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If I Knew Then What I Know Now… I’d Become a Locum GP!

I’ve been a practice manager for five years and have seen locum costs rise by at best 50%. There are credible accounts on the grapevine that some practices have paid an increase of more than 75% on fees during the last few years.

It doesn’t stop there. Locums can (and do) pick and choose exactly what they want to carry out during their working day. Some may sign a script, some won’t. Some will house visit, some won’t. Some will assist with the queries, some won’t. The truth is, locums can generally do what they want and practices have to be grateful that said locum has graced the GP car park with the presence of their Range Rover.

I’m not complaining about the locums I know. They’re great people. They look very relaxed – why wouldn’t they? My complaint is the disparity between what practices can and can’t afford along with the issue that there is no cap on locum fees in Wales (there is in England, but it’s voluntary!). We are therefore aggressively in combat with each other over who gets the locum. Sharing of locum information is a thing of the past; practice managers would (just about) rather share their stash of wine hidden under the desk rather than tell another PM who they’re using as a locum at the moment!

Joking aside, these rising costs are an issue, particularly for GMS practices who do not have bottomless budgets. Trying to run a business, trying to run a practice, trying to provide a service to their patients, trying to cover sick leave and holidays...

Even with six months planning ahead, getting a locum isn’t comparable to finding a needle in a haystack. It’s like trying to find a needle in a haystack that’s on fire while you’ve got a blindfold on. So when you find one and the pay keeps creeping up and up, practices have no option but to burden their bank balance with the cost because it’s either shell out or be snowed under.

So what’s the answer? In my insignificant opinion there has to be a cap (not voluntary) and a reasonable and equitable framework regarding the day-to-day responsibilities within the role that cannot be negotiated, putting all practices in the same boat with an impartial and consistent structure.

Practices don’t need or want to be in battle over locums, we want to be running a fully staffed surgery for the sake of our colleagues and our patients. To get there we need to have sensible session rates, not sky high costs, because the ultimate cost is going to be the service we provide.


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