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The waiting game

Locum GPs forced to claim benefits as work dries up

Exclusive Locum GPs have been forced to claim state benefits after struggles to find work during the pandemic, Pulse has learned.

Locum GPs say that the reduction in patient demand for GP services during the pandemic has meant practices are less willing to use them.

At the same time, locum GPs told Pulse they are facing bureaucratic hurdles to join NHS 111's Covid Clinical Assessment Service, and retired GPs have offered to work for free for GP practices.

This has particularly hit locum GPs who have been ‘shielding’, and the lack of sickness benefits means that the self-employed GPs are having to decide whether to take the risk of exposure or not working.

Sessional GP leaders said they have been ‘cast aside’ since the pandemic started.

Dr Saumya Jha, a locum GP based in North London, told Pulse that she had to claim benefits having been unable to find lower-risk shifts such as remote triage and patient letters. She hasn’t worked since March, when she contracted Covid-19, she added.

Dr Jha told Pulse: ‘Things are just cancelled last minute and the shifts that are available are very hard to come by and are high-risk shifts with very limited PPE.

‘So people are really struggling to find employment because either you take the risk of high viral load exposure or you don’t work at all.’

One locum colleague has gone from earning £130,000 working 10 sessions last year to nothing over the last two and a half months because he is ‘scared’ to work in the high-risk shifts available, she added.

Another GP told the National Association of Sessional GPs (NASGP) that they too have looked at claiming for state benefits after six weeks earning no money as a locum.

The anonymous GP said: ‘It has been hard as locums cancelled at short notice and it has been six weeks trying to get on the onboarding for CCAS to earn minimum wage.

‘I have looked at claiming state benefit honestly but [am] hopeful the CCAS onboarding will come through and I might not need to.’

‘Honestly speaking, [I‘m] living from hand to mouth - very depressing as I feel underutilised and very insignificant.’’

NASGP chair Dr Richard Fieldhouse told Pulse that locums are being ‘cast aside’, particularly over the CCAS service that initially targeted retired GPs.

He said: ‘People feel really let down because retired GPs and medical students have been prioritised ahead of the existing locum workforce.

‘Locums are saying they’ve come across retired GPs who aren’t going to even ask for payment, they just want to do it to help out. [But] there are people desperate to pay the mortgage here.’

Meanwhile, locums - many of whom are more recently qualified and have not yet ‘built up financial resilience’ - are left with ‘absolutely no income protection scheme or sick leave scheme’, he added.

Nottinghamshire LMC wrote to locums last month to offer its support and reassure sessional GPs that they are ‘not forgotten’.

LMC GP retention lead Dr Sonali Kinra and chief executive Michael Wright wrote: ‘We acknowledge that there are limited locum opportunities currently.

‘The reasons are multiple - cancellation of annual leave amongst doctors and fear among patients thereby not accessing care, to highlight a few.’

GPs were encouraged to join an LMC GP ‘roving scheme’ that matches staff to areas of need ‘with appropriate PPE and IT equipment’ and to consider a fixed term contract modelled by the BMA.

It comes as Pulse revealed last week that locums were facing six-week long waits to access work at NHS 111’s Covid clinical assessment service (CCAS) - while NHS England said that it ‘still needs clinicians’ to staff the service.

Earlier this month, the BMA told Pulse it had provided an ‘off-the-shelf template contract’ for local areas to offer to locums while they still lack full death-in-service benefits.

Readers' comments (144)

  • Lol@ resilient AF ..... come on! that’s not a resurgence that’s just normality in primary care. Unless some punters have been coming via 999 for their bunion.

    I must admit this comments section today has been a priceless source of entertainment and I’m sure when we look back will probably just have a good old chuckle at how ridiculous opinions or perceived observations can be.

    For example@Adoc your comment was also great ie satisfied good partners who are at the cusp of a nervous, possibly physical break down but if they are not in the described state then they are ‘exploitative’ and ‘dysfunctional’......just quality humour at its best, I couldn’t write this stuff.

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  • Locum work, by definition is ad-hoc. Freedoms, no difficult responsibility and maximum pay is a privileged choice. But ad hoc. Locum agencies should wake up, as should estate agents. 1/2 the 'work' this GP profession does is a COMPLETE waste of nannying time. Let's be honest, stop trying to be heroes for 'IBS' and 'split up with a boyfriend' and 'letter for failing my exams' - be grateful you can control time wasters better and now look after the sick, yourselves and family which is the reason for our being.

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  • working in 111 occasionally since this pandemic.The feedback from patients is that they cant get an appointment especially in London.They phone the surgery and cant get through.They want 111 to help them.Ive called a few surgeries too and couldn't get through. Its an artificial reduced demand by some practices.
    Also lot of drs receptionists telling patients to call 111 instead.Some doctors dont want to see any patients and just send them to AE/111
    The Government needs to tell practices to mandatory open up a certain number of appointments in General Practice.

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  • A lot of comments!!

    I feel very sorry for any young locum with a mortgage and kids.

    There is however a feeling - for me at least - of the wheel coming full circle. I got my first GP job in 1982 - 200 + applicants for any decent post in the middle of a really horrible recession. Many of the consultations were essentially about unemployment and money problems - so most GPs were grateful to have a secure public sector occupation. Will this be where we are again soon?

    To be honest though - 'the job' seemed 'do-able then' - it is totally impossible now.

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  • Bring back capitation, scrap the pcn’s and the ccg’s. Move every clinician who is masquerading in a “management post” back to work at the coal face

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  • ADoc - has it correct. Most locums would have prepared for something like this. Not specifically a pandemic - but they must realise that illness could scupper them for a while. And they are very vulnerable to sudden changes in the way government treats practices (like we all are).

    The majority should have enough savings to weather the storm - and the underlying problem of there not being enough GPs is not going to change soon. Things will return to normality in 6 months or less.

    The only thing I would like to correct is that partners are not happy. The majority of them are happy. Every partner has the option of switching to locum work at the drop of a hat and chooses not to.As a group doctors like a good moan.... about EVERYTHING, but if you naive enough to think that means everyone is unhappy then you are wrong.

    As a partner I have more varied work, shorter hours and more money then I would as a locum. I also enjoy the relationships with patients and the community. I probably take more holiday too - as I would find it difficult to take holiday as a locum. (in normal times). I would not swap jobs with a locum now or 12 months ago.

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  • At 61, a semi-retired GP and ex partner who has taken his NHS Pension, I have sympathy for both sides. My sessions for April, May and June have been cancelled. I had been doing telephone consultations in common with most GPs until the end of March. Holidays were foregone, maternity leave cover was no longer required but staff outgoings were the same and significant extra costs were being incurred. I chose not to see F2F patients for personal reasons. Despite being fully set up to work from home, and with all appropriate documentation it has been difficult to find alternative work. Being a locum is a choice, allowing flexibility and quite frankly it has preserved my health in the latter part of my career. It comes with a risk and for those who are at the beginning of their careers they are in the same position as many professionals and self employed across the country. We should not need people to be locums though. Being a GP should be well paid and T&Cs reasonable. We must feel valued and respected so that it is a joy to work again. The I started as a locum 5 years ago I was able to start being a proper doctor again and listening to, and taking time with, patients. I fear when this is all over, the way partners have been treated, all of those contemplating retirement will go and the GP crisis will be as bad/worse than before. There will be a backlash against GPs for doing what they have been told and not visiting. There will be a lot of angry people out there soon.

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  • Shortage of work due to cancellation shifts for locums in Surgeries and UCC. In surgeries as closed down and they can easily pass buck to 111 and get fatter cheques for partners. In UCC and A&E lack of demand as patients will not go in.Most UCCs are run by private companies and indirectly by CCGS who let go of staff when demand reduces. Mostly as patient refuse to go to hospitals unlike past when would go for minor ailments.So no wonder lack of work.
    In the end privatisation and market forces change transiently due to Covid for now. Things will change when lockdown eases-catch up next month.

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  • Dr Dean Eggitt

    May I remind all colleagues that during this difficult time, there are charities available to help you.

    Good luck and stay well.

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