Practices offered less than average locum rate for bank holiday opening

Practices in England will be reimbursed a maximum of just £62.50 an hour for locum cover over the Easter bank holidays as they remain open to cope with the COVID-19 pandemic.

(Photo: Getty Images)
(Photo: Getty Images)

Practices will be offered a maximum of £250 a session or £500 per full day to hire locum GPs over the bank holidays, with practices instructed by NHS England to treat Good Friday and Easter Monday as ‘normal working days’.

GP leaders have warned that the rate of reimbursement is below the normal range - understood to vary from around £70 per hour to more than £100 per hour across the country, with an average potentially around £90 - and could put locums off working or force practices to top up funding to recruit.

Practices will be reimbursed £289 per session for extra sessions by partners, plus national insurance and pension costs, while practices have also been offered overtime for salaried GPs and practice staff 'in line with the individual’s contractual arrangements'.

The BMA hit out at NHS England for waiting until the '11th hour' to confirm details of funding - warning it left practices little time to plan.

GP workforce

NHS England sent details of the fees to practices last night, just over 24 hours ahead of the bank holiday, but has told practices to discuss with their local commissioner the level of service required on bank holidays and 'agree in advance what additional staffing costs will be reimbursed'.

BMA GP committee chair Dr Richard Vautrey said: 'It cannot be right if any practices still loses out if they operate their surgeries as normal in the coming days. The government has promised to give the NHS everything it needs to cope with the COVID-19 crisis, but this is not bearing out in general practice.

'With a lack of PPE, little to no access to testing and now this situation, family doctors in England and their teams are feeling let down and the government has much to do to regain to the confidence of the profession.'

GPonline reported last month that many locum GPs were reducing the number of shifts they work as the COVID-19 outbreak took hold over concerns that they would be denied full death-in-service benefits if they died during the outbreak on a day they were not contracted to work.

Death in service

The BMA and NHS England are working on a zero hours locum contract that they believe could resolve this issue - but final details of the package have yet to be made public.

In this context, questions remain over whether the £62.50 per hour offer for locum reimbursement will provide an incentive for doctors to take on bank holiday shifts in frontline general practice.

National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse said GPs working in the NHS in the current circumstances were doing so because they care and were not motivated primarily by money.

But he warned that particularly against the backdrop of ongoing doubts over death-in-service rights, this was 'not a time for the NHS to be disincentivising people'.

He said: 'Locums demanding double to work at a time of crisis would be unreasonable - but at the same time, just because it’s a crisis doesn’t mean you can say: "Everyone’s got a huge emotional connection so we can get them a bit cheaper".'

Wessex LMCs chief executive Dr Nigel Watson said practices may need to top up funding beyond the £62.50 per hour rate to recruit locums - but pointed out that some practices in areas yet to experience a huge surge in workload were using locums less after switching to primarily online or telephone contact with patients.

Coronavirus outbreak

He added: 'This will cover most of the cost and some will think this is better than it might have been. Where locums are in short supply practices may need to top it up to recruit - but GPs aren't going on holiday so many will be thinking they might as well work.'

In the New Forest area where he works, Dr Watson said out-of-hours services that would normally cover bank holidays were not being stood down - so would be working together with practices to support paitents over the period. He added that some CCGs may offer additional support to help practices recruit.

Dr Vautrey added: 'GPs and their teams are going above and beyond to support the NHS in these unprecedented times, often putting themselves in harm’s way to continue providing services to their patients.

'Practices may be relieved to finally have some detail about Easter opening and the fact that additional costs will be covered, it’s disappointing that NHS England has left it until the 11th hour to provide this clarity. It leaves very little time for practices to work with CCGs to make arrangements, and the approval process for the reimbursement of costs adds an unnecessary layer of bureaucracy at a time when general practice can least manage it.'

The GP contract has been updated to reflect the requirement for practices to remain open over Easter during the coronavirus outbreak.

Surgeries are expected to offer remote triage for delivering care and treatment wherever possible and appropriate and to continue to provide high risk patients and those who have been shielded with ‘proactive clinical management support’.

Essential face-to-face services (including home visits) that may be required will need to be delivered in line with GP standard operating procedures published by NHS England.

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