Terms keep GP locums, and the practices that book them, working safely – and they also help practices make the most of the locum cover they book. This year, new policies for PPE, infection control and remote working make it more important than ever to write good terms before making a booking. Dr Sara Chambers, NASGP Head of Clinical Excellence and Safety, answers frequently-asked questions on GP locum terms
Q: What are GP locum ‘terms’?
GP locum ‘terms’ are the rules that GP locums publish and share with practice managers (or GP partners or booking managers) who book them. At their simplest, they detail things like:
- What hours a GP works.
- How many patients they see.
- Whether they have a cancellation policy.
- What rates they charge.
But they can cover absolutely anything.
Q: What is the importance of terms?
Terms are about establishing mutual protection and understanding between a GP locum and the practice manager.
Clear terms are the basis for sustainable, supportive relationships between GP locums and practices, and create better outcomes for everyone concerned, especially patients.
Discussions about locum work often focuses on fees, but considering the terms that surround is just as important.
A documented, shared understanding of what work has been agreed keeps patients safer and helps avoid disputes over workload and fees.
From a legal and financial point of view, terms which highlight the self-employed nature of an assignment also reduce the risk of GP locums being misidentified as salaried doctors. If a locum is deemed as being employed, which can be retrospectively applied, then the practice can end up having to pay tax and National Insurance, and perhaps having to offer certain statutory rights. GP locums and practices are keen to avoid that!
Q: What new terms are GP locums adding in 2020?
Given the risk from Covid-19, GP locums have increasingly been adding terms on risk minimisation, infection control, and shielding.
The NASGP has published examples of new session types for 2020 that protect GP locums, practice teams and patients from Covid-19.
In LocumDeck (Settings > My session rates > Create new session types), GP locums can set up a number ‘session types’ with exact terms they want to offer, for example:
- Catch-up and admin time needed.
- The number patient contacts they can safely manage during one session.
- Whether they can work face-to-face or remotely.
LocumDeck also includes an integrated ‘boilerplate’ terms template that we recommend, for example:
- Covering what happens in the event of a last-minute cancellation.
- Asking the practice to ensure the locum is informed if there’s a significant event.
- Agreeing for the GP and practice to work together on the feedback surveys required for appraisal.
The NASGP has published templates in full for new terms for Covid-19. GP locums can add them directly to LocumDeck (or whatever booking system they prefer) to ensure best practice for infection control, PPE, risk assessment, triage and remote working.
Q: Why should GP locums set terms and how do they benefit practices?
Reasonable, balanced terms set by the locum create better outcomes for GP locums, for practices and for patients.
The GP locum’s terms reflect their skills, experience and capabilities. As a self-employed professional going into a new environment to take on clinical responsibility for the care they provide, the GP locum is best placed to describe what they can and can’t do, what’s safe and the conditions in which they work best.
As the budget-holders, practice managers ultimately have choice in negotiations with GP locums. Managers are free to book whichever GP locums offer the best terms for their practice.
Written terms can be a starting point for a discussion which can result in a new agreement that better suits everyone. If a practice has a special requirement that a locum has not mentioned in their terms, then in our experience it’s best to ask about this upfront and not rely on assumptions.
For instance, a practice may need a GP locum to help supervise the work of non-GP healthcare practitioners. Many GP locums would relish this opportunity to work alongside colleagues if it is agreed in advance. Agreeing this work in advance gives the GP locum a chance to prepare and find out more about how they’ll be working, and the skills and background of the people they’ll be working with. But without this prior discussion, many GPs may feel blindsided if asked to take clinical responsibility for the work of colleagues they don’t know.
Going back to the legal and tax point of view, one of the important markers of a self-employed contract is that the GP locum should not be controlled by the practice to the same extent that its employees are controlled. Using terms set by the locum is one way of showing that they are using their self-employed flexibly to provide services using their own discretion.
GP locums are highly adaptable and flexible, and relish the challenges and variety of the career they’re in. Terms give the GP locum and the practice a solid basis on which to begin a strong, long-lasting working relationship.
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