When the demise of PCTs was announced, many wondered how superannuation for locums would be dealt with from 1 April. One option would have been for the NHS Commissioning Board to take on the role, dealing with superannuation and paying employers’ contributions, but the Department of Health chose to dump this task on practices instead. The amount previously held in PCT budgets for employer superannuation for locums will be added to the global sum and shared between all practices. The GPC suggested that funding should be distributed to practices through increasing global sum equivalent (GSE) payments, and the department has adopted this approach. The combination of the contract uplift of 1.32% and the locum employer superannuation funding both being added to GMS GSE payments, will provide all GMS practices with an increase of 1.47%.
Passing this responsibility to practices has two effects. First there is the financial impact and the practicalities of handling administration and making payments. Initial estimates suggest an average practice might see £1,500 go into their budget scaled for list size.
Second, although the funding will be shared, not all practices use locums to the same degree. Larger practices are often able to use fewer locums because the absence of a single GP is not felt as acutely. Likewise, some practices are better at planning holiday absences. Practices where all the doctors have children at school, and overlaps of holidays are unavoidable, no doubt find it much more difficult to avoid locum costs.
What GPs can do
The advice I am giving my GP clients is that they have four options.
• absorb the extra 14%
• negotiate a 14% reduction in their sessional rate
• agree a reduction that shares the cost
• be nice to retired GPs who do locums, since there is no 14% to be paid for them.
In areas where locums are hard to find, the first option is probably the only choice.
Note that female partners who are intending to take materinity leave also need to recognise their costs may go up.
Bob Senior is chair of the Association of Independent Specialist Medical Accountants and head of medical services at RSM Tenon