The Big Debate

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The Big Debate #1: Were some locums right to raise their rates during the first wave of COVID-19 in the Spring?

Started 4 months ago

Good evening everyone, and welcome to our very first Big Debate! This week, we're debating locum rates during the first wave of COVID-19 in the Spring. Some contractors have complained of some locum contacts vastly raising their rates in response to the pandemic, while locums have reported some employers trying to drive down hourly rates. Even the GPhC waded into the argument by warning that locums groups who tried to collude between themselves to raise rates could find themselves in hot water.

So, what's your view? Let us know by posting below and debate among your peers. The formal debate will close at 8pm, but the conversation will remain open for the foreseeable future.

The BIG question is what is a locum worth in 2020?£23 ph was minimum rate in 2008......how can that figure be the same in 2020?a lot of locums were without work during the first lockdown

As the saying goes the work they do is "above their paygrade" this is definitely the case here.

 I am a locum, I'm currently taking a career break as I worked so much during the covid period (6 different places) up to 7 days a week some weeks and completely burnt out. I primarily work in hospitals, locumed in community the first Saturday after lockdown “ended” and lived in primarily self funded temporary accommodation (as locums weren't always entitled to staff accommodation in some trusts/it took a while for trusts to include temporary accommodation for NHS workers living with vulnerable individuals). I had to isolate a few times because locums didn't always get staff covid testing and on some occasions was denied any kind of sick pay - so I would be paying to live out for work, but not paid for being forced to isolate and unable to get a test to prove I didn't need to isolate. I was also told once, locums can’t be antibody tested or get fit tested, as it was expensive and only for their permanent staff, if I needed it, I would have to pay to get it done privately.

 My role in hospital was changed when the first wave hit, and was instantly redeployed- to covid cover, when I was informed I was being redeployed I contacted my agent and asked for a pay increase not because I saw it as a money making opportunity, but because I was determined to do my very best and work as hard as possible to keep patients safe, but the new role put me at greater risk, meant I would have to distance from family for a while - isolating me, it was more taxing, more stressful, more responsibilities! It's not just a little pharmacist signature checking a box of pills, we are clinically assessing a patient's safety and therapy against an entirely novel virus causing a multitude of conditions that we had no idea about- by signing off any treatment we are taking accountability for that. I also wanted to increase my rate to pay for my temporary accommodation. Is this unreasonable? I was on a negative income. Living to work, not working to live. 

 

Community locum pharmacists stayed open on the forefront of every town, throughout the entire pandemic when stores, restaurants, hospitals etc were locked down. Pharmacies remained open, staffed heavily by locums- who were putting themselves at risk with the increased workload - increased footfall with patients being diverted to them for medical queries, minor ailments, vaccines, EHC, blood glucose monitoring, smoking cessation etc. As well as stepping up to ensure all patients (especially shielding patients) had a sufficient supply of all medication throughout the lockdown period. They went above and beyond and the risks are also much higher to themselves and to others, working longer & harder shifts, risking unnecessary exposure to themselves and their close family/friends.

 Locums, like any other freelancer, are entitled to negotiating their rate. They must work out their minimum acceptable rate ( (personal outgoings + business outgoings) / hours worked ) + tax), negotiate based on their perception of value, and knowing your worth. 

 So profiteering off the back of a pandemic is a bit of a slanderous term, locums are putting a value on their skills/life - lowering rates, capping rates and shaming locums for expecting a fair wage, devalues the profession as a whole and can further damages public faith in the profession leading to an increased risk in patient safety. Is there any evidence that locums are profiteering or negotiating unfairly? How many times did this occur? How many times was this reported and investigated? How many times was it concluded that the locum unfairly increased their rate?

 Pitch this scenario to a group of 1000 members of the public... 

 you have two pharmacies in front of you  -Pharmacist 1 in Pharmacy X charges £xx per hour and Pharmacist 2 in Pharmacy Y charges half of what Pharmacist 1 charges per hour - who would you trust more? Who do you think is more experienced/qualified? Who do you think will provide the safest care?

We are grossly underpaid anyway and need to stand together to negotiate a decent wage rise ASAP. I have just returned to UK after working in Australia for last 30 years and was very disappointed at the conditions and rates that pharmacists endure here.

I think this is an inflammatory, attention grabbing and rather tabloid-esque attempt at denigrating locum pharmacists. What evidence does C+D have to suggest locums actually raised rates during the pandemic? The GPhC had ONE complaint and it made an irresponsible statement which companies used to blackmail and threaten locums and we have plenty of evidence of this. 

Locums have always negotiated their rates, just like any other self employed professionals. What we have seen, however, is multiples abusing their position to control locum rates through bullying, market manipulation ( as we have seen in Scotland and possibly other regions), closing branches to cut costs when they can't get a locum below a certain rate. We have seen how locum agencies threatened locums to accept their rates and threatened with blacklisting if they dare to say no or tried to negotiate. So, the question should really be "Was it right for pharmacy owners to cut rates and bully locums during the COVID-19 pandemic?" The simple answer to that would be a big resounding NO. Simply because we put our lives at risk while those sitting in the head office were safe from the virus yet they decided the only way to deal with Pharmacists is to bully and blackmail them. 

What locums should be doing is boycotting any pharmacy or pharmacy chains that have used bullying, blackmails and threats to control and manipulate the market. From our own (Pharmacist Cooperative) survey we've seen certain multiple and agency named a number of times for bullying and threatening locums. 

Excited to be taking part in the first Big Debate! Pharmacy teams were under immense pressure during the first wave, staff shortages (due to COVID-19), lack of PPE, stock shortages, panic buying, lack of funding to name a few were just some of the pressures they were facing. Whilst many other healthcare services closed to the public, pharmacies remained open putting all members of the pharmacy team at risk. I think an increase in locum rate was not wholly unreasonable - working extended hours, under extremely intense conditions and putting not only themselves but their family members at risk is something that should be acknowledged. There may also be worries around finding locum hours...perhaps another reason for people rushing to put up their rates. I do think that some rates were getting completely out of control - putting into question if it was for these reasons alone or because they knew pharmacies were desperate for staff and would pay more....?

I dont understand how we are expected to take on extra roles ie vaccinations and GP referrals (CPCS) on top of everything else.

Think the big question is what the GPhC is willing to bring any charges for multiples who rather close shops even when there are locums  available to work but are unwilling to pay the locum rate requested quite reasonably for emergencies ? but are happy slander locums but are very quite on this matter , maybe CD could investigate since the bodies responsible never seem to take any action

I would also like to add that a good proportion of community locum pharmacists are of BAME origin which given the current climate puts them at risk of worsening Covid-19 symptoms should they catch the virus if caught at a patient facing clinical setting. It took a while for community pharmacies to have a formal risk assessment guidance in place which took BAME considerations into account, such as the one produced by the PDA, so I do feel that locums were correct in asking for higher remuneration at the height of the pandemic and should be applauded as well as being respected for their work in ensuring patients were still receiving the best possible healthcare advice and ensuring medication safety.

@Anisha Kothari - i think you hit the nail on the head - couldn't agree more with "knowing your worth" - and it's important to consider expenses such as petrol/travel money/other business outgoings. I've always been under the impression that negotiating pay as a locum was acceptable

also locums had to buy their own PPE who can forget the Rowlands email regarding this and then to back track after the outcry  from locums

There is no way a figure of less than £45/£50 ph in 2020 justifies a locums worth.....I wake up at the crack of dawn,drive hundreds of miles of unknown roads to an unknown pharmacy do a decent days work sometimes with unfamiliar staff and processes,perform MURs,NMSs,you jabs,EHC,ED consultations  etc and still leave the pharmacy with all jobs perfectly done

Shame there is nobody from the contractors willing to participate in the debate to give their point of view

I'd like to understand from a contractors POV.
How much am I worth to you? What value do you place on me? Have increases in rates coincided with increased workload, travel, expenses, personal risk etc?.. Or were these rising rates completely out of the blue and disproportionate?

Or even from the GPhc point of view and their thinking for making the comments but assume they might be busy in light the report today and body is not fit for purpose, which most pharmacists knew already

@Naimah Callachand- Glad you agree, driving down rates - is basically saying we've dropped in value. 

We should also look into profiteering by large pharmacy chains, for example, selling surgical masks that cost pennies for £1 each. We've seen Type IIR masks on sale on websites of some multiples for £50 per box when we at the Pharmacist Cooperative we were sourcing them for a fraction of that price and giving them to pharmacists, optometrists, dentists and GP surgeries at cost price. There is no excuse for profiteering during a pandemic. We have also seen how Rowlands pharmacy was holding back PPE from locums and after a huge backlash lead by the Pharmacist Cooperative they were forced to reverse their decision. They threatened locums that their shifts would be cancelled if they don't bring their own PPE. PPE that literally cost pennies when the announcement was made. 

@contractors, out of curiosity: Back in 2000, tell me the hourly rate for your staff and also the hourly rate you paid for a locum pharmacist?

As of todays date, tell me the hourly rate you pay your staff and also the hourly rate you pay for a locum pharmacist? 

There is a lack of any comments from contractors here. They must be in agreement that Locum pharmacists pay should have kept up with the pay gap that existed when the contractors paid minimum wage and the going rate for a locum was around £19 per hour the gap was about 5 times minimum wage. Back of an envelope calculation with the minimum wage at about £9/hr...we can all do calculations.

So, is this the bare minimum that pharmacists should be working for, around £45 / hr? Due to a deafening silence from the contractors I would take that as a an acceptance of this proposal.

The fact that we're even debating about this upsets me! I've locked in the community setting on weekends regularly for 9 years - I've only seen my pay go down (which makes it even even worse taking inflation in to account), whilst I've unskilled myself by doing a clinical diploma, independent prescribing, flu jabs, etc.

When I asked for a higher rate because I thought I could demonstrate my worth I was threatened with taking the shifts away. I wasn't concerned about the shifts taken away from me because of the money, because I wasn't doing it for money. For me it was about serving the community, getting a better understanding of the gaps between primary and secondary care and how do we bridge that. Taking my hospital clinical knowledge, by understanding of how the system works was of immense value - I've stopped countless number of A&E visits, admissions, etc. because I had the understanding of the 'system'. 

The GPhC and the RPS are oblivious and ignorant and actually as Tohidul mentioned above irresponsible to come out with the statement they did! When challenged to the GPhC and Duncan they chose not to comment. 

I think we need to stick together and drive ourselves out of this by constantly saying no to the lower rates and as with the comments above, totally agree knowing our worth is paramount. 

Locumed*

Upskilled* - apologies for the autocorrection

not much of a debate...

Everybody in agreement, damming indictment on the contractors guilty in their absence 

Absolutely ...where are they ?

Maybe CD should have rethink next time the journalists do a puff piece on them , like asking the lloyds boss for his views, if cannot be bothered to enter debates like this then i don't want to hear about his whining on the CD website

whilst his company Mckesson group post profits made for the year on the back hard working locum/pharmacists , not the fault of locums for the folly of Cormac or Well owners paying over the odds for the Sainsburys/ Co-op respectively  , any self respecting pharmacist could have told them to stay away! hung by their own petard and now squeeze the locum rates to claw back their losses, do you really think if someone offered to buy the pharmacies off Asda, Tesco or Morrisons they would refuse to sell them ? no chance everybody knows now not to bother!

have a good evening am off the footy on soon

And that's a wrap on the formal debate, guys, although the room is still open for you to carry on the debate in your own time. Hopefully some contractors will find the time to give their opinions.

We'll see you next time on 19th Nov for our next Big Debate.

Sorry to say this has been a really disappointing "debate". Dear C+D if you are going to run this kind of debate again may i suggest you have an opposition in place otherwise you are wasting everyones time. Good evening.

Let me help you rephrase the debate title: Were some locums right to raise their rates during the first wave of the Covid-19 pandemic, knowing they are risking their lives to serve the public?

Were they right to go out to help the public, although they were on the receiving end for all the aggro and frustration?

Were locums sane they were waking up in the crack of the dawn, saying bye to their family, not knowing if they will return home infected or even worse as an asymptomatic carrier?

What on earth were locums thinking going into a pharmacy with tripled or even quadrupled work load, frustrated patients, long queues and low staff levels

Why the hell should we raise our rates, each year the rates seem to be dropping. So during Covid-19 we should have been paid the national minimum wage.

Who do we think we are?..heroes?

Oh and to add to it all, contractors are taking away mileage payments. Don't worry, locums can jog from Yorkshire to Scarborough.

Wrap the debate? This debate is and can only be useful if C+D, RPS, GPhC everyone supports and values us. Locums are the back-up for pharmacy. Without them many stores would remain closed. Maybe give them the respect they deserve. Grateful for the odd patients who thanked many of us and told us we are doing a great job, that is indeed what kept us going. Otherwise we were just getting labelled as "profiteering".

Such an exciting debate

Night

As per the Bank of England inflation calculator (https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calculator)

the inflation average between 2000-2019 is 2.8%. 

If a Locum's rate was £20 (example figure, not based on fact) in 2000, the rate in 2019 should be around £33.92.

This doesn't include the additional costs and expenses caused by  the pandemic...

Sigh, again, maybe locums are just not worth the contractors' time...

We should all be working together to negotiate better rates and conditions.

Coming here abit late, but anyway...I agree with all the comments stated here and I’m not even a locum. I’m employed by a large multiple and I think that locums should be free to negotiate their rates based on all the factors stated in this debate. Judging from the comments, I don’t feel that it’s profiteering as the GPhC etc made it out to be. Our profession needs to be valued with the work we do and the rate should reflect that.