By Nick Flynn, Clinicall Cic
Locum rates and trends
I must begin with the main factor driving locum rates, and this may be an obvious one – it’s down to the time of year in which sessions are booked. This may not always be the case, but is the main contributing factor, after all, this is a seasonal market. Holiday periods during which locum demand reaches peak levels, offers locum GPs more choice and flexibility; inevitably impacting charging rates. This, at times, leads to GP practices feeling the need to increase their usual ‘ceiling’ in order to secure locum cover, with many more practices offering long sessions to doctors, reducing any usual availability they may see.
With a large number of agencies duplicating this effort to secure locum availability in offering higher rates, this then creates further opportunities and choices for locum GPs. An example may well look like this: a practice could have been arranging sessions with one locum for three months prior to the holiday period (let’s say summer in this case), with the intention to provide further sessions over the holiday period when they have an increasing need for cover. Having been provided opportunities to work for higher rates within many other settings, the doctor has a choice to make in either continuing to work with the practice s/he is providing continuity for, or increasing their earning potential with other practices in high demand, closer to home (of course, this may well be the reason they took up locuming in the first instance – for flexibility).
Typically, we find most practices to offer doctors a 15 patient surgery along with 30 minutes of admin time to wrap up consultations, along with some possible prescription signing. Previously, over 12 months ago, this wasn’t so much a trend and doctors would attend a 15 patient surgery (2.5 hours) only. The increased session length may originate from GP practices attempting to appeal to locum doctors by providing more attractive and worthwhile sessions in order to captivate them.
A proportion of doctors are happy to undertake ‘on call’ days within practices. However, as we have seen in recent times, with rates increasing many GPs would rather not take the responsibility of essentially being a partner for the day, in light of the opportunities presented within other local practices. We have seen many partners leaving their practices in order to become a full time locum GP, essentially to escape the responsibilities of being the ‘go-to Doctor’. Locum sessions generally provide flexible working hours, allowing for shorter days, which is very attractive for those who wish to see two surgeries in the day and still be in a position to attend a school run or even attend out of hours shifts later in the day.
After the summer period we generally see an increase in availability, with newly qualifying GPs seeking locum sessions and practices back to optimal staffing levels after annual leave periods (as optimal as can be as recruitment of salaried GPs is proving difficult). This period then produces lowering rates, as seen year by year, due to demand levels dropping. Planning is a key factor at this stage, with early arrangements providing lower rates with opportunities for continuity. Late and last minute requests still see an increase in rates due to the urgency of the required cover so we urge practice managers to plan ahead, wherever possible, should the cover be due to CCG meetings or annual leave.
It is very hard to envisage any change in the trends currently displayed. Permanent recruitment is proving difficult across the NHS as a whole and this doesn’t look set to change any time soon.
Typical rates in the North West, where Clinicall is based:
|Region||Hourly||Half day ( 3 hour session – 15 patients)||Full day (2 x 3 hour sessions – 15 patients)||On call Doctor||Visits|
By Nick Flynn, Clinicall Cic