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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)

  • I wonder how much more 'value' the government will squeeze out of general practice before it chokes?????? Given the debt just run up in the last month for people to sit at home and do nothing there will be no new money coming for years. The RCGP should be agitating for a co-payment system.......or put to GPs on the same salary scale as consultants, which is what we are in Family Medicine with practices becoming board run practices instead i.e. so GPs dont have to have the hassle of running the clinics anymore. Some of our older GP colleagues did well out of previous arrangements, but in my career it has been the death of a thousand cuts with only one significant pay improvement about 16 yrs ago..... which has since been whittled much will you let yourselves be bled in Britain before you stand up and say enough is enough? We need alternative leadership that actually will fight for us as a profession... I think in the end even the privates will give up when they realise you can't make money at this game anymore under the current funding arrangements.... the only people left will be the Noctors and the Mother Theresa types...... and if Matt Hancock reckoned he could get a DES to take away her sandals he would...... or she'd have to see an extra 1000 patients just to retain them....

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  • The locums did enjoy high pay, jacking it up even when the MDOs dropped their fees. They have refused to do home visits, look at blood test results and letters. Guess the good times have ended.

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  • My view. Having worked as a sessional / locum in a small practice for over 2 years I was told after my surgery on the 16th March I was no longer needed. My work as a doctor in professional sport also stopped. I could not sit at home and watch an evolving medical pandemic without helping . Well done Gp principles on removing sessional and locum GP’s from your practice , putting them on furlough , while most of you it appears sat at home doing telephone / video consultations (in most cases without training ) scripts for even more pay.
    I came over to my home in Ireland on the 18th March , self isolated for 3 weeks and signed on for the HSE on call. I was appointed to help run a small rural practice . Welcome back family doctor medicine not like the UK Superpractices where income generation seems foremost and access to services secondary. No problem where 111 and walk in centres are freely availabe and an easy deflection without affecting income. and yes no measures on accountability of GP practices workload. GP’s in Eire are front line as they should be , talk all calls during the day , get a covid fee for directing possible covid patients to Testing centres , triage patient by telephone consultations and see patients that need to be seen under strict PPE guidelines. A proper family doctor model.

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  • What a resentful, selfish, nasty, angry, smug, jealous, grudge-holding group of people some of us have become. These traits are only going to worsen as NHS General Practice self destructs in slow motion with the continuous unfunded huge workload that will follow soon enough.

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  • Have worked as both salaried and locum at the same surgery for a number of years, became a locum to give more time to being a carer. The salaried workload was 14 hour day with all the admin (some of the partners didn’t bother dealing with results or documents - one even forwarded me positive malaria test result to deal with later in the week when I was back in the surgery) and I was always the one that got the visit. One of the last straws was when they advertised for a salaried doctor at a rate greater than all existing salarieds, all female, all since resigned!

    Am taken aback by level of vitriol from partners to locums. I have accepted hourly or sessional rate set by the practice which seemed reasonable to me, and included visits until the practice stopped requiring this. However all my April sessions were cancelled with less than a weeks notice. Agree it’s not good to keep all eggs in one basket and this has pushed me to look for other work. Have the odd session at another practice and doing OOH which so far have really enjoyed. Applied to CCAS but not heard, agree it’s odd to bring GPs out of retirement to do this or ask Partners or salarieds to do this for free. But don’t resent this, great retirees came out to help!
    I like the staff and partners at this previous practice, and hope to keep on good terms. Felt a bit ill when one of the senior partners was bragging about how easy and relaxed the work was now that they didn’t have to see patients and that I should join them again (implication as salaried)..
    So I anticipate that workload is really going to increase soon for Gp partners- starting to feel it in OOH and frustration on the phone from patients during the few in hours sessions I do. I certainly won’t be going back to locum at the previous practice.
    I do have savings put aside, but feel sorry for locums who don’t and have fixed large outgoings. In a way I’m glad to have been pushed to find other work and I certainly wanted to help in some way during this pandemic. Yes there are probably some dubious locums out there, but also equally dubious partners. We should be supporting each other and working together- locums are one-fifth of the workforce - we have many reasons for choosing to locum. Most of us work hard and take great pride in our work and are not out to fleece partners...

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  • Overall ... sounds like GP locums and partners have experiences of each other at their worst ! But I'm sure at their best too; like anything its unfair to generalise; having done a day back at work today with the patients bottled up mental and health anxieties I think it's very likely the recruitment issues and burnout will continue (at least in my locality) ... tactically speaking I think not jumping for the first job you can get for a good deal may be a good idea ...

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  • DrRubbishBin

    It's weird reading bitter comments from angry partners moaning about locums. I hope I've not worked for any of you although I suspect I haven't, the universe has a habit of serving up what you wish for, you can smell that kind of attitude from a distance and Im happy to stear clear. Its odd reading some suggest locums will rush back to salaried positions and partnerships once the covid pandemic is past. I doubt it. The job will still make little sense. I'm perfectly comfortable having periods when the work is harder to come by, being a locum it comes with the territory but I cant see it makes sense calling back retired Drs and starting medical students early only to ignore 20% of the primary care Dr work force (locums) ..undoubtedly because the people running the show didnt know we are here. Really..what a bunch of wazocks! But totally unsurprising ..everything about the way primary care is managed centrally is nuts. Thats why I became a locum in the first place, and will remain one after all this is over. Being a partner/salaried is not a good place to position wonder some of you are so angry, bitter and sad. Thats your choice and not the fault of 'the bloody locums'

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  • DrRubbishBin

    well said - like yourself i;m very happy being a locum, and looking forward to going back when all this is over. i charge a flat rate for the day - no extra for calls or admin, and no need for pension contribution either.

    i start when the doors open, and finish when they close.

    i think i provide a good service at a fair price - if a practice were to take the piss, i wouldn't go back. in 12 years none have.

    i've been there, seen most of it, done most of it, got most of the t-shirts, and i'm very happy locumming.

    i am 70.

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  • @Truth finder - if you get a locum like that, dont bring them back...simples.... as a Locum when in the UK I do house visits, lab work etc. Ive also worked at practices where the partners themselves dont do lab work, dont do house visits, and expect the salarieds to do everything for them......there are good and bad partners and good and bad locums. We ALL have stories to tell. Perhaps we could have a dating website where the 'bad locums' are paired up with 'bad practices' , let CQC deal with the fallout in those practices, whilst the rest of us get on with our jobs and our lives. My experience is that Most GPs, Most Partners, and Most Locums are civil, collegiate, professional and most of all, exceptionally hardworking, the bad ones are the minority and we shouldn't use hasty generalisations to sway an argument.... again I would implore you to step away from 'he-said, she-said experiences and see the bigger picture....General Practice is grossly underfunded and grossly undervalued.......Hunt and Hancock would find it funny to watch the infighting.... united we stand divided we fall...... it doesnt look like a very united profession from where Im standing right now..... which is Western Australia....

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  • PS- quick question.... glad to see someone slowly sliding down the most popular article rankings to No 4 .... but can someone please tell me who is still reading this article? Its months old...... are there chatbots dedicated to reading it??????

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