GPonline polling in May found that more than half of locums had experienced a significant fall in their income during the COVID-19 pandemic.
Locum work dried up as consultation numbers dropped at the start of lockdown, with practices switching to total triage, carrying out most consultations by telephone - and with permanent staff cancelling annual leave. Sessional GPs were also forced to turn down work due to inadequate sick pay and death-in-service guarantees.
BMA leaders have warned that locums could switch to private work in search of greater security in the run up to winter- arguing that locum income must be protected to avoid NHS services finding themselves short of cover.
The BMA has also called for locums to be prioritised for shifts with NHS111 and the COVID Clinical Assessment Service (CCAS), with protection against cancelled sessions. Sessional GP leaders, however, have warned that experiences of working for these services must be improved.
In a paper outlining measures the government should implement urgently to protect GP services, the BMA demands better financial support for locum GPs.
The paper says: 'Locum GPs’ income must be assured/protected so that these important members of the general practice workforce are protected in the same way as others have been protected through the furlough scheme, and so they are not lost to private providers.'
National Association of Sessional GPs chair Dr Richard Fieldhouse told GPonline that private firms had been able to ‘suck up’ locums during the pandemic because of a lack of work. He explained the potential fallout from this for the NHS.
‘These services will be much better staffed, meaning that private services will become cheaper for patients to use. Patients have also got used to off-practice services, although I don’t think that is many patients' preferred choice at the minute. This will lead to more patients using services such as Babylon Health,' Dr Fieldhouse said.
He added that financial security was a ‘key factor’ in ensuring that locums remained working in NHS positions, but insisted that more needed to be done to convince locums to work in some NHS services.
‘Some locums have had a really bad experience working for CCAS. There’s been frustration around a lack of confirmation of sessions and being put on the wrong payroll,' he said.
‘It’s also about feeling that they are needed. Locums have to be treated in a similar fashion to permanent practice staff, but they’ve never felt more isolated. There needs to be a bit more unity.’
In April GPonline reported that locums were being overlooked for shifts with CCAS during the pandemic because of an influx of recently retired doctors applying for the same work. This left locums feeling 'completely undervalued' and struggling financially.
Locum GPs can apply to the government’s self-employment income support scheme, which allows workers financially affected by COVID-19 to claim a taxable grant worth 80% of their trading profits - although the maximum monthly claim is capped at £2,500.
However, many full-time locums will be unable to benefit from the scheme because of a rule specifying that a claimant's 'trading profits must also be no more than £50,000 and more than half of your total income for either the tax year 2018/19 or the average of the tax years 2016/17, 2017/18 and 2018/19'.