Welsh GP locums told they will lose state indemnity if they don’t join staff bank

Exclusive GP locums in Wales have been told they will not be indemnified by the state unless they join a staff bank, Pulse has learned.

GP leaders suggested the Government is trying to force locums to work for cheaper or into salaried roles – phasing out the locum workforce entirely.

Since 2019, state-backed indemnity schemes automatically cover all GPs in England and Wales if they are providing NHS services – including locums registered on the All Wales Locum Register.

But from December 2020, GP locums working in Wales have been additionally asked to join the Locum Hub Wales (LHW) staff ‘bank’ in order to qualify for the scheme, including registering each individual session from this month.

Locum GP Dr David Church, who is based in Wales, told Pulse: ‘Any session that they have not recorded – whether or not we think we’ve recorded it – you’re not covered for.’

And locums are unable to check that shifts entered are saved properly in the hub, meaning they may be forced to pay thousands of pounds for indemnity through medical defence organisations if they find they were not covered, he added.

National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse told Pulse that locums working in Wales have got in touch with the organisation to say that they ‘smell a rat’.

He said: ‘[The Welsh Government has] a massive recruitment problem so this seems to be a very back door way of trying to solve another problem that they say they’ve got – that the spend on locums is way too high because there aren’t enough partners.

‘If that’s the problem then that’s what they need to solve – they need to have much better recruitment, not try to shoehorn locums in in this way.’

He added: ‘Nothing about this makes sense apart from it seems to be some sort of way to get cheaper locums. All the other excuses they’ve said just don’t compute.’

Dr Church added that the Welsh Government has responded to a colleague’s letter expressing concern and ‘basically confirmed’ that its plan is ‘to phase out locums in Wales’.

And he told Pulse that locums are also being asked to record ‘sensitive business information’ on the hub such as the number of patients seen, hours worked and fees charged, although this is ‘optional at present’.

Dr Fieldhouse said the Welsh Government must ‘urgently go back to the drawing board’ and make partner and salaried roles more attractive, rather than implementing ‘punitive systems that are hard to use, ill-thought-out, poorly implemented, scary and clearly not transparent’.

Meanwhile, the BMA’s GP Committee for Wales wrote to the Government last month expressing ‘strong concerns’ about the LHW, saying it was ‘not consulted’ on the new requirements.

In letters seen by Pulse, it said the lack of start date on the announcement led ‘many locum GPs to consider cancelling forthcoming shifts thus potentially destabilising already stretched practices’.

A letter said: ‘It has also been noted that many sessional GPs who work in both England and Wales will be deterred from working for Welsh practices going forward due to what they feel are unnecessarily burdensome requirements.’

Portfolio GPs and partners who occasionally cover for other practices could likewise be deterred, while the requirement to record ‘nil returns’ if no locum sessions have been worked in a month could ‘paint a misleading position of capacity in the sessional workforce’, it added.

A Welsh Government spokesperson said: ‘In response to the call from practices for a tool to support them to better meet and manage their temporary workforce needs, Locum Hub Wales was developed and this meets the reporting requirements of the General Medical Practice Indemnity (GMPI).

‘Locum Hub Wales provides an interactive tool to enable as many locums as possible to access shifts offered by primary care in Wales and to make it as easy as possible for practices in Wales to fill their shifts.’

In July, the NHS People Plan announced that local banks of GPs working ‘flexibly’ would be set up across England, adding that practices should ‘prioritise’ sourcing cover from staff banks ‘before more expensive agency and locum options’.

It comes as talks are underway between the BMA NI GPC and the Government in Northern Ireland to secure state-backed indemnity for GPs across the country.