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A faulty production line

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)

  • i meant to say respectively face to face encounters and telephone encounters........

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  • Secure environments GP

    Zishan - this question has been posed and analysed by greater minds than me. An amount that makes you confident you are offering safe care and protecting your own welfare. A partner once bragged to be that he did 90 triage calls one morning. Ask him the same question. Frankly, the GMC should start offering guidance on this too. If you make a mistake, did you follow GMC guidance, NICE and other evidenced based guidance? Try making a medico-legal defence of lack of time to complete a reasonable clinical assessment and plan... it won't wash. I know roughly the workload rate that feels safe for me, no practice has ever complained on the rare occasions I've said I need a break slot or a fixed surgery length rather than an open ended one! Locums are not always there the next day to clear up loose ends or defer referral admin from the day before.

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  • Seems from above comments NHSE have already achieved what they wanted to do all along. Divide GPs even further and set partner against locum , part time vs full time. Now let's negotiate the new contract!

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  • Silly, bitter comments from "allied healthcare professionals" above - a locum GP's work is a little bit different to yours.

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  • Supply and demand is the name of the game in any free society except in communist setup. How come no one complains of plumbers gas engineers and many other in the society who charge much more per hour. This is hypocrisy of the highest order.
    The whole NHS needs fixing and not just bits and pieces. The locum doctors are doing it right as the alternative to this to work as salaried or as a partner in the GP is currently unfavourable. Fix the general practice and more doctors would be happy to work regular jobs.

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  • Locum GPs must stand together against this nonsense. With the pound now losing almost 15% of its value since Brexit is it even worth working with all the stress and litigation risk....Locums should come together and define the minimum hourly rate they will be working for nationally....if a practice is not willing to pay the minimum.....locums should abstain from that practice....rather than taking £ 80/hr as the cap rate....we should accept this as a benchmark for our minimum hourly wage as a locum GP set at the courtesy of NHS England.

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  • This has been added into the contract to cause disharmony between colleagues so please everyone don't take the bait. A cap in general practice for locums is not enforceable unless practices or federations collude together. As a partner I feel a rate of £85-£100 per hour is probably fair for the training and expertise for a gp and maybe even a bit undervalued. I have had some excellent Locum colleagues I have contracted and happy to pay the above rates. There have however been some very poor Locum colleagues who see the work as a stop gap till the usual gp can see the patient, do a battery of unnecessary investigations and never address the clinical problem which considering the pay is unfair. I feel for my salaried colleagues who also do amazing work and are undervalued financially. As a partner I would like to reward them appropriately (my thoughts are that a salaried gp working 40 hours a week should be worth £100k pensions,indemnity and on costs). Partner are worth more considering the risk,responsibilities and open ended nature of the work. However with the disinvestment in general practice I cant reward them appropriately as Im firefighting daily. It's a sad state of affairs. This country does not attach any value to skills,qualifications, training and experience and for that matter to any service whixh does not generate money. It promotes entrepreneurship from blaggers who take advantage of staff and employees. This is not going to change. As for general practice and the NHS,there is a central agenda to make it unworkable and as sad as it will be as the principle of the NHS is a great one, the future lies in private practice. Unfortunately we are too institutionalised to make that change at the moment. The change will also have political barriers with attempts by the GMC, CQC and our own BMA and RCGP to stop the exodus and keep doctors enslaved to the NHS. But sooner or later, all doctors will have to make the choice in order to get back self respect.

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  • Have to agree with 2:39 above. We're quibbling at the level of symptoms and ignoring the underlying pathology - which is the unsustainability of the NHS funding model. Regrettable but incontrovertible.
    It's all about column inches. The more airtime devoted to noisy symptoms, the less to the underlying pathology - which is exactly what I'd be targeted on if I was the SoS for Health.

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  • @ 2:39

    I would make a couple of points.

    The total cost of a locum paid at £80 p/h is more than the figures you give above.

    A locum working that 40hr week (like a FT salaried or Partner is likely to) when pension contributions are added (takes it to about £90.30p/h) gives them an annual total of over £162k a year (45 wks/yr). That is more than almost every partner I know earns. Partners will also have all the additional responsibility you mention.

    Also General Practice is already private practice, it just happens that the majority of practices rely on their single contract from the NHS. If all practices gave up that contract there would be nowhere for the patients to be seen and the market for patients paying individually would be created overnight.

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  • I have been charging the equivalent of £62.50/hour for 4 hour sessions.
    A local practice manager told me that asking for £70 was tantamount to theft and refused to pay when I increased my rates last month.
    I'm not going back there again in the near future ...

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