Exclusive NHS England has ‘clarified’ a clause in its locum bank framework that would have allowed practices to cancel locums on the day without facing a fee, following pressure from Pulse.
GP leaders had approached Pulse, expressing concerns that the policy would be ‘devastating’ to locums and could create instability by bringing a ‘cancellation culture’ to general practice.
NHS England’s ‘framework for digital solutions for the deployment of sessional clinical capacity in primary care’ is backed by a £120m GP workforce fund for each STP or ICS across the country.
The framework documents, which are not publicly available, set out ‘standardised financial and commercial arrangements’ for suppliers selected to take part, including around late-notice cancellation fees.
They said: ‘[Suppliers must] allow sessional clinicians and practices to access the digital platform and post or fill shifts on the digital platform without binding them by the following terms and conditions… Cancellation fees or payment if the sessional clinician or practice cancels a shift.’
As a result, locum bank Lantum – one of six suppliers on the framework – last month alerted the 20,000 locums on its books that short-notice cancellation fees would be removed from its terms and conditions from 1 March.
In an email seen by Pulse, it said the change would mean clinicians are ‘no longer entitled to charge a practice for cancelling a session within five business days or less’.
But following enquiries from Pulse, Lantum said NHS England has ‘clarified’ its framework specification, saying the ban on cancellation fees only applies to those levied by digital suppliers.
According to Lantum, NHS England said: ‘This framework removes a mechanism for digital suppliers to take fees from practices and sessional clinicians for late cancelled sessions.
‘Any interactions between a sessional clinician and practice are outside of the scope of the framework and the contractual commitment between these two parties can be determined on an individual basis.’
Lantum has now told locums they can still raise cancellation fees with practices that cancel their shifts at short notice and includes a ‘short-notice cancellation fee’ in its terms and conditions, it said.
Before the clarification of the policy, National Association of Sessional GPs chair Dr Richard Fieldhouse told Pulse that last-minute cancellations have a ‘devastating’ impact on locums.
He said: ‘I have been a GP locum now for 25 years and have largely managed to avoid being cancelled at the last minute by having a robust set of terms and conditions, but over the years I have had many conversations with hundreds of locums who have not been so lucky.
‘These cancellations have had a devastating impact on them, not so much from a financial perspective, although that is a problem, but much more so on morale at being treated in this despicable way.’
He added: ‘Locums need to be able to plan ahead when it comes to where, when and how they work, not scrabbling around on the day to try and find work.’
And he warned that allowing practices to cancel locums on the day with no cancellation fee could bring instability to general practice, potentially ‘legitimising’ locums cancelling shifts last-minute at practices too.
He said: ‘It is a new cancellation culture for general practice and really brings full meaning to the phrase “disruptive technology”. But general practice does not need disruption, it needs stability.’
A spokesperson for Lantum said: ‘Historically, Lantum has always supported late notice cancellation fees. We want all of our clinicians to feel confident that when they’ve been accepted to a session, they will be able to work and get paid for that session.
‘We respect the autonomy of clinicians and will enable them to keep the right to charge whilst at the same time following NHSE framework guidelines. As such, clinicians are free to charge a practice directly for cancelling a session on short notice; however, we will not charge practices any fees payable to Lantum for cancelling a session on short notice.’
NHS England has been approached for comment.
In July, NHS England said that local ‘banks’ of GPs working ‘flexibly’ would be set up across the country as part of its much-anticipated People Plan.
It comes as BMA data has revealed that GP locums are almost half as likely to have received their second Covid vaccine dose as GP partners.