The BMA has revealed that some locums have had little choice but to take on roles delivering face-to-face appointments to COVID-19 patients in hot hubs and practices because of ‘a current short-term reduction’ in available shifts.
Polling by the National Association of Sessional GPs (NASGP) has shown that one in four locum GPs are in COVID-19 risk categories, either because they are over 70, pregnant or have an underlying health condition.
But many locums - particularly those who work full-time - could be under pressure to take on high-risk roles to avoid being unemployed with no access to state help, because the government's coronavirus self-employment income support offer is not available to anyone with 'trading profits' worth more than £50,000.
The drop in demand for locums has been created by ‘practice staff not taking annual leave’, the huge shift to delivering GP services online and by telephone, and greater use of NHS 111 during the pandemic, the BMA has said.
BMA GP sessional committee chair Dr Ben Molyneux said NHS England's failure to highlight alternative work opportunities had left the locum workforce ‘woefully underutilised’.
He argued that it had ‘not been clear’ that locums could apply for NHS 111 clinical advice service shifts - and that doctors returning to the workforce during the pandemic had squeezed out applications from locums.
Dr Molyneux said this had left GP locums with little choice other than to take on face-to-face roles to avoid being out of work.
He said: ‘At the start of this pandemic, retired GPs were encouraged to sign up to the NHS 111 clinical advice service. Locum GPs are able to enrol on this scheme as well, but messaging around this has not been clear.
‘The BMA has been pushing for NHS England to reprioritise locum GPs over retirees, many of which don’t know about the role they can play in the clinical advice service and are having to risk seeing patients face-to-face to make ends meet.
‘As a result, we are currently in a position where many locums are unemployed and the NHS 111 service is desperately short of doctors, but the two haven’t been properly connected by government, leaving sessional GPs woefully underutilised. This must be addressed as a matter of urgency, not only for the safety of locum GPs, but also, and more importantly, their patients.’
National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse said locums were taking on higher-risk work despite often not having access to sick pay. ‘I know a locum who has had five weeks off because of repeated exposure to [the virus],' he added.
‘The reality is five or six weeks of no payment means people then start to become desperate because they’ve got mortgages and things to pay for and they are going to be forced to to work.
‘They are doing this because they feel they have to do it and… that’s the worst thing you can do for workforce engagement. [Research shows workers] will disengage and not do as good a job as they could have done, and may even leave.’
GP locums working through an agency who have been ill for at least four days in a row qualify for statutory sick pay for up to 28 weeks. However, self-employed locums using their own terms and conditions are likely not to qualify for the same benefits.
Dr Fieldhouse has previously accused the government of poor workforce planning, saying it had failed to make proper use of the locum GP workforce during the outbreak.