Locum Doctors - an area for NHS savings?

I worked at Aintree hospital, i setup accounts amongst other things for locum Drs, they got £1500 per shift, i knew one Dr was a GP in Liverpool but on weekends he did locum work also.

I was astonished when i heard about the wage.

Aintree, that was (or still is?) part of Merseycare, that nearly went bankrupt :D I worked for the Royal for a while.
 
honestly your talking out of your ass

The average pay of a doctor is not £100k

https://www.bma.org.uk/advice/employment/pay/consultants-pay-england

To get to £102k you have to have been a consultant for 19 years, plus the 8 to 10 years as a junior doctor until you make it to consultant.

This is what a junior doctor is paid
https://www.bma.org.uk/advice/employment/pay/juniors-pay-england
Year
year 1 - 22,862
year 2 - 28,357
year 3 - 30,302
year 4 - 32,156
year 5 - 34,746
year 6- 36,312
year 7 - 38,200
year 8 - 40,090
year 9 - 41,979
year 10 - 43,868

The above is plus anything between 0 and 40% banding for doing on calls and the extra 8 contracted hours.

Then you become a consultant and your pay goes up to £76k

So the average is WAY off the 100k you are claiming.

Also keep in mind we are about to take a pay cut which will be around 15%

Those figures are not a true reflection of basic pay. For example F1 on wards get additional pay as standard that is not advertised in the basic salary figures. So for example an F1 doctor on £22,862 a year will also get an additional £900+ a month in their salary

So in reality they would be on roughly £2700 a month before tax which is £32,400 so basically 30% more. This is the same all the way up the scale maybe not the exact percentage increase but basically a large increase in basic pay.

The complete lies about Dr's pay in the media etc. to make out NHS doctors are hard done by is complete nonsense. Also GP out of hours salaries for a single shift (1 night) can be £1,000.

Doctors get very well compensated for their work. Not many professions pay you a basic (forget all the OT and on-call additional pay) £32,000 while you are still learning on the job in year 1.

The current craze with Locums is simply down to the fact that people are in the profession for the money more than anything else, and they don't really want to do a stressful job for 5 days a week. So they cut their shifts down to 2 - 3 days and work them as locum shifts and happy days you get paid more to do less. If only we all had the option :)
 
Which he clearly mentions in the line below the basic pay:

"The above is plus anything between 0 and 40% banding for doing on calls and the extra 8 contracted hours."
 
Those figures are not a true reflection of basic pay. For example F1 on wards get additional pay as standard that is not advertised in the basic salary figures. So for example an F1 doctor on £22,862 a year will also get an additional £900+ a month in their salary

So in reality they would be on roughly £2700 a month before tax which is £32,400 so basically 30% more. This is the same all the way up the scale maybe not the exact percentage increase but basically a large increase in basic pay.

the post you've quoted actually says: "The above is plus anything between 0 and 40% banding for doing on calls and the extra 8 contracted hours." so I'm not sure how you can say it is misleading by pointing out something he's already stated

As for people who are supposedly only in the profession for money - given that we're talking about people pretty much among the top of their peer group academically they'd have likely have been earning much more money had they chosen other professions.

The barrier to entry to become say a solicitor, accountant or an engineer is a fair bit lower - plenty more universities offer degrees in those areas and it certainly isn't as competitive as getting into med school. These junior doctors are more at the level of the law grads who'd end up as barristers or at a magic circle firm or people who end up at top consultancies, investment banks, google/facebook etc.. in choosing to pursue medicine they've chosen to earn substantially less than if they'd chosen other careers.
 
Last edited:
The complete lies about Dr's pay in the media etc. to make out NHS doctors are hard done by is complete nonsense. Also GP out of hours salaries for a single shift (1 night) can be £1,000.

Doctors pay is about as transparent as it gets, you can look at my name badge, see what level I am and go online and find out how much I earn - it's all publically available.

The fact the media screw it up (both ways - ie the Tory press pushing the "locum doctors holding the NHS to ransom BS) is their fault. I'm not sure blaming greedy doctors for the press' perception of our pay works out.

I earn nearly £1k for a single night shift if I choose to locum. Why? Because my trust has tried paying less and no one does it. I'm not even a consultant, that would be double that. Am I greedy for working those shifts? Should I be doing them for less out of the kindness of my heart?

Doctors get very well compensated for their work. Not many professions pay you a basic (forget all the OT and on-call additional pay) £32,000 while you are still learning on the job in year 1.

How do you come to the conclusion of a job well compensated? I see this thrown around regularly but in reality doctors pay has fell year on year. At what point is it not well compensated? I am single handedly responsible for the health of every child in a county and a half, or recently I was manning a cardiac ITU full of the sickest kids you could imagine - even if I was working extra as a locum I'm still cheaper than an emergency plumber.

The current craze with Locums is simply down to the fact that people are in the profession for the money more than anything else, and they don't really want to do a stressful job for 5 days a week. So they cut their shifts down to 2 - 3 days and work them as locum shifts and happy days you get paid more to do less. If only we all had the option :)

Locums exist because the NHS is broken. Not because people are greedy. If you're running the NHS and don't want to pay locums then you need to look at why they're needed. Training numbers are falling, fully trained doctors are emigrating overseas, foundation year progression to high speciality training is falling year on year.

There are jobs that have become so unattractive (looking at you A&E) that if you want to staff your department you need locums at the moment. The departments have to pay enough to get people to do the job. We've had locum pay caps, they lasted a couple of days before being breached because no one wanted to do the work for crap pay.

Look at todays news:

http://www.bmj.com/content/356/bmj.j903

We can't even get people to do the job when they're young and enthusiastic.
 
Last edited:
A solution would be to take a medium term hit; improve working conditions and remuneration for all clinical staff directly employed by the NHS (but perhaps consolidate and increase the mix of bank staff to cover larger areas) - people will re-enter the profession and the training intake will increase, then a few years down the line locum costs will drop as the demand isn't there.

Or we could put a cap on locum pay, increasing system attrition until the workforce base is completely broken.
 
perhaps I should ask my company if I can go down to working 3 days a week for them (but keep 75% of my salary) then do private work for the other 2 - do you think they'd be happy with that?

Perhaps you should? My manager has successfully negotiated moving to 4 days a week at 100% of her salary, she could do consulting with that extra day (or 2 if she decided on a 6 day work week) if she wanted, and rightly so.
 
A solution would be to take a medium term hit; improve working conditions and remuneration for all clinical staff directly employed by the NHS (but perhaps consolidate and increase the mix of bank staff to cover larger areas) - people will re-enter the profession and the training intake will increase, then a few years down the line locum costs will drop as the demand isn't there.

Or we could put a cap on locum pay, increasing system attrition until the workforce base is completely broken.

That's what we were pushing for throughout the junior doctor strikes but it fell on deaf ears. There is simply no appetite for investment in the NHS or medical training with the current government.

Stupid thing is the government want to drive down spending and that hospitals are practices would love to be rid of agency staff and cover everything in house, - it's cheaper, the quality of staff is better - but that can only happen with prolonged investment and the government won't touch it with a bargepole.

The cap on locum pay didn't work. It was tried last year and was dead in the water before it got to the tightest caps, people wouldn't work so trusts had to just pay up. They've even tried to put a clause in the new JD contract to force you to work for your trust if you choose to locum in your free time for capped rates - that will fail aswell.

I like the analogy of the NHS being a bleeding patient. Common sense says try and stop the bleeding with surgery whereas what the government is trying to do is just soak up the blood with fewer and cheaper bandages.
 
As others have mentioned, there is nothing secretive or hidden or "not advertised" about doctors salaries. Naming no names, some people seem to have a slight misunderstanding about exactly what a doctor's pay is, so have a read of the following, definitive, pay and conditions circulars from the NHS employers website:

This details the new (much disputed) junior doctor contract which covers the first year out of med school (F1) up to the highest level of specialty training (ST8). It clearly details basic pay followed by supplements i.e. on-call allowance, weekend supplement, flexible pay premia etc. For what it's worth, my own personal forecasts when I qualify are ~£28,000 in F1 and ~£32,500 in F2, all in, dependent on how many unsociable hours my specific job will entail.

This, if you go to annex A section 2, will tell you everything you need to know about the current consultant contract, including pay progression and clinical excellence awards. It also reiterates salaried GP pay as mentioned earlier in the thread. GP partners are more akin to a business enterprise and their pay is related to the performance of their practice, put very simply.

As for locum pay - that's a matter of supply and demand.
 
As for locum pay - that's a matter of supply and demand.

This is the crux of it. Supply is poor, demand is high. The Government don't like it and are trying to price fix/control the market/bring in fidelity clauses and cripple penalties for overworking - none of it will work. They just need to train staff and make an attempt to keep them.
 
That's what we were pushing for throughout the junior doctor strikes but it fell on deaf ears. There is simply no appetite for investment in the NHS or medical training with the current government.

Stupid thing is the government want to drive down spending and that hospitals are practices would love to be rid of agency staff and cover everything in house, - it's cheaper, the quality of staff is better - but that can only happen with prolonged investment and the government won't touch it with a bargepole.

The cap on locum pay didn't work. It was tried last year and was dead in the water before it got to the tightest caps, people wouldn't work so trusts had to just pay up. They've even tried to put a clause in the new JD contract to force you to work for your trust if you choose to locum in your free time for capped rates - that will fail aswell.

I like the analogy of the NHS being a bleeding patient. Common sense says try and stop the bleeding with surgery whereas what the government is trying to do is just soak up the blood with fewer and cheaper bandages.

It's divide & conquer at the Tories worst. If they can successfully turn the public against the NHS (the thing almost all of us regard as this countries greatest achievement) then we're proper ******.
 
Last edited:
Ahh so this is what all this is really about, envy.

No wouldnt say envy, i have family who are doing the same thing now "locum work" and its nice for them, i just cant stand people moaning about how tough it is and how they are having a pay cut, give me a break. :)
 
Those figures are not a true reflection of basic pay. For example F1 on wards get additional pay as standard that is not advertised in the basic salary figures. So for example an F1 doctor on £22,862 a year will also get an additional £900+ a month in their salary

So in reality they would be on roughly £2700 a month before tax which is £32,400 so basically 30% more. This is the same all the way up the scale maybe not the exact percentage increase but basically a large increase in basic pay.

The complete lies about Dr's pay in the media etc. to make out NHS doctors are hard done by is complete nonsense. Also GP out of hours salaries for a single shift (1 night) can be £1,000.

Doctors get very well compensated for their work. Not many professions pay you a basic (forget all the OT and on-call additional pay) £32,000 while you are still learning on the job in year 1.

The current craze with Locums is simply down to the fact that people are in the profession for the money more than anything else, and they don't really want to do a stressful job for 5 days a week. So they cut their shifts down to 2 - 3 days and work them as locum shifts and happy days you get paid more to do less. If only we all had the option :)

If we are going to throw around numbers lets be factual.
Yes the base pay is £23k, that’s for 40 hours a week, they got a extra £9k for doing an extra 8 hours a week and to compensate for doing nights, evenings and weekends.

I have quite a good rota but I do 1 weekend in 4 (so that’s 12 day stretch without a day off), 3 blocks of nights in 4 months (3 or 4 nights), these are both 12.5h long shifts. On average around one and half times a week I have a oncall day which is a 12.5h shift.

So a F1 is getting paid £32k for doing long hours and difficult shift patterns, don’t forget the rest of you are contracted to do 38h a week, we do 48 that’s over a week of extra work per month (and thats why we get the 40% banding), that works out to £12.50 per hour and lets not forget most do quite a few extra hours unpaid.

Yes we are all learning on the job, but don’t be under any illusion that they are not providing a service. At night I take referrals and my F1’s provide ward cover, so if you are a inpatient and need a doctor at night, get sick or the nursing team need anything it’s the F1 that is taking care of you. They work very hard and during the day they more or less do the same as the rest of us. The only difference is they can’t clerk in new patients without someone looking over the plan.

Very few people go into medicine for the money unless they are truly stupid, even after 10 years when you are a SPR the hourly wage is £24 per hour.
If you are not a consultant its simply impossibly to say that you will work 2 days a week and locum the rest. Its just not allowed and you would not be able to complete your training.

Yes I do extra locum work, yes I get £36 per hour for it, but its in my annual leave or on weekends that I am not supposed to be on the rota to work.

Would I ever consider working as a doctor if I was not already well established, HELL no.

Rojones, how much do you get paid per hour? Im guessing its probably around the same or more than a doctor. Do you think you are better educated than a doctor? do you think you provide a more important service? do you think your job carries more stress than a doctors where every decision you make could cost a life and see you end up in court?

Doctores are worth twice what they are paid.
 
Last edited:
Back
Top Bottom