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Covering holidays when locums are scarce

Vacancy rates are very high at the moment – up to 65% in some areas, and 29% overall – and finding locum cover is becoming increasingly challenging.

Fewer trainee GPs are taking up roles a locums. While the results of a Pulse survey published in November show nearly half of GPs have been told by trainees that they plan to become locums when they qualify tally with the message we get from trainees, once they qualify many want the consistency of a salaried or partnership post.

So, covering holidays this year could be tricky, but these three tips may help.

1 Incentivise internal cover

To encourage staff to cover internally, stagger holidays by planning them early and encourage part-time GPs to do extra sessions in peak holiday periods. Consider restricting holidays in peak months too.

For partners doing extra sessions, agree a sessional rate higher than for locums, to recognise the extra benefit a partner brings. Being able to maximise income and other efficiencies should offset the extra cost. Typical locum rates are £225 to £250 plus employer superannuation; for a partner, this may well be £50 more. Look at the last practice accounts and divide profit share by sessions worked to see the effective rate for partners.

Additional sessions for partners will be shown as a prior share of profit in the accounts. The payment to a partner should be after deductions for employer and employee superannuation, and for tax if this is paid by the practice.

If you pay your salaried GPs for additional sessions, this should be treated as overtime and as additional pay.

2 Book locums a year in advance

Smaller practices may have to rely on locums, which makes it important to book them well in advance. I know of practices that book up to a year ahead to secure their preferred locums in summer.

While in theory trainees join the locum ranks after qualifying in August, they may want a break. In any case, unless they have trained with you, you might be reluctant to take on a brand new locum.

3 Save on pension contributions

Consider seeking locums who are not in the NHS Pension Scheme, which will save on the employer contribution, although these locums may charge a higher rate.

Your locum contract should state that employer pension contributions must be returned to the practice if the locum does not pay them into the NHS scheme, as it is illegal for them to keep the contributions.

Luke Bennett is a partner at Francis Clark LLP and a committee member of the Association of Independent Specialist Medical Accountants