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GPs go forth

Locums out of work: 'I never thought as a GP I would struggle to find work'

Locum GPs are struggling to find work in the face of the pandemic. Read their stories here

Dr Saumya Jha, a locum GP based in North London

‘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.

‘I can’t work because I’m shielding because of my asthma.

‘I did get Covid and had to call the ambulance in mid-March. From that day on I’ve never been back to work. I’m still on benefits.

'A guy I know was making something like £130,000 last year and he’s gone from that to nothing. He did 10 sessions [but] now he has been sat at home for two and half months, same as me. He’s not even shielding, he’s just scared because he’s seen what’s out there.

‘Why are we being excluded and marginalised because footfall has dropped? There’s far more as a skilled GP that you can offer to a surgery, aside from just face-to-face consultations.’

 Anonymous GP told the NASGP

’I can confirm [I have] not earned any money for six weeks as a locum. I am not entitled to any Government grant as earnings in the past were over the threshold - bearing in mind most of this profit went to the taxman so actual profit limited. 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 really want to do my part to top it up, have also had non-specific covid symptoms - very difficult time indeed. I have looked at claiming state benefit 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. Huge impact on mental health as well but unfortunately it is what it is. I still feel the Government grant should not have excluded us but then I don’t make the rules. Hopeful still things will improve.’

Anonymous GP, London

’I had been advised by some of my non-medical friends to look into some of the Government schemes for self-employed people as I was struggling to find locum work. In honesty, I felt like I couldn’t do this - as a doctor I just felt I should be able to find work! 

’I think my situation is a little different in the sense I am not used to being a locum GP. I have always had a salaried GP job and left it to start in another salaried role. I had a contract with a practice signed and was ready to start work then they rescinded the offer before I was due to start. This happened when I had handed my notice in and then Covid hit and suddenly I found myself needing to locum and struggling to find work.

’I cannot even tell you how many people I have emailed, called and even used online forms to try and find work. I have lost count of how many times I have tried 111, OOH and practices through word of mouth and mostly did not hear back or practices said they were quieter than usual and did not need help. On occasion I would get a response and then not hear anything again. 

’I am based in London and ended up leaving London and coming to my parents’ house in Cambridgeshire to try and find work. I have contacted PCN leads and again didn’t get much response. I’m astounded that there has been no organised response for locum doctors who are usually a younger generation and willing to work, yet they have called up retired GPs more at risk from Covid! 

’Everything aside, it has caused financial stress and general worry and uncertainty about the future. I honestly never thought being a GP I would struggle to find work. 

‘I think there is a real issue here with recruitment and protection for both locum and salaried GP (as my experiences have shown). I have been left high and dry and I’m sure there are many people with similar stories.’

David Church

’By the end of March, I started to get cancelled sessions because the regular GPs’ holidays, training courses, and meetings were being cancelled. We fairly soon realised that there was a gradual spreading pattern, with a lot of hospital demand in the South East of England, and a bit of a slow-down locally - coinciding with the Easter holidays when our student population leaves the area, but the expected holidaymakers were not allowed to come, (and cancelled routine work in hospitals), the GPs (and hospital staff) were, for a change, slightly overstaffed and under-occupied.

’At that point I started looking at doing sessions for the CCAS by telephone - not that I felt I needed to avoid face-to-face work, but that I did not feel it would be helpful to travel long distances and then shortly come back when needed here, without possibly having got used to different systems in a strange GP practice in England. Many locums seem to have found this service hard to get into.

’I am lucky in having sufficient reserves to be able to look forward and say, well, at the end of this period without holidays and study breaks, there are going to be many GPs going off on leave or study days, or meetings, later in the year, so demand may be strong in the autumn, and can re-fill the coffers then perhaps.

’That approach will not suit every locum: some have only just started up and will be living on small margins whilst paying off mortgages and student loans, that I no longer need to worry about. There will even be some who went into ‘shielding’ mode in late March, with the prospect of no income for initially 3 months, but now maybe 6 or 12 months!

’Curiously, whilst I expected there would be demand for cover to GPs off "self-isolating" this does not appear to have happened. 

’One possibility is that the sudden drop in demand for locums reflects partly just how much GP time was, until recently, taken up with non-clinical activity, such as meetings and audits, and so on?’

Anonymous GP in a private Facebook support group for doctors seen by Pulse

‘I am out of work and can’t get any for love nor money. I have filled in every single form going - CCG extra capacity form, 111 OOH and emailed local trust as I have background in acute medicine but there just doesn’t seem to be any response.

‘GP practices seem to be managing well and are cancelling annual leave etc so have plenty of staff. Seems there’s either a mismatch going on somewhere and information not getting through or they generally don’t need the number of doctors that they thought they would at this stage.’



Readers' comments (27)

  • A point: CCAS work is not minimum wage. If this isn’t a typo, it is a rather daft comment.

    A comment: as an out of work locum, I sympathise with much of the above BUT I certainly don’t expect sympathy. I would suggest that the prudent locum would have some savings to cover a potential gap in work, for whatever reason.

    I would hope, however, that the anger and frustration of locums at NHS administration and prioritisation is widely shared. The onboarding for CCAS is a shambles, and I hear that the contact tracing service (which I have also just applied to) is similarly blighted. And the fanfare about the return of retired doctors feels a political points scoring insult.

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  • There is a drop in demand both in primary care and acute care...A&E departments have never been quieter
    Not that long ago locums were holding GP practices to ransom with exorbitant rates and being paid more than partners compared to hourly rates. Most locums presumably made a choice to work like this. Markets prevail and right now it looks pretty bad for locums.
    As always their comes a time when balancing is now for some

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  • As a locum who left my partnership a short time ago, I can completely see why some partners feel very little sympathy or even some quiet satisfaction ( not implying any malice just that its nice to be on the better side for once) for the situation some locums are in. When you're cutting into very hard earned profit and personal take home wage to pay for someone who walks in and walks out for a good hourly rate without taking the background grinding down that a partner suffers from endless dumping from every angle, those people having 3-4 months of a harder life financially doesn't tug on your heart strings. Nor on your wallet. Expecting practices to call in locums when the work load is manageable is ludicrous. GP practices in the majority of cases are severely underfunded for the work they do and having a few months of reduced outgoings cannot be resented. The practice I'm locuming in are seeing a nearly day on day increase back up in demand for GP appointments phone/ video F2F - this was purely a lull and the deluge of untreated/ delayed patient demand is coming...

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  • Hard to have sympathy when practices have been bleeding money in the form of locum fees because so many walked out and left the coal face over the past 10 years, then came back to some of the same practices they left, often charging more than double the money for half the work. To see reports of someone who earned £130k now poor-mouthing it is a bit of an insult, given that most partners and salaries dcotors don’t earn that much. We were fortunate to have a locum who, despite the increased rates, shared all aspects of workload because it needed to be done. Many practices are looking for salaried doctors and partners - maybe start applying. Time for some balance to return to the system.

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  • i left a high earning, dispensing, single handed practice in south wales in 2007, after i had a haemoglobin of 5, and a dvt in mt right (dominant) arm. the LHB (same as PCT in england) declined to give me any help, saying "you're either working or you're not - get on with it".

    so i left.

    i now work doing two days a week as a locum, and i'm very happy. the pay is not so good, and the work is often unpredictable - but you don't have all the admin shit that partners do. no PCN's, no fishing trips from lawyers, no being told to work weekends or bank holidays because of the corvid crisis (partly man made by NHSE poor management), no staffing issues, holidays when i like, more time with family, no CQC, no interference from the nosey parkers or administrators etc etc etc etc.

    the money is not as good, but then the outgoings are much less. and we should all keep enough to one side for the unexpected - letter from the GMC (remember bawa garba ?), government confiscating your pension, tax hike (it's on the way to pay for corvid), MI or CVA, car accident, etc etc etc.

    ok - there is a downside, but i'm not complaining. swings and roundabouts. i can't work at present anyway (severe COPD), but i'm looking forward to going back when all this is over.

    meantime classic cars and bikes still need fixing, garden needs doing, house needs maintaining, wife needs servicing, etc etc etc.

    so stop squabbling amongst ourselves, and make the best of a bad lot.

    i doubt the government read this, or they would realise the fury they are are causing, but they must be falling about if they are !

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  • I have some sympathy for older colleagues who leave partnerships to ease their workload and move away from bullying managers. But I have none for the young ones who love cherry picking. However, the ones I deeply resent are the mushrooming go-betweener merchants and their greed.

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  • @4:08 pm

    Do you mean the older colleagues who did not have to pay student fees/take out student loans and who have the gold plated pensions ? Yes boomers/cardies I'm looking at you with my bleeding heart !

    p.s. Are you for real ?

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  • Vinci Ho

    Don’t really want to be judgemental in here . This is another phenomenon which demonstrates how devastating Covid 19 is in terms of impacts in medical, economic and social terms . The ramifications are far reaching and could have been even worse if the government did not pay off the 80% salary in those being furloughed . For those with non-contractual employment i.e. our locum colleagues , lack of realistic job security has led to this plight of no income tragically . Equally , I am not convinced that we should blame those retired colleagues volunteering to work for free in the middle of a human disaster .
    Truth is , a locum life is entirely determined by demand and supply in the market . Making the choice to be whether partner , salaried or locum always carries pros and cons . Perhaps , some people might not have thought through about their choices in the first place ,given their individual circumstances. For partners and salaried ones , what our workload will become post Covid 19 remains an uncertainty especially against the backdrop of the PCN DES(yes, one can choose not to sign it). Once the level of workload becomes unbearable again , locums are in need once more ?
    All I would say is our profession has been in a crisis prior to Covid 19 and it simply turns it into a double-crisis .

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  • Suddenly partnership is looking attractive again. And maybe three years to parity !,

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