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GPs having to travel ‘from Cumbria to Cornwall’ to secure locum shifts

GPs having to travel ‘from Cumbria to Cornwall’ to secure locum shifts

Exclusive GPs are driving across England, staying in hotels overnight and driving up to four hours on a daily basis to get locum work amid a shortage of shifts available.

GP locums in England said they are being forced to travel dozens of miles to find sessions available in the current employment crisis, with some willing to accept shifts anywhere in the country.

It comes after the BMA’s GPC chair warned general practice has suddenly gone from a recruitment to an employment crisis, driven by the Government’s squeeze of practice finances, while Pulse has reported extensively on a reduction in demand for locum posts, in part driven by the additional roles reimbursement scheme.

Recruitment consultant Ruth Hennessey, a director at the GP Locum Agency, explained that GP locums from her agency are now willing to travel ‘around the whole of England’ to find work.

‘If I have a doctor in Cumbria, they will go to Cornwall for a week’s worth of work, because they have to go where the work is,’ she told Pulse.

‘There’s so many without work at the moment that they are all wanting to do bookings around the whole of England – they are just taking it where they can get it.’

North Devon GP Dr Finola O’Neill told Pulse she was willing to accept shifts anywhere in the UK, and regularly stayed in hotels overnight to be able to secure work far from where she lives.

She said: ‘Suddenly around October work dried up and initially I wasn’t getting any work and had to go via an agency.

‘It seemed really sudden. The locum agencies that always had work had nothing, even if I was willing to travel anywhere in the UK.’

She is currently working two days per week in Weston-Super-Mare, a two-hour drive each way from where she lives, and often worked weekends in Somerset and Plymouth and stayed over in hotels.

‘Luckily because I’m self-employed I can charge the petrol against my taxes and the practice has been very helpful letting me start at 9am. At one point I was driving 12 hours a week and that is time I could have spent seeing patients.’

Dr O’Neill added that she was asked to reduce rates to secure shifts and worried that this is going to drive GP locums out of the profession.

‘I have options to get out of medicine – but I would happily work as a GP for another 20 years if I could.

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‘I know so many GPs are thinking of ways to get out, and I think this is going to have long-lasting implications.’

Dr Najma Hussain, a GP based in Greater Manchester, said she had to travel to Cumbria to secure work.

She said: ‘I had to travel to Cumbria which is a four-hour round trip, with standard pay but additional workload and huge amounts of admin compared to standard locum workloads.

‘Agencies are always asking us to reduce our rates, as the work is offered to the cheapest bidder.

‘Working away from my three kids has been something I have had to consider to make ends meet. It’s a soul destroying situation, one I never thought I would have to face.’

North Leeds GP Dr Andrew Summers said that his average GP locum session now ‘usually starts with a journey on the motorway’ driving to a practice 40 miles from where he lives.

He told Pulse: ‘I started off travelling max 15-20 miles. Mostly now find I have to travel to Bradford or to sessions in Hull, Humberside and Rotherham.

‘Even when sessions come up and recruiters send us the details by text or email if you don’t respond within literally minutes they are gone.

‘I assume there are huge numbers of GP locums all battling for scraps. GP locums are in my experience dead in the water and your only option now is salaried posts and maternity cover.

‘If I was a young recently-qualified GP right now I would be hugely disappointed and feel robbed.’

Pulse reported that requests for GP locums within primary care settings ‘have reduced since the summer’ with ‘various new ARRS roles coming to the forefront at surgeries’, and locums were asked to consider reducing their rates to secure work.

Earlier this month, GPs told Pulse there are concerns around ‘misleading’ wording used by some agencies that seem to be pushing for ARRS staff to replace GP locums.

Earlier this year, the National Association of Sessional GPs (NASGP) said that GP practices are in no way ‘cutting back’ on employing locums despite reports of a scarcity of work.


          

READERS' COMMENTS [12]

Please note, only GPs are permitted to add comments to articles

Simon Collins 29 April, 2024 12:08 pm

Re Dr O’Neill’s comment about being able to charge petrol (and presumably hotel) expenses against tax – I anticipate that this “loop hole” will likely be closed off in the very near future. It is an anachronism that I am sure HM Treasury has in its sights.

Not on your Nelly 29 April, 2024 1:12 pm

Market forces….. everyone knows what they are signing up for. You have to change and get on with it or die trying sadly. The long term GP locum (as already in the article) has died a death for now. People will need to join a practice long term or think of an alternative career. Surgery is quite good I hear.

Marilyn Monroe 29 April, 2024 2:49 pm

Not market forces. Medical employment in the UK is not a market. Its almost entirely controlled by the UK government. The government controls the supply of Drs through training, it does its best to control how Drs practice through the GMC and NICE, it uses every mechanism it can to control how much they get paid. The aim is to secure as much much health care as possible for the tax payer whilst paying as little as they can get away with. When market forces do genuinely show themselves (for example locum rates) the government intervenes to crush the market. Fir example ARRS funding that CANT be spent on Drs. Nothing is off the table..to the extend they are currently getting rid of Drs ..in primary care at least. Those long term salaried job you’re referring to Nelly are disappearing too. I know, I’ve looked. Its absolutely farcical to suggest the UK has a functioning market in the employment of Drs. The government has suffocated the medical profession to the point it is barely functioning. They’d rather give the money to bankers..now they ARE worth it. You simply cant pay enough for top banking “talent” in the UK

The Locum 29 April, 2024 3:13 pm

I finish as a UK NHS Locum this week and start my own patient list in Canada full time in June.
There are still good options outside of the UK for UK doctors

Michael Johnson 29 April, 2024 4:05 pm

Things started going to hell in a handcart with the introduction of “performers lists”. It was clearly a restriction on trade. On recent years the rise of the Noctor, not just PA’s funded externally whlist practice funding has been ever squeezed has shown the direction of travel by government.
The plan is clearly to make primary care doctor “lite”
However, my wife reminded me that back in the halcion 90’s I found it hard enough to get locum work as your face needed to fir, you needed to be the “right sort” vs that colour, class or religion.
The gilt pension brigade dud the rest of us no favours.

John Graham Munro 29 April, 2024 4:27 pm

To think-all those years ago, I was so proud to have got a place at Medical School——————–but now?

Rob M 29 April, 2024 4:50 pm

Agree with MM, in no way can todays Primary Care workplace be considered open to free market forces as far as the newly qualified concerned – no Partnerships available and Salaried posts pegged down to artificially low rates in order to keep existing partners going.
Why would any new GP not be looking abroad these days? And good luck to them.

M symon 29 April, 2024 5:03 pm

Unfortunately, to an extent, professional locums have contributed to this crisis. They have requested renumeration similar to that of a GP partner, but with none of the responsibility.
Many GP practices have been unable to recruit due to the obvious job stress & had to rely on Locums who demanded increasing fees for a number of years. This money was required in order to see a defined number of patients, the occasional visit (for an extra fee) and no administrative work/extras/emergencies as opposed to salaried or partnered GP doing all of the above for similar or less money.
The fallout is that as soon as a more affordable option presented itself many practices will have opted for this I’m afraid.
Ideally GPs would be best served to opt for a Salaried/Partnership role, as preferred, & offer the continuity that is the mainstay of the profession. The renumeration may not be as good as a locum, but job security is worth it.

So the bird flew away 29 April, 2024 6:03 pm

All metrics for many years have shown we need more GPs and appointments. There’s currently a horde of (locum) GPs unemployed. This Govt, apparently savvy about economy theory, doesn’t fix the problem. This can only be intentional and ideological. It’s almost like they’re allowing locum GP labour to be hoarded and kept out of circulation. They should have learnt from Roman history that, to avoid people rioting, legislation was introduced to avoid hoarding (of grain in their case).
I would have thought that great wrestling and bloviating Catweazle classicist of our times, Boris Turds (nod to Stewart Lee), would know this. Fully agree with MMs comments above.

Finola ONeill 30 April, 2024 12:49 pm

To the couple of commentators here who enjoy buying into the governments divide and conquer tactics; No. Locums haven’t caused this issue. The government has; by keeping GP core funding down and ring fencing funding to noctors.

Salaried doesn’t pay enough, I know my worth, I don’t care if I develop another career to make money (already doing it, passed my Law Masters and starting a small business). Will do some medicine for hobby to keep skills up and use my talents for what I was trained for. I won’t apply for partnership until liability is underwritten by the government (as they already did with our indemnity) and we have some control over income and contracted responsibilities as having no control of either and unilaterally imposed contracts doesn’t appeal as a business model, funnily enough.

What the journalist didn’t quote me as saying, unfortunately as I personally find this the most important issue, is that by trying to crowd GPs out of General Practice and healthcare, by squeezing GPs’ finances and ring fencing funding for ARRS, the government have made an arse out of primary care which affects predominantly the patients. Shite healthcare. No continuity of care, no high quality of healthcare. Noctors are not trained to be GPs and can’t do our job very well except for specific limited circumstances-usually where they stay within their skillsets; paramedics-home visits, pharmacists-medication reviews, queries, etc, physios-msks appts, experienced nurse practitioners-simple urgent care lists

Chris Witty recently mentioned challenges of our current (and expanding) elderly population. We need generalists to manage their complex and intertwined conditions and complaints. GPs are the only generalists left apart from geriatricians, and there’s not many of them. Not long after I qualified 25 years ago, physicians stopped doing general acute take, until which point all physicians were generalists. They then started streamlining acute take and care is now very compartmentalised.

We already refer patients to multiple out patient specialties with disjointed and poorly coordinated care.
Now the government are even trying to block half those referrals.
Who do they think is going to care adequately for this aging population.
It won’t be noctors.

So I am happy to diversify. But It’s not looking good for future patient care.
But there you go. We don’t make the government money. We are not large private corporations that can lobby politicians or give them donations.
In fact we are one of the few professions left that front them up, cf recent strikes and BMA communications, the population still trusts doctors and we appear to be somewhat of a thorn in the side.
Especially GPs, who because of our private contractor status and being data controllers wouldn’t even let the government do what they like with GP records, a very valuable little asset for whoever can get hold of it. US pharma, healthtech, AI health, genomics are all frothing.

So not expecting for us to be given an easier time any time soon. Whatever. We will be alright. None of us are poor.
Healthcare’s going to hell in a handcart though. I do care about that.

Shame about the petrol and hotels. You are right. They will be closing that tax break long before amazon or Starbucks pay their tax. shame.

a S 30 April, 2024 6:31 pm

Been a GP 15 years and yes the market has collapsed. Many say it’s because of PA’s but I’ve rarely seen a PA and even still their work has to be duplicated. Personally i feel the main reason for this collapse is the NHS visa introduced a few years ago which means anyone from anywhere can take up a salaried post in UK and get an instant visa. This means all the surgeries that were struggling to fill posts and ran on locums can now fill any post so locums are no longer needed. That explains the 13k applicants for 4k GP training places whereas usually there area only about 3k applications. No other profession would allow such international competition. Most surgeries are run by companies now so it suits them perfectly. Cheap foreign labour means they can pay pittance and walk away with a massive profit. GP’s are heading to minimum wage so better get used to it or find something else to do like I am.

Katharine Broad 1 May, 2024 11:58 pm

I have found very little work as a locum GP.
I don’t feel that there will be GPs in the future.