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The waiting game

Stop denigrating GP locums, 'livid' GP leader tells NHS England

Exclusive The Government's negative attitude to locum doctors is harming efforts to retain GPs, the BMA's GP locum representative has warned.

Dr Zoe Norris, chair of the GPC's sessionals subcommittee, told Pulse that she was 'livid' upon reading NHS England's Five Year Forward View delivery plan last week and has demanded a response from NHS England.

The document suggested that locums 'are individuals who are actually available to work and are doing so - but in a way that is unfair to their permanent colleagues and is placing an unacceptable burden on the rest of the NHS'.

It also said that NHS England would discuss with unions 'new options to encourage individuals who are currently choosing agency or locum work back into substantive NHS employment'.

Dr Norris said that although the specific section referred to hospital locums, she thinks it 'reflects generally the way that locums are viewed', suggesting that 'there is a persisting view that the problem is locums rather than the underlying issues'.

'As an individual locum it makes me feel devalued, and like I want to quit now. And I’ve got to say that as chair of the sessionals, it makes me despair,' said Dr Norris, who has written to NHS England's primary care director Arvind Madan about the phrasing, and will also call a meeting with junior doctor and consultant leaders in the BMA to discuss how they can improve NHS England's understanding of the locum workforce.

She said: 'I am staggered to be honest, that that is their view and also that that has made it into an official document that is in a public domain - that that is how they view a significant part of the workforce.'

She added that this has come as she was already due to meet NHS England chief executive Simon Stevens to talk about 'unfair' comments he made while addressing doctors at a previous event, suggesting locums only practise for money.

She said: 'That was actually going on prior to this because of comments that Simon Stevens made at one of the workforce conferences at the BMA House about locums.'

'He said - I paraphrase - we don't want partners working themselves to death, but equally we don't want locums who work somewhere for a week and then leave the next week because they get a better offer and more money.'

Dr Norris said that the current policy was 'vilifying' locum GPs, affecting their morale.

She said: 'When you look at the Facebook forums today, locum GPs are saying "why am I bothering then, if they are going to push me?"'

According to Dr Norris, the policy also risks destabilising NHS England's own plans aimed at boosting retention of GPs considering retiring altogether from the profession.

She said: 'Some of them are former partners who have retired, who have stepped back from the partnership but are still working in the workforce, and they are staying because they can choose to locum.

'If that is gone, if you're forced, then they will just leave, and that will only worsen the situation.

'You can’t dictate to the medical workforce how they work, you have to improve the environment.'

An NHS England spokesperson said: 'Locums provide a very important service, particularly during staff shortages and surges in demand. However patients value continuity of care and we have heard from many practices that want to see ways of making general practice a more attractive career choice for GPs.

'That is why the General Practice Forward View is delivering a range of ways to boost the number of partner and salaried GP positions.'

Can the Government retain GPs while disincentivising locum work?

The news comes as NHS England's GP retainer scheme, aimed at encouraging GPs who are thinking of leaving to stay in work, was extended as part of the 2017/18 contract deal.

Under NHS England's own scheme, GPs are encouraged to take on sessoinal work rather than leaving the profession.

But last year's GP Forward View said locum GPs were ‘undermining service continuity and stable team working’ and raised the prospect of ‘new measures’ to create an alternative for those who ‘can commit to working in a practice or an area over a period of time’.

It also comes as NHS England has set a cap on what they think should be the maximum GP practices should pay locums.

Under the policy, any practice that pays a locum more than £80 per hour has to report this to NHS England.

Readers' comments (28)

  • Chill Zoe, Chill :) It's the way the govt is - denigrating locums, regular NHS staff, just everybody they can. There's nothing in the world you can do to change them. Somebody just threatened Spain with aggression and then explained - ''We just want them to know what sort of people we are''. What sort? the psycho killers who stalk and kill anything that won't play ball?
    It's like a Consultant in Ashford who was put in charge of Infection Control although had been working in the Stroke department with no idea of IC. He ordered his deputy to do things as he wanted because ' It's a game, you've just got to play it'. Locums are in the firing line because they are less organized and NHSE can blame them for shortages, prices, not playing ball.
    Hmmm balls, I'm going home too.

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  • NHSE dont like people they cant bully or control by the usual means.They dont like Locums they dont like GPs. The dont like anyone who works on the coal-face.Agency staff do it for work life balance control.Come to think of it they dont like anyone.I for one hate NHSE and the DOH a deep deep hatred,I hope they get what coming to them an I there to see it.

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  • Dear All,
    They want people to come back to substantive NHS roles, then make it attractive to do so.
    Paul C

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  • Cobblers

    Nope even with NHSE dressed up really attractively they can swivel for substantive roles.

    I am a locum as it is my choice. I work where and when I like, for rates that I like. If people don't like it/me they don't have to offer me work. If NHSE don't like it I am pleased. In fact I am smiling as I write this now. Hehehe.

    Seriously I thought it was the Tory party that espoused markets. This is a market. Get used to it boys.

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  • I'm a locum GP by choice. Run a local locum Group and and increasing number of GP partners and salaried GPs are embracing locum life.
    NHSE , without much opposition from GP leadership has made GP work unbearable for many. Ask Simon Stevens why should anyone consider a salaried or a partnership position in current climate ? with STP plans in the horizon planning to dump more work into GP ?
    Tell him that as a locum I've got choices. If NHSE makes
    my life hell , I will increase my non-clinical sessions and leave NHS clinical work.
    Finally saying thank you for meeting with NHS England and try to raise our profile. Need more people like you on GPC prepare to stand up for GPs , regardleds of their employment status

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  • I am a locum GP- not by choice as I was bullied out of a partnership for whistle blowing about the senior partner and how unsafe clinical practice was by the rest of the doctors- to the LMC, NHS England and the GMC. Nothing was done and I lost my job. Those GPs are still working..

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  • Try looking up "Indentured servitude".

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  • There are some excellent and not-so-good locums around just like partners. Let us not criticise each other. Some locums choose to work in this way. However, increasing numbers are seeing it as a way out of the demands and liabilities of partnership. If NHSE wants to stop the dominoes of collapsing practices, it needs to make joining a practice more attractive.

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  • I am happier as a Locum,do not get exploited by a monopoly employer like NHS which add to contract without need to increase payments and do it happily with flexibility. For me to return to partnership things have to improve rather than empty speaking up or talk. Every human being yes yes including GP's have right to earn money and live well. It would be nice for Government to hand out contracts to their pals without profit and lo everything will turn out cheap-like ask a contractor to build 2miles of rail instead on 1mile at same cost. Oh boy easy solutions like in NHS

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  • Unbelievable. Who do they think provides cover when regular GPs in the practice are on holiday/study leave/away days or during periods of staff shortages and the recruitment and retention crisis. If partners are getting their increases in medical indemnity covered, I certainly will as well, and I am going to give myself a 1% pay rise, like partners. So I am going over £80 per hour later this year.

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