LOCUMING MADE SIMPLE
BY DRs. CHARLOTTE BATCHELOR , ALISHA SYMONS
& RAMESH MEHAY
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WHY LOCUMING?
WHY NOT?
Feeling like this?
Wanna feel like this?
Aims
• Gain insight into:
• preparation needed to become a
successful locum
• financial issues and record-
keeping
• how it can be enjoyed
Objectives
• Get a better idea of:
• steps required to set up as a locum
• what administration work is involved and how to keep on top of it
• how to keep records for the tax man and whether to self assess /
recruit an accountant
• financial issues e.g. income protection, superannuation
• pitfalls common to locums
• benefits of locuming
Summary of locuming
PREPARATION

MAKING CONTACT

BOOKING

ON THE DAY

INVOICING

OTHER THINGS
Record keeping
Fees
Tax
Preparation 1 – Change your mindset
• Don’t think for a second that all practices that you locum in will be like
the training practices you have been in as a GP trainee.
• Practices differ in so many ways.
• Infrastructure and design
• Design of building
• Computer systems
• Appointment systems (5min, 7min, 10 min etc)
• On Call, Home Visit Procedures
• Patient population
• Ethnic makeup
• Age range
• How well trained patients are (in terms of self-care)
• Whether teaching practice or not
• Relationships
• Between doctors
• Between different teams
Preparation 1 – Change your mindset
Because practices differ in so many ways…
• It’s illogical to have ‘one rule for all’
• Don’t be so rigid about things - yes, there is a business relationship
but that doesn’t mean you can’t bend the rules and be flexible.
• Although you need to be business like, there is no need to be
autocratic – like an Alan Sugar like person.
• Practices are likely to use you again if they like you – so be
personable.
Preparation 2 – Work out your work
Start early!
• Where do you want to work? Which regions?
• When do you want to work? Everyday?
• How much do you want to work? 2h surgeries, 3h
surgeries?
• What type of work do you want to do? Just surgeries, on-
call, home visits? OOH?
Preparation 3 – Certificates & Registers
Start early!
REGISTERS TO GET ON
• Performer’s List (WYCSA)
• Information Commissioner (for handling personal data & information):
https://ico.org.uk/for-organisations/register/
• HMRC as ‘self-employed’ - HMRC business taxes, Self assessment, Class 2 NIC
CERTIFICATES TO GET TOGETHER
• CCT certificate
• GMC certificate
• BLS certificate
• Safeguarding certificate (Child & Adult)
• Indemnity cover certificate
• DBS certificate – do it online: https://www.gov.uk/dbs-update-service
Preparation 4 – The Doctor’s Bag
Start early!
• Stethoscope, Auroscope, Ophthalmoscope, Thermometer, BP & BM
machine
• Headed note paper (of the practice you are working for)
• Prescription pad for the practice you are working for (or print off ‘blank
prescription’ through the surgery’s computer system.
• What emergency drugs do you need to carry?
• Do you need to carry any?
• Get them from a pharmacist (write a private prescription out)
• Aspirin, GTN spray, Salbutamol inhaler, Benzylpenicillin, Water for injections and
syringes.
Preparation 5 – Your things
Start early!
VACCINATIONS
• Are you up to date? If not, get boosters etc.
CAR INSURANCE
• Need to update to ‘Home & Business’ use.
GET YOUR CV READY
• Needs to be short and concise – max 2 sides of A4 for locums.
GET A COMPUTER AND FILING CABINET
• To start doing your invoices and things. Try and use an electronic diary like the one that comes
with Outlook for booking sessions in. Develop a website to advertise your services and perhaps
even an online booking system?
OPEN A NEW BANK ACCOUNT
• For locuming work
GET SUPPORTED AND INFORMED
• Sign up to an accountant and seek advice.
• NASGP – National Association of Sessional GPs – sign up https://www.nasgp.org.uk/
• Join a local locum group – if not one available, start one up.
Summary of locuming
PREPARATION

MAKING CONTACT

BOOKING

ON THE DAY

INVOICING

OTHER THINGS
Record keeping
Fees
Tax
The Curriculum Vitae
• Be concise
• Be precise
• No more than 2 sides of A4 with a personal statement
• Referees
• Clear contact details
• Sent to Practice Managers with a covering mail shot email.
• Via NHS Outlook – select PM group for your desired region
• Do NOT send to GPs re: e-overload
Summary of locuming
PREPARATION

MAKING CONTACT

BOOKING

ON THE DAY

INVOICING

OTHER THINGS
Record keeping
Fees
Tax
Booking Work
• When & how long for?
• How many patients/visits?
• Any admin. work/other clinics?
• Any on-call?
• Details of surgeries, e.g. start times, breaks
• Fees
• What computer system?
• Do they have a Locum pack?
• Get confirmation in writing
Remember, you can choose what you want to do (even if a PM would
prefer someone for visits and tasks but you would prefer not to). You
can cherry pick the nourishing bits of the job.
Summary of locuming
PREPARATION

MAKING CONTACT

BOOKING

ON THE DAY

INVOICING

OTHER THINGS
Equipment
Tax & finances
Leave
On the day
• Self care – toilet, tea and coffee, panic button
• Computer system
• Phone system and numbers
• Equipment, emergency meds and BNF
• FP10’s/MED3’s
• Investigations
• Referrals
• Appointments
• Delegation
Say ‘no’ if not appropriate
Summary of locuming
PREPARATION

MAKING CONTACT

BOOKING

ON THE DAY

INVOICING

OTHER THINGS
Record keeping
Fees
Tax
Invoices
• Use a computer
• Keep layout simple
• Clear heading
• Legible figures
• Precise
• Superannuation
• www.pennyperfect.co.uk (fab for finances)
messy or complicated - your payment may be
delayed
Summary of locuming
PREPARATION

MAKING CONTACT

BOOKING

ON THE DAY

INVOICING

OTHER THINGS
Record keeping
Fees
Tax
Record Keeping
• Set time aside for this each week/month
• work done
• mileage
• expense receipts
• KEEP ON TOP OF IT
• makes invoicing, superann. and self assessment a lot easier
Fees
• ‘BMA-suggested’ locum rates ruled anti-competitive in 1999
• Locums and Practices must negotiate rates
• You must have a base to start from:
• Sign up to NASGP.ORG.UK – they provide an audit of rates in various
regions (helps you decide what you might like to charge)
• Speak to other locums
• Ask the practice manager what they normally pay
• Vary rates
• surgery only
• on-call
Learn the art of negotiation
• hourly/sessional
• You can even charge different practices different rates
• As doctors we are not trained up to financially negotiate. But it becomes
easier the more your practise.
patients!
We negotiate management plans with
Tax
• Self Assessment +/- accountant
• High interest savings account
• Save about 1/3 of your monthly earnings
• Make payments twice a year (Jan & July)
• Don’t touch it until after you receive your tax bill!
• Don’t be fooled if low tax return in first year
PAY TAX ON TIME (31st Jan deadline) - otherwise
you will be fined and charged interest!
Other Finances
• National Insurance
• Class 2 contributions
• Monthly direct debit
• NHS Superannuation scheme
• Locum form A (give to practice with invoice) and form B
• Personal pension contribution by cheque
• Income protection
Extras
• Long-term locums
• Locum agencies/chambers
• Cancellation policy
• Details of other locums
• Continuing Professional Development
• Appraisal/Revalidation
Potential pitfalls of locuming
• Being poorly organised
• Abuse by practices
• Income
• unpaid leave/no sick benefits
• hidden costs
• appraisals
• CPD
• Isolation (so join or form a local locum group)
• Not being able to say ‘NO’
Enjoying it!
• Own boss
• Flexible & varied
• Cherry pick the things you like doing (e.g. can say no to
home visits)
• Income can be good
• Gain insight into workings of different practices
• Good way of finding the right practice for you in the future
- networking
Useful websites & contacts
• Institute of Chartered Accountants of England & Wales: www.icaew.co.uk
• HM Revenue & Customs: www.hmrc.gov.uk (registering as self-employed)
• www.hmrc.gov.uk/selfemployed/register-selfemp.htm
• Register with the Information Commissioner (because you are handling personal data
& information): https://ico.org.uk/for-organisations/register/
• NHS Pensions: www.nhsbsa.nhs.uk/pensions
• National Association of Sessional GPs: www.nasgp.org.uk
• Financial management software: www.pennyperfect.co.uk
• Example of a locum website: www.drilyons.com
• BNF: 01268 495600 bnf@binleys.com
• Newly Self-Employed Helpline (Inland Revenue): 0300 200 3504
Locuming Made Simple
• Preparation is key
• Keep on top of finances & record-keeping
• Avoid pitfalls and enjoy the benefits!