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Locum shortage driving GP practice costs ‘through the roof’

Exclusive A dire shortage of locums mean that GP practices are paying agencies almost double the rates of independent locums, warn medical accountants.

A snapshot sample of locum fees, obtained by Pulse from locum insurance specialist MIC, showed that some agencies are hitting GPs with charges of £160 per hour.

An agency charged a GP practice in Warrington the fee, which marked a £70 hike on rates charged by an independent locum in the same area.

Rosemary Smith, owner of medical accounting firm RS Accountancy, told Pulse that spiralling locum costs were being driven by a drastic shortage of locums in some areas.

She warned the fact some practices ‘can't get hold of locums for love or money' meant many practices are being left with no option but to turn to costly locum agencies in a bid to secure cover. 

Ms Smith estimated that most GP surgeries spend between £5,000 and £20,000 a year on locums. She told Pulse: ‘The problem is you can't get hold of locums for love or money. People are going with the agencies because there is a shortage, certainly here in the North of England.'

‘I have not spoken to a practice this year that hasn't told me they have struggled to find locums. Locum bills are going through the roof – that could be down to increased locum fees or simply increased usage.'

Other factors have also been driving GPs to increase locum use, particularly over the summer period, medical accountants said.

Bob Senior, director of medical services at specialist accountant RSM Tenon, told Pulse changes in GP tax calculations, which means GPs who earn over £100,000 do not qualify for a personal tax allowance and pay a higher tax and national insurance allowance, had made it more attractive for GP partners to work fewer sessions and hire locums instead.

He said: ‘I have come across practices struggling to get locums. I think that where we are seeing increases it is mainly due to increased usage rather than fees going up. The particularly ugly tax charge for GPs earning between £100,000 and £114,000 has caused many to make a quality of life call at times of pressure.'

‘In their mind they worked out that if they paid a locum £1,600 to cover them for eight sessions, thus allowing many to take a full week off, the actual net cost to them in take home terms was approximately £480.'

Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs and a GP in Chichester, said the NHS spends roughly £1.5bn a year on GP locums. He urged locums to join forces to set up locum chambers in a bid to help practices avoid forking out hefty locum agency fees – and prevent GP locums from having to pay a substantial proportion of their earnings to agencies levying hefty commission charges.

He said: ‘Practices, and locums themselves, try to use agencies as a last resort. There are some good agencies out there, but a lot of locums I know have dealt with bad eggs. Quality isn't always the driving force in agencies and sometimes training and support for locums isn't there. We feel that locums teaming up in chambers is a more efficient service that saves the NHS, locums and GP practices money.'