Locum Doctors - an area for NHS savings?
- Thread starter Nitefly
- Start date
Yet they are pretty specialised, it takes years of training to get to become a fully qualified GP. If your business (a GP practice) has a serious need to recruit one for a short period as there is such a shortage then it could cost that much. Though realistically you're quoting a rather high rate.
You'll find that plenty of other self employed professionals who've had years of training to go through will charge those sorts of rates and more. Barristers, certain IT contractors etc...
It isn't like the practices are paying these rates for fun, they reflect the demand for the role.
I don't see why it is massively different to any other business that employs contractors. You've got various additional costs for full time employees, pensions, future pay rises even if you're not meeting their pay requirements right now. Any extra few grand in pay now actually costs you tens of thousands over the course of their employment. Whereas the cost of a contractor or locum are short term, you'll drop them as soon as you're able to.
Mhmm it's not really any more training / experience than any other qualified professional role IMO. We're going round in circles a bit as, as I've said, as barristers and IT constructors don't carry out jobs that are the business function of their 'employers' and if they are charging that much they are ultra specialist or ultra experienced - locum GPS are not that specialised nor require that level of experience to be earning that money. Barristers also pay for their chambers running costs.
If practices can afford to pay £1,000 a day for what are in reality not 'short term' posts than it boggles my mind how much money they are making out of the NHS.
I am admittedly biased against lots of 'public sector' roles and bitter over their frankly 'ultra lol' pensions
Mhmm it's not really any more training / experience than any other qualified professional role IMO. We're going round in circles a bit as, as I've said, as barristers and IT constructors don't carry out jobs that are the business function of their 'employers' and if they are charging that much they are ultra specialist or ultra experienced - locum GPS are not that specialised nor require that level of experience to be earning that money. Barristers also pay for their chambers running costs.
If practices can afford to pay £1,000 a day for what are in reality not 'short term' posts than it boggles my mind how much money they are making out of the NHS.
I am admittedly biased against lots of 'public sector' roles and bitter over their frankly 'ultra lol' pensions
A GP has had to get through more training than a barrister in or typical IT consultant. I don't see how a barrister in general is any more 'specialist' in that respect. Are barristers in receipt of legal aid money 'public sector' too? A locum doesn't get a pension and GP practices are privately owned partnerships.
The rates also reflect demand for their skills, if junior barristers are losing lower level advocacy work to solicitors then there is less demand for their skills. In future we may see some solicitor firms losing work to the likes of Tesco for basic wills, conveyancing etc.. there is an oversupply of law grads. Medics on the other hand are in high demand and can't be readily supplied so easily. There is a higher barrier to entry in medicine compare with say becoming a solicitor, accountant etc... there is a shortage of junior doctors choosing to become GPs and a push to get more of them to chose that path rather than other specialisms.
I think some of the pay figures in this thread have already been demonstrated to be a bit off the mark. I don't think you'll find many GPs earning 200k+ a year through locum work.
Last edited:
We are going a bit off topic now but I don't think you are thinking of training in the same that I am. Let's take something I'm familiar with - law. If you were born to law and went straight to uni, right through to qualification as a solicitor that would take (including getting your degree) a minimum of 6 years.
If you want to be a GP, that's 5 years of med school, 2 Junion years than 3 years GP training, so 10 years I think.
But an NQ lawyer is basically crap. Not incompetent by any means but not experienced enough to know the nuances and no commercial experience. Basically will be negligent on every single thing they touch without a keen eye to look over their work. For leading substantial transactional work, you are looking at being ~5 years PQE at least and even then there will be enourmous holes in their knowledge. It's only the 10 year plus PQEs that are at 'Heisenberg' level (breaking bad reference). All broad guidelines but you get the jist. A GP will continue to learn through their career as a solicitor does but more training... really not sure about that. All professions continue to learn and adapt.
As for a shortage, isn't this year the first year that there will be spaces on rotations as confirmed earlier in the thread? There aren't the facilities to train more doctors but it's not as if they aren't people applying... it's been competitive to get a place to train. I think we can all agree we'd rather have more doctors than lawyers in the world
All very off topic and waffley, sorry!
If you want to be a GP, that's 5 years of med school, 2 Junion years than 3 years GP training, so 10 years I think.
But an NQ lawyer is basically crap. Not incompetent by any means but not experienced enough to know the nuances and no commercial experience. Basically will be negligent on every single thing they touch without a keen eye to look over their work. For leading substantial transactional work, you are looking at being ~5 years PQE at least and even then there will be enourmous holes in their knowledge. It's only the 10 year plus PQEs that are at 'Heisenberg' level (breaking bad reference). All broad guidelines but you get the jist. A GP will continue to learn through their career as a solicitor does but more training... really not sure about that. All professions continue to learn and adapt.
As for a shortage, isn't this year the first year that there will be spaces on rotations as confirmed earlier in the thread? There aren't the facilities to train more doctors but it's not as if they aren't people applying... it's been competitive to get a place to train. I think we can all agree we'd rather have more doctors than lawyers in the world
All very off topic and waffley, sorry!
in General a GP partner will have £100k left after the expenses of running the practice, which sounds like a lot but if you think they would be paid £75k as a salaried GP they are only making 25k extra for all the responsibility and stress of running a mid sized business.
Yep. Any industry where contractors are fulfilling permanent roles only comes about because of a shortage of people able to fill the positions.
The only way to sort it is to train more doctors (probably won't really work as doctors command top $ outside the UK as well) or ban it - which probably won't work either as doctors can just leave the country!
Soldato
- Joined
- 9 Oct 2009
- Posts
- 9,287
- Location
- United Kingdom
Not meaning to reiterate too much but we live in an area where there is a huge shortage of GPs and even here the daily rate for a locum is nowhere near the figures being branded about in this thread. I also object to the point being made that GP's aren't"specialists". They are generalists yes but think about the wide range of clinical knowledge they need for patients from birth to end of life. It's fairly widely accepted that GP training is suboptimal and actually most GPs that qualify will have actually on have done 18 months to 2 years at most in a general practice setting. (Probably one of the reasons why indemnity fees and the risks are so high in the first few years after qualifying). The vast majority of GP trainees that are qualifying have no interest in becoming partners (and more recently even salaried posts) for reasons mentioned above and until we address the reasons for the chronic lack GP's we'll only see a greater reliance on locum staff.
Caporegime
- Joined
- 8 Jan 2004
- Posts
- 32,926
- Location
- Rutland
I think having more doctors is the only way we can sort the problem, even if some leave and some locum - you'll firstly have a proportion taking salaried jobs (less demand for locums) and those that choose to locum will increase the locum pool (supply) so rates will drop and some of those locums will take salaried jobs for a more reliable income/less travel.
Another major factor is trying to keep staff and stop this constant attrition of the workforce with cuts to pay, pensions, working conditions and rights. This applies to all healthcare workers, not just doctors. This farming out of non-clinical staff to private companies so they don't have to give them the same rights and pension of NHS workers is tragic.
Last edited:
It is, but as I've pointed out before, the government/NHS management seem to be doing things very strangely. Offering a cash incentive towards foreign Drs but not offering anything for people to train as one in the UK. I've said many times if there was some way to take care of the uni fees I'd retrain in an instant.
As it stands though I couldn't afford the 60k fees and to be out of work for 4 or 5 years. Take the fees away though, even temporaily and it becomes a potential option despite the paycut
Last edited:
Caporegime
- Joined
- 8 Jan 2004
- Posts
- 32,926
- Location
- Rutland
Yeah I can only imagine they don't want to invest now in a glut of doctors for an NHS they don't expect to be around long. Just slap a short term cheap fix in place.
The other thing is if they genuinely improve the NHS they'll struggle to get rid of it as they'll face objections and poor insurance take up rates. If they bring in a poorly implemented system of imported doctors then quality can slide whilst they are being seen to be doing something and once the public are disillusioned with the crap NHS quality of care they can sell them insurance based healthcare happily.
Your mind is on the same cynical level as mine. That's why I think they're doing it too.
Sorry I didn't mean to cause offence - GPs are obviously professional specialists with a lot of knowledge.
Soldato
- Joined
- 31 May 2009
- Posts
- 21,471
I am admittedly biased against lots of 'public sector' roles and bitter over their frankly 'ultra lol' pensions
The 2015 nhs pension scheme applies to all nhs staff now, you retire at stat retirement age, which i believe is going to be 68 for anyone under about fourty, perhaps 69. The pension contributions that GPs are making are 14.5%, some fourty and over may have remnant payments to make from their old scheme for added years also. Its a career average scheme, so each year is it own little pot now. A lump sum can be bought from your contributions, assuming you live to 69.
It is a very different scheme to the chap retiring this year at sixty, who paid contributions for much of his career at 6 or7%, get a three times pension salary lump sum, and get it all at 60.
Vast differences in the scheme, which was laughably generous at the time. The new scheme should cover itself with ease, given that I know the equivalent scheme for dentists when the contibution level was increased still covered itself in northern ireland, the new scheme can't fail to, unless we cure all diseases and every lives to 112.
Caporegime
- Joined
- 8 Jan 2004
- Posts
- 32,926
- Location
- Rutland
Yup and the new JD contract significantly increases pension contributions because it was previously only on basic pay and not banding. Now your whole pay package is pensionable.
I assume you mean 'all NHS staff going forwards' - someone I know is in a final salary scheme, is dropping to a 4 day week at 34 years old and will retire at 50 on a higher pension that I will ever get at 70 
(He specialises in private cosmetic dentistry FYI but his NHS pension is ridiculous - even he thinks so... although I'd agree he works harder, is more skilled and knows far more than I do... perhaps I would share more sympathy with locum doctors if I knew them closely and could appreciate their skill set)
(He specialises in private cosmetic dentistry FYI but his NHS pension is ridiculous - even he thinks so... although I'd agree he works harder, is more skilled and knows far more than I do... perhaps I would share more sympathy with locum doctors if I knew them closely and could appreciate their skill set)
Soldato
- Joined
- 31 May 2009
- Posts
- 21,471
I assume you mean 'all NHS staff going forwards' - someone I know is in a final salary scheme, is dropping to a 4 day week at 34 years old and will retire at 50 on a higher pension that I will ever get at 70
(He specialises in private cosmetic dentistry FYI but his NHS pension is ridiculous - even he thinks so... although I'd agree he works harder, is more skilled and knows far more than I do... perhaps I would share more sympathy with locum doctors if I knew them closely and could appreciate their skill set)
He needs to check his contract, he will have as of April 2015 moved to the 2015 scheme, and his only pension pot that he can access at 60 is his first few years, the rest of his contributions will be in the 2015 scheme. He is no different from every other NHS employee, and if he is 34 now, he would have been 32 when the scheme changed, giving him not so many years in the old 1995 scheme, lucky he wasn't in the 2008 scheme.
He is basically wrong about his projections. Unless he is part of some non-NHS bizarre hospital scheme, there is no NHS scheme he can be part of that will allow him out in that fashion. The old scheme isn't even claimable from 50, and when you do claim early there is a massive drop off in what you get for the year early you take it.
Is he a hospital consultant or something?
Have him check again, I think he is completely wrong.
I'm 40, a dentist who does 90% NHS work, with added years I will get around 18 years eventually in the 1995 scheme, which is payable at 60, which was never final salary scheme, ever. It was always CAR for dentists, as we were private contractors to NHS services. My other pension part form April last year onwards is the 2015 scheme, which is as I described above, not payable to 68, and as I described. Only those who were 54 or older when the new scheme hit are immune and stay in the old scheme, which was still career average.
Is he some form of hospital based consultant? Only way I could see it being final salary, as dentists never have a high salary at the end of a normal career, as we simply can't manage the NHS treadmll anymore, even then if he is he should be switched in schemes at his age. Are you sure with his private work he isn't dumping tons into a pvt pension? As even those don't allow you to draw before 55, and that will likely be pushed to 58 by regulations over coming years.
This intrigues me greatly.
Caporegime
- Joined
- 8 Jan 2004
- Posts
- 32,926
- Location
- Rutland
That's my understanding as well. He's too young for a full final salary NHS pension.
He's definitely either wrong or just bravado, because what he describes doesn't exist. He might earn enough that he feels he can retire at 50 but that doesn't mean he is drawing a pension then. I would guess he will need a very healthy investment portfolio to do that though