Locum GPs forced to self-isolate repeatedly in the coronavirus outbreak could go bankrupt unless they are guaranteed sick pay, the chair of the National Association of Sessional GPs (NASGP) has warned.
A failure to arrange death-in-service benefits is also dissuading locums from taking on more work during the coronavirus outbreak, he warned - as the number of UK cases jumped to 456 on 11 March, with 8 deaths confirmed from the virus.
Earlier this week, 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 has since confirmed to GPonline that the NHS England guidance does not apply to locum GPs, despite them being ‘essential members’ of the primary care workforce. Locums are estimated to account for at least 20% of the GP workforce.
NASGP chair Dr Richard Fieldhouse has argued that locum GPs forced to self-isolate multiple times could run into financial difficulty or even go bankrupt if they are not compensated by the government.
He added that locum GPs risked being forced to choose between patient safety and financial difficulty during a widespread outbreak - a decision he said they should not have to make.
The NASGP leader added that locums would be hesitant to take on extra sessions during a coronavirus outbreak because of the government’s failure to ensure temporary death-in-service benefits to locums in the event of an outbreak.
He said ‘all obstacles’ had to be taken off the table in order to mobilise the ‘hidden army’ of sessional GPs.
The BMA has called on the government ‘to do more to support GP locums and the vital work they do’ by giving them the same benefits offered to other employed doctors. BMA GP committee deputy chair Dr Mark Sanford-Wood told a special conference of LMCs on 11 March that GP leaders were in daily contact with NHS England over steps to support general practice - including calls for death-in-service rights for locums.
Locum sick pay
Dr Fieldhouse told GPonline: ‘Those who come into contact with COVID-19 need to self-isolate for two weeks. But say a locum goes back to work and the first person they see is a child with a high fever - they may have to take another two weeks off.
‘That will definitely happen and it will happen to probably quite a few individuals who may go weeks or months without actually working. If you keep telling locums not to turn up to work, then what can they do? They could go bankrupt and face all sorts of financial problems. I wouldn't be surprised if some locums feel almost like they've no choice, they've got to go to work.'
He said that in the current 'exceptional circumstances' created by the coronavirus outbreak the government must act to protect locums on the frontline in general practice.
‘The NHS completely, completely relies on locums. We are an integral part of the primary care workforce. In a very unusual situation like COVID-19, which could go on for months and months, a compensation package needs to be available… something which says, you helped out in an emergency situation, we’ll look after you.’
In a worse case scenario, the government predicts up to a fifth of the UK workforce could be off sick at the peak of a coronavirus outbreak.
Dr Fieldhouse said locums would be expected to step up and take on more work in the coming weeks to fill in for contracted staff forced to self-isolate. But he warned the absence of full death-in-service rights would be a worry for locum GPs and their families - making them think twice about accepting extra work.
‘Should push come to shove and there is a collapse of general practice, you will have hundreds, if not thousands, of locums who could who, in an emergency, might say they are going to step up and work six days a week,' he said. 'Individuals need to have obstructions taken off the table - and, at the moment, death in service is a big obstruction that needs to be taken off the table.'
The DHSC has said locums are eligible for death-in-service benefits during ‘periods of active locum service’. This means GP locums are not covered if they die on a day off.
BMA GP committee chair Dr Richard Vautrey said: ‘The guidance from NHS England does not apply to GP locums, but they are essential members of the primary care workforce.
‘As this situation develops we would expect the government and NHS England to do more to support GP locums and the vital work they do, not least by offering sick leave payments and death-in-service pension benefits, in the same way that this is offered to other employed doctors.'
NHSE has yet to respond.