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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)

  • Look guys and girls, we all choose the job that suits our lifestyle. Debates about pay are irrelevant, as we can determine our own circumstances. The NHS does offer a lot of benefits which locums dont get, such as death in service benefits, sick pay, maternity pay etc etc..... when I worked it out there wasn't much in life insurance costs me £600/month as a locum..... so Ive got to earn a good lump sum every month just to pay this. Lets just face facts, the job of General practice as a whole has become increasingly unappealing. Im sure there are roughly equal levels of happiness and unhappiness in partnerworld, the salaried system and locumland. Yes you may make more of a daily rate as a locum, but as another contributor here has demonstrated, when compared to the costs of a salaried post with the cost of pension, annual and study leave, it works out not much differently. So please just accept if horses for courses, you pay your money and pick the method that suits you ask an individual. The locum world and partnership have different risks and stresses, but we are all supposed to be colleagues here..... now just imagine Jeremy Hunt and CQC walk into your practice with NHSe hot on their heels ready to micromanage everybody......with whom do your loyalties lie? Your professional colleagues( irrespective of employment status ) or our 'glorious leaders'??? We should not be each others enemies, we have a much bigger foe to fight to make our profession worth doing again.

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  • This is so sad to read. I have returned to work as a retired GP for CCAS. I am working from home and so any shielded doctor could do this. Locus would be an ideal workforce to take this role on and I just can’t understand why we are being brought out of retirement to do a job where there is already an available and willing workforce who should have been the first port of call.

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  • In my opinion the real disappointment in general practice is the lack of support for colleagues. I can't help thinking that if we pulled together and showed each other real support and empathy the stress levels in our jobs would be less and we would be happier and more productive. Be grateful for what you have and support those who are less fortunate at the current time. One day you might need the support.

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  • As far as I know all the locum GP’s in past 5 years have charged us double the rate of partners for much less work and have held practices to ransom. They have no idea what is normal earnings. A junior hospital consultant starts at £70000 but junior GP’s with much less experience where earning double that or more with reduced tax due to being put through a company. So no sympathy and as previous posts we have advertised for salaried post a year ago and no one applies. So it is Karma and I hope it makes them rethink.

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  • CK

    I was a partner for many years and now salaried pas 6 years doing 1 day a week locum and ooh on weekends ; in other words , I never did put all my eggs in one basket , so if one thing dried up , I fell on another ; some Locums are worth their weight in gold ( I know many ) and others I would not give the time of day , in the end it’s a choice and you must take responsibility for it , it was a locum market for many years which some have abused with exorbitant fees with little or nothing to show for .

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  • GP Locums (self employed) will benefit from the Govt income support scheme as long as

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  • Don't know what happened to my full comment

    My comment was that the gov't support scheme will compensate partly those who earn

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  • Hi Prabu.... lets look at your maths....
    A Junior consultant starts on much closer to £80,000 before on-call commitments,(Which are paid separately) Plus they get pension contributions of 20.6% which adds to their package by £16,480 annually. This makes 96,480. They have crown indemnity if they dont do private.
    He / she likely works 3.5 days of clinical work a week. Plus one admin session. Lets say they get 7 weeks paid leave a year-( 6 annual, 1 study)- 52-7 = 45 weeks
    45 weeks x 4 days year = 180 days. This means a locum would need to earn £536 AFTER paying life insurance, and their indemnity to be on a similar level of pay. To allow for this and working the same number of days a locum would need to earn £620 per day if there are no pension contributions, to earn a similar daily rate to a new consultant.
    A GPS rates will not reliably increase every year.... a consultants will.
    A GP would need to earn 33% more to match the pay of a senior £824. per day- so if we go mid career a GP should be billing £720/day. Now look at the GP daily rates being paid....
    You are comparing a gross number but not including paid holidays, annual leave etc..... £140,000 probably equates to 196 days worked in a year as a GP locum (Assuming 720/day billed) .....with only 4 weeks leave.... and working 5 days a week.
    If a GP was working 4 days a week like a consultant and 45 weeks a year they would need to bill £111,600 to match a first years consultant first year salary and perks, and closer to £150,000 yr to match a senior consultant..... so 140,000/yr billings for a GP locum, not their take home pay.... is NOT unreasonable... plus we dont have the option private which soon puts a consultants pay way beyond what we can ever hope to earn........

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  • Not good to see GP colleagues suffer but we may be seeing a re-balancing of the market. Market forces drove up wage demands and locums very much been in driving seat regarding specifying fees and terms of service. In my opinion things had gone too far with the increase in GPs being locums driving the demand for locums due to lack of applicants for substantive posts.

    Locums are necessary to cover sickness, holidays and maternity but we were in a situation of needing to employ them just to provide a service. We have had some excellent locums - usually recruited through contacts of partners or local 'chambers'- and some dire ones who we have cancelled after a few sessions.

    We have just advertised for one substantive post and within a week have recruited 2 salaried GPs both of whom want to develop services and training in the practice and may well move into partnership in the future. This feels much more 'normal' now and helps us to be confident about practice stability in the future.

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