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Salaried, freelance and locum GPs: GP contract changes will affect you

Posted on 6 February 2013 by Vicky Weeks  12 comments

The focus of much of the comment, coverage and concerns about the government’s proposed changes to the GP contract have fallen on how GP partners will have to manage the impact of the double whammy of rising workload and contracting resources.

To an extent this is understandable – but sessional, freelance and locum GPs should not be lulled into thinking that this is something that doesn’t affect them or a headache they won’t have to deal with.

The changes will have a profound effect on the working environment of every GP. There will be more work to do and more targets to meet with fewer resources available in practices. These changes affect each GP, whatever their career portfolio or working pattern.

More worryingly, a spectre of staff cutbacks hangs over general practice. It is difficult to know how this will pan out, but it is almost certain that in this even harsher economic landscape, there will be fewer jobs to go round and diminishing pay levels for those in work.

This is why it is crucial that salaried, freelance and locum GPs don’t bury their heads in the sand. I would urge you to look at the available BMA’s resources and understand the impact of these proposed changes will have upon you and the rest of general practice, including the differences between Scotland, Wales and Northern Ireland.

If you are in England, please take a few minutes to fill in the BMA’s survey about these changes – this will help inform our response to the government’s consultation on the proposals.

As BMA GPs committee chair Laurence Buckman said in his blog last week, this is one survey that GPs must not delete – and this is even more true for the many salaried, freelance and locum GPs who will have to work with the wide ranging ramifications from these ill thought out plans.

Vicky Weeks is chair of the GPC sessional GPs subcommittee

Posted in:  Contracts

Tags:  general practitioners committee contracts england

Comments

  • Theresa Foxton

    9 February 2013

    I couldnt agree more.The proposed changes to sessional doctors pension arrangements are especially worrying;Particularly in view of the fact that no one seems to understand ( including SBS and the BMA pensions subcomittee ) how this will work in practice.The bottom line is crystal clear- Sessionals who still need to try and stay in the NHS scheme will effectivley become much less attractive to employ or will have to be prepared to take a big hit to make up the shortfall.Traditionally we are a group that have been sidelined by Principals to the extent that manyof us have started to believe that we dont matter.Time to get off the sidelines, get informed and make your voice heard

  • Dr Martin Dace

    9 February 2013

    Essentially the pension rights that the BMA has won for GP locums working in the NHS will be lost again for all practical purposes (as indeed have similar benefits to NHS GP principals). On the other hand I don't see demand for locum services declining - quite the reverse. Market forces will determine locum pay.

  • Dr Martin Dace

    9 February 2013

    (My comment appears to have deleted the previous comment!)

  • Susan Swanston

    9 February 2013

    There are still plenty of jobs in Australia!

  • Dr T

    10 February 2013

    Those Of us who have bought added years will be even more unattractive to employ , and or will take bigger pay cuts. I suspect that will mean quite a few women who took maternity leave.

  • Denise Hennessy

    10 February 2013

    We have been to a BMA roadshow so find out more of the facts and report back to the other clinicians.
    We are going to loose up to £30.000; we dont agree with the new QOF recomendations on clinical grounds and the new DES are ridiculous.We were reminded that QOF is voluntary but that is not realistic overall but I do agree we need to pick and choose what is worth the hassle.
    The maximum QOF is still upheld as a badge of honour, a measure of quality but is unachievable.
    Some of my young partners are keen to maximise this as they are a new mortgage payers so to disagree and become a luddite is divisive in a partnership.
    I gave up being an appraiser as I didnt agree with the prescriptive direction it was taking but I am no worse off financially because of the tax situation.
    Our access is deteriorating but it seems beyond our control; especially at this time of year when we are chasing QOF points.
    But after 25 years I still go to work because of the patients who are loyal and grateful. Medicine is a still a great career but it is hard not to let all this dismay you!
    Wet Sunday rant over..

  • Dr Juneja

    10 February 2013

    I was a locum for 5 years before becoming a Principal. I know how hard it is to go to a Practice you don't know - the uncertainty of workload, the apprehension about the Principals,Staff and patients you would have to work with; and the daily worry that tomorrow there might not be any work.
    Today I employ locums and give them the respect and consideration I expected.
    However, due to recent re-negotiation of Contract, my MPIG was taken off overnight.
    As a single handed GP, I now have 3500 patients and a bare global sum for a weighted population at 64.59 per patient for a weighted list of 3200. With further cuts looming, to recover the loss of MPIG, I plan to increase the list size to 4000.
    The other radical step planned is to cut locum cover although this would reduce slot availability and queues for patients. Cuts in QoF could be digested but the rationale behind compelling GPs to pay locum superannuation is something I will never comprehend.
    There is one question which I can't answer -
    Should I thank my stars that today I am not a Locum who may not find work, or should I curse fate that I am a Principal who has to work like a donkey.
    Do you know the answer ?

  • An "old Buffty"

    11 February 2013

    The only firm conclusion one can draw is that life isn't easy in either camp and we are all being exploited. Evidence changes so targets are carrots and sticks which make us all more tied to performance related targets which no other profession or part of our profession would countenance. We are no longer professionals in the true sense. The concept of increasing list sizes to 4000 per principal reverses all the work our forebears did in the 1960/70s to reduce list sizes to increase quality. We are trying to get a quart from a pint pot. We cannot do all the work that is required to address the Public Health agenda without reducing some of the work in other areas which often means aspects such as home visiting and care of the elderly esp in care homes. We need to get back to a contract that reflects the fact that there are a lot of patients who need care and that we need to spend more time thinking about those aspects and worrying less about our income. I agree making us focus on our income and the quality of care may appear to be incentivisation but the baby has gone with the bathwater. Where did professionalism go? What resources are dedicated to managing the contract both in practice and in HAs? Would this not be better spent on patient care? Would we as doctors be happy as patients with the care our services provide?
    As someone who works OOH and as a locum I know the weakness of the "only clinical work" I do is that I have very little knowledge of the patients either personally or of their history. We are all doctors but we all know we are not equals. Changes that increase the cost of locums to practices will reduce their use and deter practices from backfill when they really need it which will further increase pressure and especially on quality of care.

  • Dr.Samia Bushra

    11 February 2013

    With the growing divide in general practice workforce mainly brought on by the scarcity of partnership offers in the last 10 years, this was bound to happen. Locums/salaried like myself have never been taken seriously when it came to changes in the practice or in the local teams. We have gradually disengaged ourselves from commitments and realised that working overtime was not doing a good job but doing unpaid work. The changes which come will just mean more of us will opt to be locums. Perhaps if things had been different in the past a large number of us would have become partners or been happy to remain salaried. That would mean the bulk of general practice would have the same agenda and worries. A large workforce all aiming for the same thing might have a stronger impact on politicians etc. As it is our problems differ widely and the proposed changes to contracts affects the partners first and them maybe locums but not siignificantly. ?Divide and conquer?

  • Dr Imam

    13 March 2013

    Please correct me if I am wrong but my understanding is that all practices will be paid a lump sum (to be included in the global sum) to pay for the locum's employers' contribution. Some practices are under the impression that Locums will drop their rates to reflect the 14% employers contribution, while others want to negotiate with Locums to pay half (7%) of it while the practice pays the other hallf - what they should understand is that the employers contribution must be paid by the practice that employs the Locum and is not up for negotiation. It is law. Locum work may decrease initially but this wont be for long as the Locum workforce in indispensible.
    We are all doctors and should fight together for the benefit of our patients - dont let there be a situation of Divide and rule here!

  • Dr Sambandan

    15 March 2013

    Fully agree with Dr.Imam. It is the Employer who has to pay the 14%. The Freelance GP pays only the employees contribution. The Locum fees should take into account1) his/her Superann contribution 2) Medical Insurance 3) college/BMA Subs 4) sick leave. 5)!annual leave 6) Study leave. Many locums/ Freelance GPs are unaware of this. Perhaps the GPC, BMA needs to emphasise this. But there is a conflict of interest for the BMA which always tends to align with Partners. Time will tell! Worth remembering that the majority of the workforce is Salaried & Freelance GPs in UK. Your Rep in the LMC needs to take action too.

  • Dr.R.Es

    27 March 2013

    May I ask from colleagues is this changes of GP Locum pension contributions is for Locum GPs in England or whole the UK?Thanks

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GP contract changes

The Government intends to impose GP contract changes.

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