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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.