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Just one in 10 locum GPs interested in future partnership role

Exclusive Just around one in 10 locum GPs would consider taking on a partnership role in the future, a major survey of locum GPs has revealed.

In Pulse's first ever survey of locum GPs, only 13% answered yes to whether they would ‘ever’ become a partner in future, while 65% said no and the remainder that they did not know.

The main barriers appear to be a lack of a financial incentive and concerns regarding partner workloads.

This comes after those behind the government-commissioned review of the GP partnership model said they would be looking at the possibility of introducing 'attractive features' of locum GP roles.

When asked what was most likely to entice locums to take on a partner role, the most popular response in Pulse's survey was ‘increased partner pay’, chosen by 81% of respondents, followed by ‘more practice funding’ (76%), ‘reduced bureaucracy’ (70%) and ‘reduced workload’ (68%).

The survey further revealed that the majority of locums (51%) would shun a future salaried GP position, although one in four (25%) would consider this option (see charts below.)

It appears that offering work flexibility and a high salary are the best way to entice locums into salaried roles.

Some 65% said the ‘ability to work less than full time’ would attract them, while 56% would be lured by increased pay.

The news comes as recent analysis by Pulse revealed that over the past decade, the NHS in England has lost nearly 5,000 partners.

In response to the decline in popularity of the role, the Government has launched a review aimed at identifying and breaking down the barriers to GPs choosing partnership.

Interim findings from the review, published last month, showed GP workload is rising to the point where it ‘verging on unmanageable’ and in some regions of the country may be putting patients at risk.

Commenting on the Pulse survey findings, BMA sessional GP subcommittee chair Dr Zoe Norris said they were ‘consistent’ with what she hears from locum GPs.

She told Pulse: ‘I think it's a really important thing that the Department of Health [and Social Care] and NHS England need to realise that the locum workforce is not made up of career locums now.

‘It's made up of people with a huge amount of experience in lots of different areas who are choosing to work in a freelance portfolio way.’

According to Dr Norris, the only way this ‘would be reversed’ is ‘by significantly improving the role of a partner in terms of workload and finances’.

She added: ‘But they need to recognise that this is a sea change. This is how the market is going now. This is how doctors are choosing to work.

‘And they need to embracing that and working with those doctors rather than trying for force them unilaterally back into a substantive role if that's not what they want.'

A Department of Health and Social Care spokesperson said: 'GP partnerships continue to be an attractive career choice and an important part of the health economy.  

'We know GPs want more time to spend with patients – that’s why we have invested £30m in innovations which are estimated to help free up 10% of GP time.  

'We are committed to growing the number of doctors in general practice by 5,000. This year we recruited a record 3,473 doctors into GP training against a target of 3,250 – a 10% increase on last year.'



Source: The Pulse survey was launched on 25 September 2018, collating responses using the SurveyMonkey tool. The 29 questions asked covered a wide range of GP locum topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for £200 of John Lewis tokens as an incentive to complete the survey. Around 283 locum GPs responded to this survey.

Readers' comments (14)

  • It would be difficult to go back. Foolish even. Why go back to hamburgers when you've got used to steak?

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  • apparently austerity is over so lets some evidence of this on GP front line

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  • Just Your Average Joe

    Hire as many trainees as you like - need 2 to replace each full timer retiring,and you still won't plug the gaps fully.

    New trainees don't want to work full time, work long hours, see more than a limited set number of patients, and no Home visits.

    The bottomless pit of partner workload is unattractive, but they don't want the lower limited salary of salaried GP.

    Locuming lets them set their own workload and terms and earnings are higher than salaried - win/win for them - loose/loose for patients and NHS.

    Have to put money into partnership or the same shock to politicians will occur as when out of hours work was underestimated, and huge gaps in funding and provision appeared.

    Partnerships are keeping primary care afloat with loads of extra work, if it all goes salaried, double the number of GPs needed to do the same work.

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  • I, as a partner, earn more than I ever would as a locum. I suspect my work sessions are more full and I think that my hours at work slightly longer than a locum, but perhaps by two hours per week across 8 sessions.

    Overall though my pay per hour is more than a locum. That applies to all the partners at my surgery (as clearly we get paid the same per session). Yet when advertising for a role we don't get that many applicants (1, after the closing date).

    I think there is an assumption that partners are not earning that much, but there is great variability between practices and those who are looking for a financial incentive should actually look a little harder.

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  • The governments skew the market by starving Primary care of funding,altering pensions and pension age, make being a partner highly unattractive with high liabilities and they have opened pandora's box.It will now be very difficult/impossible to close without a massive sea change(massive increase in funding).The main reason to do locum is control of your work life balance.One thing partners have little control of.Add to this there is less bullying /regulation,no staff issues more freedom,less liabilities.The current decision to locum if you dont emigrate is a no brainer.Lucky Buggers.

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  • When we were in a Health Centre owned by the health authority, being a partner was definately the best deal.
    Now we are landed with a PFI-type lease new GPs are actually advised by our LMC NOT to have their name added to the lease.

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  • There are many advantages of being a partner and obviously it comes with its own disadvantages.
    Many well performing GP surgeries have good partners profit (more than locum would earn, sickness cover, ownership, moral rewards are great, more likely to be a trainer etc.
    one has to balance it against doing locum work. Locus are less attached to the pts due to the infrequency of being in the same practice, working in multiple places and risks associated with it.
    As locums, working via a company seems to me more tax efficient and hence lots of my friends who are not partners are locuming.

    I wouldn't put off any trainee from becoming a partner. My own trainee has recently joined my practice and became a partner. He did locum for few months before he decided on it.

    I also do significantly longer hours and at times working in the evening from home to catch up with pathology and docman, but I enjoy it. It may not last, I know that.

    Keep an open mind and find a right practice if you want to be a partner. That's what I tell to all my trainees.

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  • 🤔 cardigans or cash 🤔

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  • Argil

    I would like to highlight some limitations of the survey published by Pulse.
    The outcomes certainly do not reflect the motivations that led me to choose the career of locum and agency director.
    I do not think there can be any objections to the fact that the results of a survey are a function of the questions that this raises.
    In this survey 2 key questions are missing: "would you work as a Partner if this was much more independent of NHS management?" and "Do you trust management at the CCG level and above?".
    The survey shows that, substantially, many locum GPs would like to work less, flexibly, but earning more money. In that case they would be willing to become Partners.
    It is a state of the obvious.
    The reason why I chose to work as a locum after 10 years of service as GPwSI ENT for the local PCT is very, very, different from the above.
    For me it was the great incompetence and absence of acumen as well as empathy, which I noticed when the PCT closed down. Pulse covered very well at that time my personal experience.
    Regardless of the illogical "economic loss" for the PCT, and damage to the planning of personal and professional aspects of my life and, above all, of my very young family (not compensable at all even with a lucrative bonus exit which has never been of my interest), the most shocking thing to it was the observation of an absolute lack of administrative acumen and of medium-long term planning.
    I had an average of one line manager per year over the 10 years period, hence that should not have been a surprise to me.
    There are then obvious illogicities, such as that it is not possible to set a maximum limit on the number of patients to be seen in a day or home visits. For me it is very similar to not setting a speed limit on a high-density urban road, or not penalizing a dangerous driving. If a doctor perceives that the work load is excessive, perhaps on that day for the type of pathology or patient seen or other reason, the Principal should be able to modify the list of available appointments accordingly.
    I am also aware of a significant proportion of partners earning considerably more than I do, of course.
    To conclude, if it is true that my revenues have unsurprisingly doubled working as a full-time locum, the reason why I do not consider the possibility of joining a Partnership is my inability to receive directives that I can easily anticipate going to bad end, or not delivering clinical benefit, or perhaps taken for exquisitely political reasons.
    Likewise, I have the greatest appreciation and respect for the Partners able to work on that interface I do dislike, and I would do anything I possibly can to lessen their workload in return.

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  • Until the conditions for GP partners change, I would never recommend this to any doctor.
    It is not just about the pay, it is mainly about the enormous responsibility and financial liability.
    In fact I wouldn't even recommend a young doctor stay in this country to work as a GP.

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