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Welsh locum GPs raise fees by 20% to cover indemnity over hub concerns

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Exclusive Locum GPs in Wales are charging practices around 20% more to ensure they have indemnity cover amid a lack of confidence in the state-backed scheme, Pulse has learned.

Wales brought in state-backed indemnity for all GPs in 2019, but in recent months has stipulated all locum GPs must join the new Locum Hub Wales to qualify for the cover.

GP leaders recently warned that Welsh locums could face ‘potentially financially crippling’ effects from the new requirement to join a staff bank.

They said that the system – which requires every shift to be recorded – is open to administrative error, meaning that GPs may not be able to prove they had indemnity cover and could be left to pay for clinical negligence costs.

Now Pulse understands that locums working in Wales have raised fees by around a fifth to mitigate this and take out additional cover with a medical defence organisation, while others are avoiding shifts in Wales entirely.

National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse told Pulse the organisation has seen examples of locums putting up their rates by ‘about 20%’.

He said: ‘We’ve got definitive evidence to prove that locums are working in Wales less and some that are still working there are charging a lot more to cover the indemnity cost.’

Dr Fieldhouse added that some ‘don’t want [their data] to be on the Welsh system’, while many are concerned that they are not adequately covered by the indemnity scheme.

He said: ‘The IT system [the locum hub has] used is so clunky and [GPs are] worried that actually if their IT system breaks down and their session gets lost then they might be working illegally – they’re not covered. 

‘That’s just too risky so they’d rather pay the extra money and charge it back to the practice.’

Chair of the BMA’s Welsh GP Committee Dr Phil White said that locums ‘are of course entitled to seek expanded cover from medical defence organisations over and above the professional indemnity cover’ offered by the Welsh Government via the hub system.

However, he added that the rise in fees will have a knock-on effect on practices that ‘rely’ on support from locum GPs.

Dr White said: ‘Overall this does cause concern for general practices in Wales especially with the current unprecedented demand for our services where we rely on additional support from locums. 

‘We have met with Shared Services Partnership, who operate the Welsh indemnity scheme, to discuss collaborative working in future.’

He reiterated that the BMA was ‘unable to discuss likely problems’ as the hub was introduced without consultation and that it has ‘expressed these concerns strongly to the Welsh Government’.

A Welsh Government spokesperson said: ‘Practices have long called for a tool to support them to better meet and manage their temporary workforce needs. In response to their feedback, Locum Hub Wales now provides an all-Wales solution designed to increase opportunity for locums and practices, at a time when practices and health boards require a straightforward route to engage locum services.

‘Since the release of the full functionality of Locum Hub Wales, NHS Wales Shared Services Partnership (NWSSP) has received positive feedback from both practices and locums using the system, including noting an increase in choice within their area.’

They added that the Government has engaged with union representatives and stakeholders throughout the development of the hub.

Meanwhile, locums working in Northern Ireland have been given reassurances that they will not see indemnity cost increases this year despite a discount rate change.

In recent months, talks have begun between the BMA’s Northern Ireland GP Committee and the Government in Northern Ireland to secure state-backed indemnity for GPs across the country.

If an agreement is reached it would mean all UK countries have a state-backed indemnity scheme in place, apart from Scotland where indemnity costs are lower.

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It comes as Pulse revealed that one medical defence organisation has seen its busiest months ever as it supports GPs with increasing complaints and claims.

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Patrufini Duffy 2 July, 2021 3:25 pm

Your workforce is scared to work because of litigation by the state itself? That is the fundamental flaw of the UK state free buggery system.
Dumb beyond a generation.

John Graham Munro 2 July, 2021 5:23 pm

Of course practices have always expected locums for free——ask Richard Gordon who once said ”G.Ps know more about finances than swiss bankers”

David Church 2 July, 2021 11:06 pm

That statement from Welsh Government spokesperson needs challenging on several grounds :
with which stakeholders and unions did they engage?

Did they engage with any locums at all or any representatives of locums, during the period?

They are a bit selective about the feedback received – they have mentioned the positive fedback, but not the negative feedback! I would not pass my appraisal honestly by doing that.

terry sullivan 3 July, 2021 8:24 pm

sounds illegal to me–CMA?

Mark Cathcart 13 July, 2021 10:05 am

Three years late, BMA ni are starting to have negotiations with Ni department of Heath
Says it all really!
Northern Ireland gps are the only gps in the uk still paying full whack medical indemnity
Think about that for a second!
12000 pound penalty every year for being a gp in Northern Ireland:
I know the scenery is nice where I live but really folks, 12000 pounds annually over and above what my English and welsh colleagues pay!