THE LATEST UPDATE
The government have introduced a cap on locum rates that was in complete effect since 1st April 2016. We have now found that predominantely across the UK these caps have been a complete failure and are now not even being enforced by most trusts, however in some areas, most specifically London and other popular areas it has been quite the opposite and the caps have been successfully enforced.
Why so bad in London?
The trusts in London are the most popular, so they fill all their training posts easily. They are also some of the largest trusts, so have a larger internal bank of doctors to try and fill shifts. Finally more doctors have worked in these hospitals so prefer to take locum shifts back in hospitals they know; so there are a handful of available locum shifts with an abundant of locum doctors wanting the shifts, and even some willing to take these shifts at the capped rate. This was also why London rates were lower even before the cap was introduced.
Will the rate go back up in London?
It may take a bit longer before the rates come back up in these popular areas, and with the difference in rates from locum work in/out of London getting larger we expect more doctors to travel a little bit and start to take more work outside London, gradually stripping the number of locums available to trusts down in London which may take more time but we would expect to gradually bring the rates up.
For those taking locum shifts on the capped rate. The table below shows the capped rates which indicates the total value given to the locum agency, ie. for the capped rates trusts will pay locum agencies £28.40 for SHO core hour shifts and £34.07 for SHO unsocial hour shifts. Which may be paid down to the locum doctor as £25 an hour for core hours and £30 for unsocial, with on average 10% commission to the agency. Some agencies will however try and take more commission and pay £20 and £25, but you can use the table to work out what rate the agency is taking which helps you to know how well/badly you are being paid by your agency, helping you know if you have scope to haggle.
ADVICE FOR TRAINEE DOCTORS DOING INTERNAL/BANK LOCUM WORK
1. AGREE A RATE WITH YOUR HOSPITAL
If you feel like the rate is low for internal bank locums then we advise discussing with your colleagues in your hospital and formally agree a rate with Medical Staffing that is reasonable (negotiations should be led by your year rep). For internal rates FY1s should not be getting less than £30 per hour, SHOs £35 per hour, and Registrars £45 per hour (more for A&E). You are stronger together so if it is an issue across the trust then you need to try and pull everyone together, request a reasonable rate and stick to your guns and don't take the shifts if they don not agree to a suitable rate.
2. DON'T GET BULLIED INTO DOING EXTRA SHIFTS
If your trust is following the price caps it will be harder for the Medical Staffing personnel to fill locum shifts and they may start to take advantage of doctors (especially FY1s) so don't be bullied into doing any extra shifts you don't want to do, or into taking a shift for a rate that you don't want. You are not obliged to do additional hours. If you do feel bullied into covering extra shifts then please call BMA for advice. 0300 123 1233.
3. SUBMIT INCIDENT FORMS
If you are understaffed and a locum doctor is not supplied as a result of the locum price cap, submit an incident form as a risk for patient safety, and continually bring it up in junior doctor/departmental forums. For patient safety issues you must also inform the Clinical Director each time this happens.
4. TAKE YOUR NAME OFF THE INTERNAL REGISTER
If Medical Staffing personnel are refusing to negotiate on the rate then stand your ground and ask them to take your name/details off their 'internal locum' register. This is a register of doctors in the hospital who have opted out of the European Working Directive and who get emailed about internal locum jobs. This leaves a clear message that you are not interested in the locum shifts for the rates they are offering.
If you want to get in contact with us directly then drop us an email here