Almost half of locum GPs who responded to a National Association of Sessional GPs (NASGP) survey said they were making themselves ‘less available’ for bookings during the pandemic because of the absence of death-in-service benefits.
Just under a third of 158 respondents indicated that they would not book any future locum sessions because of the same issue - 12% said they had cancelled sessions.
Significantly, 24% of GP locums taking the survey said they were in the ‘at risk’ category, either because they were over 70, pregnant or had an underlying health condition.
NASGP chair Dr Richard Fieldhouse warned that locums had been the 'cement holding general practice together' for a decade - and that failing to support them could severely affect the workforce during the ongoing pandemic. Locums are estimated to account for at least 20% of the GP workforce.
The results come after GPonline reported last week that locum GPs could refuse to work or face bankruptcy if the government failed to support them during the coronavirus outbreak.
On 20 March the government announced a second package of measures to protect the UK economy and workforce during the COVID-19 outbreak, including the equivalent of statutory sick pay for self-employed people, who will also be given tax deferrals.
However, self-employed workers are not part of the 80% earnings pledge that was announced by chancellor Rishi Sunak, meaning GP locums could lose out financially. The government has also failed to give an update on death-in-service payments for GP locums working during the pandemic.
Death in service
Under existing rules, a locum who dies on a day when they are not contracted to work may not be eligible for the lump sum that would be paid out for an employed colleague or partner - despite having paid contributions in full to the NHS pension scheme.
A total of 37% of GP locums responding to the poll said they were not booking future locum sessions during the pandemic because of a lack of guarantees around sick pay. Meanwhile, 31% said they were making themselves less available for sessions and one fifth said they were cancelling bookings.
The BMA has confirmed it is working with NHS England and Improvement (NHSE&I) to roll out solutions for both sickness and death in service benefits for locum GPs as soon as possible.
Dr Fieldhouse called for the government to deliver ‘a fair level of sick pay’ for locums who have to self-isolate and for death-in-service benefits to be ‘instated immediately’.
The NASGP chair said he was surprised at the ‘sheer number’ of locums in the ‘at risk category’, adding: ‘With massive strain already on key NHS staff, poor personal protective equipment (PPE), no death-in-service benefits, practices cancelling locums and no special sick pay provisions, when the call does come out for locum help, I’m not entirely sure sessional GPs are going to have as much motivation as they otherwise would have had.
‘Something that’s become very clear from our members is doubt around, when they turn up to the practice, will the practice properly induct them, will they get proper PPE? What do they do if they see a patient with fever or cough? What are the practice’s procedures?
‘I think of locums as being the cement that’s been holding all the brickwork of general practice together for the last decade. What does a building with crumbling bricks and patchy cement look like?
‘We’re calling for death-in-service rights to be instated immediately and a fair level of sick pay being guaranteed to any locums who have to self-isolate. It doesn’t have to be "automatic" and could be on an application-based basis, but something is needed.’
Locum GPs have expressed concern via social media about a lack of government protection, with many sessional staff reporting a lack of guidance around how they should work during the pandemic. Some have also pointed out how GP locums could suffer financial difficulty in the event that they have to self-isolate.
Locum GP Dr Angela Wilson asked whether locum GPs would be guaranteed adequate sick pay to give her the reassurance she needed to work.
I’m a GP locum and my other half is also a doctor. I would like reassurance that one of us can work at a distance if possible and that locums have adequate sick pay/death in service benefits if needed.— angela wilson (@angemwilson) March 19, 2020
Meanwhile, Suffolk GP Dr Lucy Henshall said GP locums were unjustly affected by a lack of death-in-service benefits.
Loss of income is an issue for all doctors yes. And for the wider public too.— Dr Lucy Henshall (@DrLucyHenshall) March 13, 2020
But within the NHS, loss of life affects Locum GPs unjustly. Discriminatory. They are frontline too.#Deathinservicebenefit @NHSBSA @MattHancock @NHSEngland @MartinRCGP @helenamckeown @BMA_GP @TheBMA
BMA sessional GP chair Dr Ben Molyneux said: ‘At a time when the NHS is calling upon sessional GPs to help with the COVID-19 effort, it’s never been more important to ensure their own health and wellbeing is properly supported and looked after.
‘This is the highest priority for the sessional GPs committee, and we are working with NHS England and NHS Improvement to roll out a solution for both sickness and death in service benefits for locum GPs.
‘It is essential that this is worked out as quickly as possible not only to protect our workforce, but also the patients we serve every day.’
Earlier this month, NHS England guidance confirmed that employed NHS staff required to be physically present at work would receive full pay ‘for any period in which they are required to self-isolate as a result of public health advice’.
But the BMA confirmed to GPonline that the NHS England guidance does not apply to locum GPs, despite them being ‘essential members’ of the primary care workforce.