Setting locum rates for freelance GP locums

NASGP LocumDeck

  • Set your own rates to keep you in control
  • Keeps a full audit trail of confirmed sessions to reduce risk of double-booking and unpleasant disputes
  • Automatically populates Locum A and B forms (currently only England & Wales)
  • Pre-formatted pension receipts so that you can keep track of your pension payments
  • Generate your own unique personalised online T&Cs using NASGP model locum 'contract'

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NASGP/BMA guidance for negotiating fees for locum services in general practice

In the past the BMA published a range of ‘suggested fees’ for locums, but in 1999 the Office of Fair Trading (OFT) advised that publication of locum rates was anti-competitive in the context of the Competition Act 1998. As a result the fee guidance, which had been published as Fee Guidance Schedule (FGS) 12, Fees for GP Non-principals, was withdrawn and guidance issued to BMA staff that no advice could be given to members on suggested fees for sessional GPs.

The BMA's publication of a locum rates or even a minimum or maximum level of fees is considered anti-competitive by the OFT, and those who participate in ‘price fixing’ can be fined up to ten per cent of their UK turnover for up to three years.

The BMA’s policy was to maintain full compliance with the advice provided by the OFT in 1999. The BMA Professional Fees Committee has agreed that clear guidance, compatible with competition law, should be made available to locum GPs on how to calculate and negotiate their own locum rates for each job. The Committee established an informal Locums Working Group to review the information and good practice guidance available. The Working Group held a series of meetings and drafted a guidance document as well as a ‘locum calculator’ document. The purpose of the ‘locum calculator’ document is to provide a helpful checklist in spreadsheet form to allow doctors to calculate their own sessional fee rates.

The attached guidance document and calculator document (as drafted by the Working Group) has been approved by the BMA Professional Fees Committee and also the NASGP. It has been subject to careful legal scrutiny by the BMA’s lawyers to ensure compliance with competition law.

The guidance document includes references to car and home expenses as office expenses. This and other accountancy related advice has been subject to careful scrutiny by specialist medical accountants.

This guidance has been produced to support all parties involved in negotiating for GP locum services.

These notes have been prepared solely for the use of providing background explanatory information on the document ‘Guidance for negotiating fees for Locum services in General Practice’ and also the locum calculator document. Please note that the advice must not be considered as providing any guide to the level of fees that may be set by sessional GPs. Competition Law is complex and anyone with a Competition Law enquiry must seek appropriate legal advice.

Set your own rates using NASGP's LocumDeck, our fabulous new online platform that's free to NASGP members and allows you to fully customise every aspect of your locum work.

Other than the negotiation itself, which we provide some advice on below, you need to remember that it is not just your rate that you are negotiating. Your contractual terms are an integral part of your agreement, and you need to ensure that they are also acceptable to both parties. If the practice can’t or won’t negotiate on rates, perhaps there is something in your contract that you could ask them to look at instead.

What should your rate be?

There are two ways of looking at your rates. Firstly, there is what is a fair rate given the costs that you will incur etc and secondly, there is what is the market rate for someone with your experience?

The calculator covers the first of these areas very well. When calculating a rate, the other expenses that you have to pay for can catch out many inexperienced locums. Items that people might miss include professional memberships, NHS appraisal and also accountancy and tax advice. You need to think more like a business now and to be sure that you cover all of the costs of providing your service. The calculator is a great way to ensure that they include everything.

The second route is far more difficult now that the BMA doesn’t publish suggested rates. The easiest way to find out is to ask around. Ask other GPs and other relevant professionals (for example if you use an accountant who specialises in sessional GPs) who are in a position to know. Always be sure to think about the background of the peer whose rate you are asking about. Rates are impacted by lots of things including someone’s skills and level of experience.

If you can’t find a direct comparator for your experience, as is often the case, then find out some benchmarks but then flex that figure accordingly. If you are more experienced or more qualified than the benchmark, then it would be fair to charge more, as it would be if you have experience of the practice’s particular area. Equally, if you are less experienced than your benchmark, it is probably unlikely that you will get paid the same rate as them.

In this way you will know approximately what is market rate for the service that you are providing is, and also what rate you need to charge to cover your costs and get paid at a fair rate. Obviously as a GP you hope that the former is larger than the latter, given that your skills are in demand.

Contractual details

Before you agree a rate, it is vital that you also agree the full details of the terms and conditions (see NASGP’s model T&Cs). The technicalities of this are too long for this article but it is the principle that is key.

The terms under which you earn your rate are arguably almost as important as the rate itself. Certainly more favourable other terms in your contract, it can be worth much more than a small increase in your fee.

Key things to think about include being clear about pension contributions (which practices now need to pay for locums in England and Wales), about exactly what services you are required to provide, and where and how and when you can expect to get paid.

The final part of this is the actual negotiation itself. Obviously, how your rate gets negotiated will change with each particular practice. That said, the principles of negotiation do now change whether it is carried out on the phone, by email or any other means of communication.

Working for the NHS means that most doctors have very little experience of negotiation, which can make this an anxious experience. As with most things in life, negotiation is a learned skill, so don’t worry, you’ll get better at it!

The internet has some very useful resources which can help with this. Locum rates are not as fluid as day rates that are paid to freelancers in the private sector; however, the advice that is available to freelancers is still highly applicable.

For example, this guide to assertiveness for freelancers has a great chapter on negotiating your rates.

The video below also contains some great tips and would be very useful for anyone who worries about negotiating. It has a freelancer discussing how they learned to negotiate their rate and the mistakes that they made as they learned.

The guidance document includes references to car and home expenses as office expenses. This and other accountancy related advice has been subject to careful scrutiny by specialist medical accountants.

This guidance has been produced to support all parties involved in negotiating for GP locum services.

These notes have been prepared solely for the use of providing background explanatory information on the document ‘Guidance for negotiating fees for Locum services in General Practice’ and also the locum calculator document. Please note that the advice must not be considered as providing any guide to the level of fees that may be set by sessional GPs. Competition Law is complex and anyone with a Competition Law enquiry must seek appropriate legal advice.

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The BMA and NASGP are not liable for any loss or damage, howsoever arising, which is occasioned to anyone acting, omitting to act or refraining from acting in reliance upon the contents of the guidance.