Employing locum GPs in your practice

Locum guidance for employers includes factors to consider when employing a locum and how to get reimbursements

What all locums must have:

• All locum doctors must have the same training, postgraduate medical education and training board accreditation certificates as the medical provider they work for.
• All doctors must be included on one performer’s list in the country they practise in.
• Doctors can only be registered on one performer’s list in each country.
• It is in the GP practice’s interest to support trained and qualified locums so that they can cover for annual, maternity, sick leave or management time.

Deciding on a locum GP’s fee

What is a ‘session’?

A locum session is an agreed period of time, or agreed task of work, usually of around four hours. A session should include adequate time for administrative work arising from clinical contacts in that time.

Each session length and content has to be negotiated and agreed with a realistic assessment of work. Any additional administrative workload is negotiable with the contracting organisation.

Deciding a fee

The fee paid to the locum GP must take into account all duties performed during their session. What you should consider when deciding a fee:

• self-employed locums have to bear similar professional costs of practice as other GPs (what other GPs earn); 
• postgraduate qualifications;
• background skills (eg familiarity with local healthcare systems);
• knowledge of the local practice area and practice;
• local training in primary and secondary care, and experience in general practice (including experience as a principal);
• experience increases with the length of service as a GP – this cumulative experience may be reflected in the rates charged;
• job security – locums take the risk that if they fall ill, take time off for family reasons or take leave, they won’t be paid;
• previous experience of working in a similar practice or situation;
• the type and intensity of the work – read below.

What is your practice like?

Assesing the work environment – factors to consider:

• large volumes of high workload patients, e.g., patients in nursing homes, the homeless, asylum seekers, those with drug misuse problems etc;
• familiarity with practice procedures, e.g., ordering investigations, referring patients to secondary care;
• familiarity with practice equipment, e.g., computer systems;
• availability of practice partners for advice, support etc;
• the type of session, e.g., open access, booked appointments, enhanced service provision;
• practice staff support, e.g., availability of practice nurses;
• any other factors that could have an influence on the degree of intensity experienced within a worked session.

Locum GP cover for parental and sickness leave

When a salaried GP or GP partner is absent due to parental (maternity, paternity or adoption) or sickness leave, the practice is eligible to receive funding towards the cost of cover for that GP.

Locum reimbursement for parental leave

Eligibility

The GP must be on leave for longer than one week and must be entitled to parental (maternity, paternity and adoption) leave under statute, their contract of employment (in the case of salaried GPs), the partnership agreement or other agreement between the partnership (for GP partners).

Cover for the absent GP can be provided by either an external locum or another GP already employed in the practice.

Payments

Under the SFE, practices are eligible for a maximum of £1,143.06 (£1,113.74 in Wales) a week for the first two weeks and £1,751.52 (£1,734.18 in Wales) a week thereafter. If the full cost of the locum is lower than the maximum, the practice will receive the invoiced amount.

Practices should submit costs at a frequency agreed with the commissioner, or within 14 days of the end of the month for which they are claiming reimbursement. These payments will not be pro-rated in line with the working pattern of the absent GP.

Timescales

There are no timescales set out in the SFE for locum reimbursements for parental leave. Whilst NHS England’s policy protocol sets out that the practice will receive the stated reimbursements for weeks one-to-26, it is expected that payments will be in line with the length of maternity leave.

Locum reimbursement for sickness leave

Eligibility

The GP must be absent for more than two weeks before reimbursement costs will be paid; the only requirement is that the absent GP provides a fit note. Cover for the absent GP can be provided by either an external locum or another GP employed in the practice, provided they do not already work full-time.

Payments

After the first two weeks of absence practices are eligible to receive up to £1,751.52 (£1,734.18 in Wales) per week. If the full cost of the locum is lower than this, the practice will receive the invoiced amount.

Practices should submit costs to their commissioner/health board at the end of the month in which they were incurred. Payment should then be made to the practice on the day that it receives its next global sum monthly payment. These payments will not be pro-rated in line with the working pattern of the absent GP.

Timescales

Practices should receive the full agreed amount for the first 26 weeks (six months) of leave, followed by 26 weeks at half that rate. This begins after the initial two-week qualifying period.

Commissioners will account for any previous costs claimed for the absent GP in the same financial year when calculating the number of weeks for which further payments can be claimed – for example, if a GP was on sick leave for six weeks during May/June and then had a further sickness absence in December, the four weeks of reimbursements claimed earlier in the year would be deducted from the 52-week annual total.