply of GPs to push down the price otherwise __THIS WILL NOT WORK!

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  • If the position of being a partner was made more attractive this problem would not arise .

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  • I charge a bit more than £80 an hour and will not be reducing it either.I have worked booked for the next 6 months. I think that this is a fair rate as I am an experienced GP and bring numerous extra skills which I have studied hard for and some of which have ongoing costs. I do not ask for indemnity on top of this and am not aware of any locums that do, however I factor this expense and other expenses into my rates and will continue to do so. I have plenty of strings to my bow and can also find other work if I feel that locum rates are going to reduce. I would not increase my rate however purely down to being a scarce resource.

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  • Alan Ferris

    The man who fixes my dishwasher charges more than that. and doesn't have to pay eye-wateringly high indemnity fees.

    We are all doomed

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  • We are having to pay upwards of £100 an hour plus superan then additional for admin and home visits etc in Liverpool where Locums are very competitive due to the high demand for them, I will be very happy to submit our Locum costs for those months to NHS England if it results in something being done to help general practice and isn't just another hoop they expect us to jump through!

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  • I charge £85 an hour + pension and I won't reduce it for all the tea in China. Factored in is my effective 60% tax rate. If I reduced it I may as well be a baby sitter I would earn more.

    Also to previous PM I bet you couldn't employ even a desperate locum with your horrible attitude.

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  • So what happens to practices who do not submit the mandatory reports? Write 50 lines "I must not overpay my locums" or go to detention?

    £80 per hour for high risk, front line work with no income at times of absence and higher indemnity costs, is a total insult and I can't believe anyone in the profession can endorse this.

    Non front line works pays as much, if not more than this, yet doesn't carry the indemnity issues and usually has employment benefits attached.

    Just because Partners are being screwed over, don't let this be an excuse to screw locums.

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  • The GPC have also agreed that Locums are entititled to utilise any Stethescope colour, as long as it is grey.

    The new GMS contract stipulates that practices are obliged to report any Locum with a stethescope other than Grey.

    This is not a law against non-grey stethoscopes, but merely to allow the department to health to collect data about how many GPs will be targeted for spot Revalidation MCQs.

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  • gp's income goes down, locum cost goes up, indemnity cost reaching sky. who are these people to ask for locum rate. if it is higher than 80/hour so what? what are they going to do. cover the shortfall?? some idiotic exercise.

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  • I cannot see what business it is of NHSE.
    The rate paid comes out of the partnership earnings so if the locum is paid more the partners take home less and that is their own business.
    There is no extra cost to the NHS.
    Yet again the powers that be are "fiddling while Rome burns" in the continuing delusion that micromanagement will cure the ills of the NHS.
    Without locums many practices would simply be unable to provide contracted services.
    I will not reduce my rate especially while some Trusts give payoffs of huge sums to incompetent senior managers on the grounds that they are legally obliged to do so!

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  • 'having been written into the GP contract against the GPC’s wishes earlier this year.'

    what is the point of the GPC again ?

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  • let then know cost of locum as it is. see what happens. i presume nothing will happen . majority are paying over £80 per hours. paying mdu appraisal, petrol, car . telephonr, cpd event, bmj fee then 40% tax, not much left. people like me will stop working soon

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  • To The practice manager at 5:44 pm ....Highly unprofessional calling sessional GP and hospital doctors greedy . We work hard and have to cover the indemnity , travel , business expense , taxes with no sick leave etc ourself .
    Btw practice manager does not pay locums and he/she also gets paid by practice . How about they have their pay cut too if they can't cover their own GP annual leaves/ shortages .I bet he / she is just jealous of the fact they can't earn higher than a locum .

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  • Newly qualified GP's are not seeing any fewer patients compared to more experienced GP's. Why should pay for this group be lower?

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  • This is great news! As a GPST3 doing 50+ hr weeks this will end the NHS quickly which will put a proper end to the Uks insatiable appiteite for more more more!
    Well no more. I'm out.

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  • Jeremy is frustrated that the rate of practice closures have not been fast enough due to locums. Get rid of locums and the road to privitisation is shorter! Simples!

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  • i've two choices - go on the dole and let the state look after me or work in the private sector.

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  • Re: "Newly qualified GP's are not seeing any fewer patients compared to more experienced GP's. Why should pay for this group be lower?"
    (1) Pay per session for locums works out as MORE than we get as partners in our practice.
    (2) Compared with partners, locums generally see a lot of quick and easy stuff and advise patients with complex problems to return to see a partner, which IS often perfectly reasonable and sensible. In addition, locums do not have all the administration/results/forms/letters that are almost 50% of our workload.
    I regard locums as mainly an expensive quick fix solution to patient demand for appointments.
    These comments apply less to long-term locums and we have had some excellent short-term locums.
    (3) Where will locums work once all the practices have closed? Perhaps for £50/hour in government-run clinics? Being a partner needs to be made more attractive, but doubt if that is possible?

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  • THE GOVERNMENT FOUND NO WHERE TO TARGET TO SAVE MONEY BUT POINTING ALL THE TIME TO NHS. MPs SALARIES , INFLATION, COST OF LIVING ETC ALL RISING, WHEN COMES TO NHS THEN JUNIOR DOCTORS, CAPPING RATE AND SO... ALL DOWN );
    WHY?
    PLZ DON'T SELL YOURSELVES CHEAP

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  • GP's are leaving practices in significant numbers threatening sustainability of primary care. Locums have an unfair expectation that they should be paid the same as their colleagues commited to the sustainability of practices in the bigger picture when they have less than half the work load of a salaried or partners. It would be delusional to ignore the widespread belief that locum = more pay with less responsibility and paper work, but in the current system it's actually true.

    I'm all for capping. Pay scales need to be fair if you want less work load, then you have to accept to be paid less. I work as a GP partner and work 8-6:30pm, see on average 16-18 patients, do 30 telecons in a 3.5hr session with on average 50-60letters to review 30 path results to action 50scripts to sign 1-2 home visits a day, support my nurses/staff, write reports (child protection, medicals etc) and oversea various projects in the practice, I could really go on. The point I'd like to make is how does a locum's pay of £80/hr compare. Personally even £80/hr I think is generous when you consider my hourly rate is definitely much lower.

    Locuming these days is escapism, from the many more pressures the rest of us are facing in the NHS. Many practices are facing recruitment crisis & over whelming work load. Capping would be a start to encourage more to return to practices to lessen the workload & ensure the sustainability of primary care. Why should primary care be any different secondary care, who already face capping. I welcome equality and fairness.

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  • In other unrelated news the fixed markets of Venezuela have failed and citizens are being forced to work in food production.

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  • I have been a locum now for 18 months and have always charged £80/hour plus pension. Having read the comments above this seems to be the lowest going rate.
    Some of the comments inferring locum GPs have easier patients are ridiculous. Practices make sure they get their money's worth and more.
    Home visits can take a lot of time and I have noticed some locums decline this part of the job as the rate does not justify the effort.

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  • I charge per day for a fixed number of consultations and visits, so don't know how the practices I work for are going to translate this into an hourly rate. They could divide it by the average hours worked per day by their partners, which would make me look mega-cheap...

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  • GP Registrar 9.52pm
    When you have been doing this work for 25 years you may well wish for "escapism" for £80/hour!

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  • As a gp registrar I'm finding this all quite hilarious. Imagine a lawyer being told his wage was going to be capped. He'd laugh his head off. It's yet another reason for me to work abroad where I'll get paid more and in return get a better quality of life. The NHS is not sustainable and capping locums wages is the last of their problems as it will only lead to more shortages. Wake up people, you are taking on such high risk and responsibility these days that you deserve a high wage. Or do you think a league one average football player who merely kicks a freaking ball around on a pitch deserves more money that you?

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  • 10 years ago when the sole partner had to take sick leave I had pay £80 per hour and got reimbursement of on £1000 for whole week.
    I needed at least 30 hr per week.There was no help from Lmc which she had paid for years.After 6 monts of illness that was then reduced even further to £500 per week.She had given 27 years of service as G.P.First 10 years as sham parter ship, where GP parter took an parter to get the extra funding to have parter ships of 3 or more doctors.Only this extra money was paid to the practice was paid to junior parter.BMA actually provided watertight contract so if you leave a partnership you could not join any practice within one or two miles of the practice and the list you had built up if you allowed, had to be transferred to senior patner.Some had more then 10 serfs before every one knew in GP vocational team and the poor chap had retire to lack interest from new junior and he had already lost habit of working.Having been fed on reach diet of Q.O.F,various incentive schemes,CCG management fees, Fees to seat in meeting, now the cost of locus, which now exceed income from those fees.The reason why Gov wants data is they pay your locus for maternity,sickness, for sitting in meeting worming the chair.And your leaders are demanding more reimbursement.So NHS want evidence.And you are going to provide the evidence so that they can warm the sits in FED, CCG, other thousands of committees
    where they are trying to do trained managers or financial managers jobs.If you ask a manger operate, what is the result yet you expect theGP who cannot run his own practice to buy services for whole borough.then you blame private organisations to take advantage.Lift building which cost 7/8 time compared to what it costed in your old surgeries rent.You were very happy ably questioned it when recently they asked you for service charged which was 10 times old cost. Then the white elephant of P.F.I.
    Where were those LMC members or CCG members.
    It is still not too late.Repent and you will be ok.Like my boss all youhave to retire and make room.Donot worry future will take care of it self.World is not comiming to end.Any party that allow NHS to die will never come back to rule the country.

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  • I'm a GP partner. My take home pay, from which I pay tax, equates to £18 per hour. My basic workload as a 7 session GP over the last year has resulted in me working 60 hours per week 45 weeks per year. I work up to 75 hours per week when we can't get or can't afford locum cover. That reduces my hourly rate to about £15 per hour. I care about my patients and my practice so I won't be leaving and becoming a locum but it seems bizarre to me that hard work and commitment are remunerated so poorly.

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  • First let me apologies to locums it is converting word locum to locus as it is american programme and they do not have such work ,they call them contract workers.Secondly to the GP patner who is working so hard to give service to his or her patients.YOU have family to look after.My wife got blind, did not look after herself,
    worked in surgery up tp 3pm and then quick bite and back afternoon surgery.Could get a nurse so did all child imm herself.
    Retinopathy took her eyes and irony is BMA,LMC PCT no body helped .MDU was the only organisation who refunded the subscription when she was sick.GMC even had an audacity to remove her name for non payment of subs, which she had paid and when she voluntarily asked for her name to be removed they wanted PCT sign that she had no complaints pending and when the PCT chief refused as she had no mandate.Meanwhile GMC refused to transfer name to the retirement list and more than 60 years.
    She is 69 this and still on GMC list as removed from list for administration reasons euphemism for non payment of fees during retirement.So my advice please first find out why such low take home pay per hr.I have just retired having worked in NHS for 25 years , but will not accept any assignment for less than £50 per hr.If you do not respect your self, nobody will not even your patients.

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  • £80/hour is £228,800 pa which is more than double GP partner pay who have all the expenses listed by the locums you have replied. Sorry guys, we just can't afford you.

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  • First the tax man introduced tax on dividends thereby negating any tax advantage of Ltd co and doing locum. Then I got my MDU quote for 50% more in one year, I made one simple decision. I am not going to work harder and harder to pay for someone else - taxman/MDU. Just started work in Canada. It took me 6 months to do the paperwork and start work in a big city in Ontario. No exams to start work. But one needs to do 2 exams within 3 years of landing to get full registration and stay here permanently.

    Now the UK Govt want to cap rates for locum !!!
    No other reason to collect data - they did this first for hospital locums - collecting info and then capped the rates - played consultants vs locum well.
    They are planning to play partners vs GP locums - They will tell partners - if all of you partners agree to a cap where will GP locums go to work - we are making it mandatory. This would greatly help in reducing cost of running the business now for you partners and in future for the private sector. This one thing might even make NHS more saleable. Just my thoughts.

    If any young doctor still staying put in UK hoping things will improve ........??????????????????!!!!!!!!!!!!!!!!!!!!!

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  • Ha ha hilarious what is this country North Korea?
    Ive never charged more than 80 plus pension TBH and often less as full day with visits is 10 hours which equates to 800 quid so i usually knock a bit off if if gets near that.
    The problrm is we doctors feel we should be well paid after all the work at school med school and training and we see people earning a lot more with less stress including doctors abroad. Conversely the Btitish public and politicians feel we should be on a modest wage. Im not sure why.
    Point is 80ph is ok if u stipulate minimum hours and charge for all ur time not just the booked appointment time.
    The bigger problem is partners and saleried are underpaid, often tertibly as the commenter above said he earned £15 an hour as partner. It was similar for me.

    They use jealousy to encourage some to go along with further micromanagement and over regulation. Further state control. Very communist/orwellian.
    I think ill put my fee up lol

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  • Come on... No need to worry. What happened to hospital cap. 82 %hospitals broke it.
    Do we have to give a rats a... About these government initiative.
    The crunch hasn't yet started, i know personally 15 gps leaving to Australia this January. I would love to see how it works especially our local ooh service which pays 55 per hr.
    Every practice has to break it almost. Easiest way is ask gps to charge per session or day or number of patients and don't divide by hrs.

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  • I can sympathise with all sides here. As a salaried GP doing 8 sessions, I was taking home £3k a month after indemnity and living in Surrey and thus fairly broke after racking up £40k debt doing a 4-year med course in my 30's.

    I have a regular post now and do occasional locums. I charge £500 a day inc pension. I'm just in the top tax bracket. After pension and MPS I get less than £150 in hand. Not worth doing it. There's only one loser in all this - the patients. Comes back to the old bottom line - make conditions reasonable and pay a reasonable rate.

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  • "Freshly qualified GPs with little experience are asking for ridiculous rates which range from £85 to £105 per hour + pensions + indemnity"

    As a newly qualified solicitor my son's time was billed at £150/hour by his firm. Sounds about right to me for a freshly qulaified GP.

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  • As a salaried who does the occasional locum, I charge per session rather than per hour. I put a cap on the number of patients I will see, and all practices are happy with my sessional rate + pension. I think the hourly rate they are asking for is nonsense. Some locums will see patients every ten minutes flat out whereas I like a few gaps to space my patients out, hence the sessional rather than hourly rate. This gives me a time buffer as every practice operates differently, especially with referrals in different areas, and makes it much safer too as I feel I have more time with the patients having never met any of them before. I rarely pass on problems to other GPs as I feel we can sort complex as well as simple problems most of the time. The only thing I won't do is medical reports. If I'm working more than one session in a place I also fit coils and implants for the practice I'm with (having needing to counsel a patient first). I've had patient compliment letters from working locum shifts so we are a hard working, helpful and useful part of the team. If I divided my sessional rate by hours, it seems I am pretty cheap, I charge absolutely nowhere near the £800 a day someone else claims but perhaps they see almost double the workload I do! I am looking for the right partnership, but am taking my time, locuming gives that valuable insight into how a practice operates and treats its staff so I'm glad I'm doing it.

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  • NHSE has no right to regulate rates for locums. They are neither employers nor contractors for locums. This is a supply and demand issue. If you want to put restrictions on locum pay, why don't you pay their indemnity and also contribute to their holidays.
    It's as if you could give power to a statutory body to regulate fees of plumbers and electricians or any other self employed contractor who runs a similar limited liability companies. Absolute nonsense and just reflects how out of touch with reality NHSE Managers are.

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  • I got my MDDUS subscription renewal the other day. GP cover has increased by just over 17%. This has prompted me to put my rates up by 2%. I still think I'm pretty good value at £450/day for 30 consultations but I don't do visits or others' admin. I provide a degree of continuity of care and certainly don't see just straightforward patients.
    To be honest I'd prefer a salaried post but can't find one with acceptable terms/conditions. Having been a partner for 12 years and imploded I don't want to go back there.
    GPC completely missing the point and ineffectual as ever.
    RCGP and BMA fees total waste of money.

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  • BTW, locum agency rates fluctuate from £90 upwards. Those employing locums directly have to pay a min of £75 and add NHSP contribution which takes it to above the rate set by NHSE.
    For those employing locums directly even if they are Limited companies - they do need to have a Contract in place which takes care of liability for NHSP and prevents a relation of employee- employer coming into force for long term locums.

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  • Setting a rate at £80 as indicative may be a way of capping the help Practices can get to employ locums and to be honest, in this case it would be reasonably set.

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  • NHS England does not realise how important are locums to practices who struggle to recruit doctors. I know quite a few practices who rely on locums to cope with ever increasing patient demand. NHS dictate does not serve any purpose as locum fees are not reimbursed by them

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  • Just paid £300 to have my AGA serviced and a minor repair. Took engineer less than 2 hours. I don't think the £100/hr I charge is excessive for a GP with over 30 yrs experience and I pay my own MPS fees.

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  • Are such potentially restrictive business practices seen in other professions?

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