Locums twice as likely as partners to see higher increases in indemnity costs

GP locums are twice as likely as partners to see larger increases in their indemnity costs, a GPonline poll suggests, with 14% of locums and 7% of partners reporting that fees rose more than 30% this year.

BMA sessional GP subcommittee chair Dr Zoe Norris (Photo: JH Lancy)
BMA sessional GP subcommittee chair Dr Zoe Norris (Photo: JH Lancy)

Some 14% of locum GPs saw their indemnity costs rise by 30% or more this year, compared with half as many partners (7%), the poll has shown. One in 10 salaried GPs reported fee increases in the same range.

BMA sessional GP subcommittee chair Dr Zoe Norris warned that locums were being ‘priced out of work’ because they were ‘financially penalised' for working extra sessions by their indemnity costs.

Just under half (44%) of locums said their fees had risen between 10% and 20% this year, compared with just over half of partners (54%). Some 22% of locums and 20% of partners saw fees hiked between 20% and 30%, while a fifth of both groups said fees had risen by under 10% or not at all.

The survey included responses from more than 100 locums, 100 salaried GPs and 190 partners.

The results also show that one in five GPs working out-of-hours shifts saw their indemnity fees rise by over 30%, compared with just one in 10 of GPs who never work out-of-hours.

Indemnity costs

The results mark the latest in a string of findings on the true cost of indemnity – GPonline reported earlier in the week that indemnity fees rose for over 90% of GPs this year, with more than a quarter seeing fees rise by over 20%.

The rise in indemnity cost is having a devastating impact on the workforce, with the majority of respondents revealing they have been forced to cut back on or turn down extra sessions as costs become unmanageable.

One locum respondent to the survey said: ‘My take-home pay once I've paid [my medical defence organisation], the GMC and childcare is less per month than when I did a paper round as a teenager – I get about £50 a month for four sessions.

‘If my husband didn't work, I couldn't afford to continue as a GP and would have to leave medicine. I don't mind paying childcare but the indemnity is ridiculous and I don't know how long I can persevere at this ridiculous level of income.’

A recent survey by GPonline’s sister site Medeconomics found that many locums have increased their daily rates over the past year as a direct result of rising indemnity costs.

Reduced sessions

Many respondents to GPonline's indemnity poll who are nearing retirement said they were unable to work occasional shifts as a locum because indemnity fees meant it was ‘not cost effective’.

GPs also warned that costs were so high it prohibits them from covering just one additional session per week, or an occasional shift to help out when practices need extra staff.

One said: ‘Working variable locum sessions I can only get cover that goes in jumps so if I have reached the limit on my average two sessions a week and it will cost £1,400 to work just one day extra I have turned down work.’

Another added: ‘As a freelance GP, I cannot offer to "help out" when asked to do a locum or out-of-hours session if I have exceeded my indemnity cover.’

'Priced out'

Dr Norris said: ‘We know that the average indemnity rises quoted often hide huge individual variations for GPs. I regularly hear of locums being priced out of work because of indemnity hikes.

‘This is absurd given the workforce shortage and the fact we need all GPs to work as many sessions as they wish to, and not ending up having to pay to do so because of huge indemnity costs.

‘Locums are especially hit by new models of care. We have always known out-of-hours indemnity is unfairly high, but now models of hub working, A&E working or remote working can be classed at the same risk as out-of-hours depending on the set up such as access to the patients’ records.

‘I know many locums who would happily work more sessions, both in- and out-of-hours, but are financially penalised for doing so by their indemnity costs.

‘With no sign of a repeat of the winter indemnity scheme, out-of-hours is especially vulnerable with patient care already suffering. Locums must consider whether they are fully indemnified, and adequately supported in such an environment.’

More on GPonline's indemnity investigation

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