Five steps to setting up a locum chambers
Dr Richard Fieldhouse and Dr Penny Newman advise on how to start a group for sessional GPs in your area
A locum chambers is a collective of local freelance or locum GPs, whose members pay a proportion of their income to employ managers to look after all the non-clinical aspects of working as a team of freelance GPs. All business, professional development and clinical governance relating to the day-to-day engagement of all GPs in the chambers takes place within the chambers.
Locum GPs who establish the chambers employ the managers, but the GP members all remain self-employed and sign a ‘conditions of membership’ agreement. Practices who book GP locums through the chambers agree to abide by a set of terms and conditions set by the members, including a well-defined but flexible range of session types to suit all needs.
Benefits to locum GPs include:
• Bookings handled by managers (including last-minute bookings and standby cover).
• Financial perks including that the fee for the management is fully tax-deductible, discounts are available for medical defence subs, and superannuation payments are managed in-house.
• Chambers hosts its own educational and training events.
• Chambers have their systems for managing patient and colleague feedback, including significant events and complaints.
Chambers are funded by GP locums themselves, and the management fee varies on the GP’s role in and longevity with the chambers. There is no membership fee as such - the only payment the locum GP members of the chambers make is 10% + VAT of their locum income - so if they don’t work, they don’t pay. GPs who start a new chambers pay 0%, and leading GPs in chambers are entitled to a lower rate of 6%. The fee system differs from locum agencies, as the management fee is born by the GP locums themselves rather than the practice.
Several chambers have been set up by local GPs in England over the last decade, providing some 200,000 sessions for practices from Yorkshire to Sussex, and Bristol to Essex. The following five steps explain how to set one up.
1 Find colleagues who will help set up and join a chambers
You will not be able to do this alone. Agree together your chamber’s aims and objectives, and where you all want the chambers to be in 10 years’ time. If you are clear about your purpose, it will be easier to explain the concept. Consider your marketing strategy. How will you identify and encourage other locums to join? How will you explain this to your practices?
Identify important people locally (CCGs, LMCs, NHS England etc) and explain your plans – explore their ideas and concerns, the benefits of chambers and potential for support.
2 Recruit a business team
Consider the team and investment you need. Recruit someone who’s handy with a spreadsheet, good on the phone, organised and professional, to help co-ordinate appointments and run the management aspects of the chambers.
Work out between you who’s taking on the leadership roles, such as financial planning, clinical governance, managing staff and marketing the chambers. You will need to meet regularly as a team to discuss issues as they arise.
Get a good accountant to advise you about any potential tax implications, and speak to a solicitor to draw up contracts.
Consider investment in an IT system to hold diaries, book appointments, manage standby cover, share intelligence and store significant events. Most existing chambers already have sophisticated systems you can use.
3 Market your new service
Consider how you’ll spread the word about your chambers. Use multiple routes such as informal networks, newsletters, personalised letters, posters, social media and practice visits.
Go back to your contacts and ask for help - for example, issue a press release or communicate through CCG forums.
4 Analyse any feedback from GPs, whether partners or chamber members
Sympathetic and receptive two-way communication will enable your chambers to flourish. Treat every single piece of feedback you receive from practices or members with the seriousness it deserves, and respond quickly with a workable solution. The reputation of your chambers and its members is paramount.
5 Set aside a day a week to develop the chambers in its first year
Review your aims and objectives at least every few months to make sure you’re on track. Dedicate the equivalent of at least a day a week between you to devote to growing the chambers. Your time will include discussing queries with you manager, meeting your fellow directors, developing ideas on how you operate and talking to others who’ve done this sort of thing before.
Dr Richard Fieldhouse is the CEO of the National Association of Sessional GPs, and clinical director of Pallant Medical Chambers. Dr Penny Newman is a GP, and a director of service integration at Colchester Hospital.