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Moumunne
3rd March 2017, 21:38
Can we avoid IR35 as lucky doctors?

SueEllen
3rd March 2017, 21:44
Can we avoid IR35 as lucky doctors?

If you are a consultant then maybe - the issue is if you are managing and/or training other more junior staff you can be considered to be an office holder.

If you are junior doctor you are under D&C so nope.

SueEllen
3rd March 2017, 21:49
And I forgot to add it is posted elsewhere on this forum that all NHS workers who are contractors working with trusts are within IR35.

I guess you only escape if you are a locum GP or similar.

northernladuk
3rd March 2017, 21:53
I thought there had been quite a bit of discussion about locum doctors working in hospitals being a real problem for IR35. If that's the case nothing has changed and it will still be a problem.

Plenty of articles focused on locums out there to give you an idea about risk before looking at the tools and changes.

eek
3rd March 2017, 22:02
Can I refer you to this document https://jumpshare.com/v/Et8z2DADOzCYGTJDFmHo

cojak
5th March 2017, 13:24
Can I refer you to this document https://jumpshare.com/v/Et8z2DADOzCYGTJDFmHo

So I'm afraid that they are gunning for you.

NHS1979
5th March 2017, 13:55
I think NHS Improvement are all over NHS Trusts for using bank or agency nurses, and locum doctors. The hierarchical structure and massive governance stuff means most Hospital docs will struggle to show they are freelancers coming and going as they please. The letter from Jim Mackey is typically blunt and inaccurate - "HMRC will treat all public sector ‘self-employed’ contractors using a PSC as falling under IR35" - simply not true.

If I were you I would instead network with fellow docs to push for a rise in fees to compensate being inside-IR35 (only a supply shortage will get the attention of the higher powers locally and above).

On the management side, if you're lucky enough to work for one of the tiny number of NHS Trusts that hasn't just done a blanket decision, then your hopes of being outside IR35 rest on time-limited non-BAU projects such as 'transformation', 'CIP' or 'service redesign'. You come in, do something, then leave.

Moumunne
5th March 2017, 20:23
:violin:
I think NHS Improvement are all over NHS Trusts for using bank or agency nurses, and locum doctors. The hierarchical structure and massive governance stuff means most Hospital docs will struggle to show they are freelancers coming and going as they please. The letter from Jim Mackey is typically blunt and inaccurate - "HMRC will treat all public sector ‘self-employed’ contractors using a PSC as falling under IR35" - simply not true.

If I were you I would instead network with fellow docs to push for a rise in fees to compensate being inside-IR35 (only a supply shortage will get the attention of the higher powers locally and above).

On the management side, if you're lucky enough to work for one of the tiny number of NHS Trusts that hasn't just done a blanket decision, then your hopes of being outside IR35 rest on time-limited non-BAU projects such as 'transformation', 'CIP' or 'service redesign'. You come in, do something, then leave.

Moumunne
5th March 2017, 20:49
Thank you for this .

SlipTheJab
5th March 2017, 23:34
Can we avoid IR35 as lucky doctors?

Only if you're... eer...lucky... HTHBIDI

Andy Hallett
6th March 2017, 09:16
I believe locums, nurses, teachers and social workers were squarely in the HMRC firing line in regard to inappropriate use of PSC structures.

I suspect most if not all locums will be caught.

eek
6th March 2017, 09:22
I believe locums, nurses, teachers and social workers were squarely in the HMRC firing line in regard to inappropriate use of PSC structures.

I suspect most if not all locums will be caught.

+1. I also suspect management and ministers feel that the tax incentives have encouraged people who would otherwise be working permanently to become locums instead...

Reality is that Drs will be like the rest of us, people not wanting the people management hassle you get from being someone senior in an office. They can just turn up spend 8-12 hours looking after patients and go home again. Yes there may be a take home pay cut for these workers but its not going to change how they work. The reality is that most "temporary" workers want the politics free live that being "temporary" provides.

uyejyen
6th March 2017, 09:53
+1. I also suspect management and ministers feel that the tax incentives have encouraged people who would otherwise be working permanently to become locum's instead...

Reality is that Drs will be like the rest of us, people not wanting the people management hassle you get from being someone senior in an office. They can just turn up spend 8-12 hours looking after patients and go home again. Yes there may be a take home pay cut for these workers but its not going to change how they work. The reality is that most "temporary" workers want the politics free live that being "temporary" provides.

100% this. I'm in a different field and have been declared outside IR35 by current client. If I genuinely couldn't operate outside of IR35 from now on, I'd suck it up and go PAYE rather than perm (although I'm more likely to pack it up and travel). I just want to be paid for what I actually put in. None of this staying late to impress nonsense that perms seem to be falling over eachother to do, hoping for a 0.5% rise following three appraisals...

Andy Hallett
6th March 2017, 10:35
100% this. I'm in a different field and have been declared outside IR35 by current client.

Out of interest, how did they get to that decision?

b r
6th March 2017, 10:43
Out of interest, how did they get to that decision?

Probably the same way my OH's clients did; sat with the agency and played with the tool until they got the result they wanted that corresponded with how the contracts were setup and how they could agree to their contractors working.

QED

Andy Hallett
6th March 2017, 12:14
Wondering whether HMRC will get more out of investigations or agencies falling foul of the GAAR arounf this!

https://www.gov.uk/government/publications/tax-avoidance-general-anti-abuse-rules

Hawkesbaynz
7th March 2017, 08:09
A forum user mentioned locum GPs may continue to fall outside IR35. I work as an Advanced Nurse Practitioner directly for GP practices & Private management companies (IMH & Virgin Assura). Rarely agencies. Similar employment terms as locum GPS I imagine (bar the pension!). As these as private businesses rather NHS Trusts would I be outside IR35?

Massive reduction in income when PAYE although hourly rate still good. Loss of pension/sick/leave is a big lump. Although with 30 years in the NHS the lack of hassle a massive reason for working in this manner.

davetza
7th March 2017, 10:11
This seems to indicate the BMA will be issuing guidance on this shortly and they are saying GP locums will not be affected.

https://twitter.com/clairedocdavies/status/838809326768775169

northernladuk
7th March 2017, 10:12
This seems to indicate the BMA will be issuing guidance on this shortly and they are saying GP locums will not be affected.

https://twitter.com/clairedocdavies/status/838809326768775169

You mean they will still be inside?

eek
7th March 2017, 10:43
You mean they will still be inside?

What it says is that it won't effect GP practices (which makes sense depending on how they answer my bug bear question - I suspect however they are answering it wrongly). It doesn't however mention hospitals....

Aceofgas
12th March 2017, 13:20
Good afternoon all,

Anxious doctors joining the conversation...

I am a full time hospital locum and the hospitals and the in betweeners ( Liaison FS and 247Time ) has started to send out their versions of the new world after 6th of April. I have included a section from a letter sent to me by a hospital for your interest:

Option 1

- Contact the locum booking desk to arrange appropriate notice period to be provided to your agency
- Notify your agency of your intention to work directly for the Trust
- Promptly provide all required documentation requested by the Trust’s Locum desk.

Option 2

- Your agency updates the 247 Time system and selects your payment method as P.A.Y.E.
- Your agency will need to complete new starter form with you and new starter checklist (replacement of P46)
- Your agency will need to upload copies of your right to work documentation, identity check documentation, DBS details and National Insurance Card ensuring that your profile contains your correct NI Number. The documents required to be completed can be found at Home (http://www.247timesupport.co.uk) .
- Complete pensions opt out form if you wish to opt out of the pension scheme. You will be auto enrolled into the appropriate pension scheme.
- Your agency will need to update your candidate profile on the system with your personal bank account details and your home address.
- Finally, your agency will provide you with a Trust contract to sign and this will also be uploaded to the 247 Time system.
- If your agency fails to do this for you after the 6th April 2017 your wages will be held until the correct documents have been uploaded for your PAYE payment. Changes cannot be back dated so please gain confirmation that your agency has actioned this fully.[/I]


In my reading option 1 means you say goodbye to the agency and you directly contract with the hospital becoming a bank doctor. Choosing option 2 means you can use an agency however they say you are going to be paid through your personal bank account which precludes being paid as a PSC.
This also means this hospital does not even consider any candidate being paid through an umbrella.
According to HMRC you could be still paid as a PSC the public sector engager or agency deducting NI and PAYE the balance being paid into your business bank account. What this hospital is doing is slightly outside of what I would have considered as standard approach.

What do you think ?

Istvan

northernladuk
12th March 2017, 13:50
From what I see hospitals locums are considered inside anyway and both those options seem to reflect that going forward.

Do the previous replies in this thread not answer your concerns already? I don't see anything PSCs in there so that appears to be off the cards now. So client runs your payroll or agency doesn't. Looks the same end to you.

eek
12th March 2017, 14:06
From what I see hospitals locums are considered inside anyway and both those options seem to reflect that going forward.

Do the previous replies in this thread not answer your concerns already? I don't see anything PSCs in there so that appears to be off the cards now. So client runs your payroll or agency doesn't. Looks the same end to you.

+1. He also wants to read https://jumpshare.com/v/Et8z2DADOzCYGTJDFmHo which will explain the instructions the hospital /trust are following..

malvolio
12th March 2017, 15:29
Good afternoon all,

Anxious doctors joining the conversation...

I am a full time hospital locum and the hospitals and the in betweeners ( Liaison FS and 247Time ) has started to send out their versions of the new world after 6th of April. I have included a section from a letter sent to me by a hospital for your interest:

Option 1

- Contact the locum booking desk to arrange appropriate notice period to be provided to your agency
- Notify your agency of your intention to work directly for the Trust
- Promptly provide all required documentation requested by the Trust’s Locum desk.

Option 2

- Your agency updates the 247 Time system and selects your payment method as P.A.Y.E.
- Your agency will need to complete new starter form with you and new starter checklist (replacement of P46)
- Your agency will need to upload copies of your right to work documentation, identity check documentation, DBS details and National Insurance Card ensuring that your profile contains your correct NI Number. The documents required to be completed can be found at Home (http://www.247timesupport.co.uk) .
- Complete pensions opt out form if you wish to opt out of the pension scheme. You will be auto enrolled into the appropriate pension scheme.
- Your agency will need to update your candidate profile on the system with your personal bank account details and your home address.
- Finally, your agency will provide you with a Trust contract to sign and this will also be uploaded to the 247 Time system.
- If your agency fails to do this for you after the 6th April 2017 your wages will be held until the correct documents have been uploaded for your PAYE payment. Changes cannot be back dated so please gain confirmation that your agency has actioned this fully.[/I]


In my reading option 1 means you say goodbye to the agency and you directly contract with the hospital becoming a bank doctor. Choosing option 2 means you can use an agency however they say you are going to be paid through your personal bank account which precludes being paid as a PSC.
This also means this hospital does not even consider any candidate being paid through an umbrella.
According to HMRC you could be still paid as a PSC the public sector engager or agency deducting NI and PAYE the balance being paid into your business bank account. What this hospital is doing is slightly outside of what I would have considered as standard approach.

What do you think ?

Istvan

PM sent...

eek
12th March 2017, 15:39
PM sent...

He hasn't got pm rights yet so may or may not see it..

LoughriggFell
12th March 2017, 16:25
And I forgot to add it is posted elsewhere on this forum that all NHS workers who are contractors working with trusts are within IR35.

I guess you only escape if you are a locum GP or similar.


I am not sure that locum GPs do escape. Although they work at private practices, the practices receive public funds, and all GP's are included in the FOI.

They may not be subjected to the PSC blanket ban, but I think the practice will have to make the determination.

malvolio
12th March 2017, 16:48
He hasn't got pm rights yet so may or may not see it..
True, but hoping the mods are in a good mood...

eek
12th March 2017, 16:55
True, but hoping the mods are in a good mood...

Doubt it only Admin can authorise that change and he's rarely around at weekends...

Either way I was just warning you in case you were expecting a response (as if the system fails to send a mail to a recipient it doesn't notify sender).

Aceofgas
12th March 2017, 20:11
From what I see hospitals locums are considered inside anyway and both those options seem to reflect that going forward.

Do the previous replies in this thread not answer your concerns already? I don't see anything PSCs in there so that appears to be off the cards now. So client runs your payroll or agency doesn't. Looks the same end to you.

I have read up on a fair few threads here and other message boards and I am fairly clear about what is likely to happen in the NHS. All hospital HR managers will classify any medical locums as within IR35.

I respectfully disagree with your conclusion that either way it will bring us to the same end. I can see one main issue which is the employer's NI and the resulting issues aorund rates. Another in betweener/timesheet company already said that as employer's NI is paid by the NHS trust from April instead of the locum doctor's PSC the locum has to suck it up. This company also states they are going to pay PSC and would accept umbrellas with some reservations.

The specific example I used was about a hospital trust which created their own interpretation of what needs to happen to implement IR35 changes. I think simply refusing to contract/engage with PSC or umbrella is a deviation from HMRC advice. I would say however it is within those measures and logic Jim Mackey CEO of NHS Improvement describes in his latest Soviet style dictat.

On the other hand my agency produced another dictat saying they only work with candidates employed by umbrellas. I think the dust is going to take some time to settle.

Aceofgas
12th March 2017, 20:34
+1. He also wants to read https://jumpshare.com/v/Et8z2DADOzCYGTJDFmHo which will explain the instructions the hospital /trust are following..

Thank you for the link I have come across this a few times this weekend. Apart from the usual moral high ground type of claims of how painful it is for permanent staff to work alongside much better paid temporary staff he introduces one important dictat which is to prevent permanent medical staff from other trusts to be booked through agencies allowing only bank type of assignments. I think he may not realise that tackling the temporary workforce this way is not going to change the general lack of supply of medical workforce. In itself capping locum rates has been relatively successful with non-medical staff and I have seen quite a few permanent locum ODPs taking up permanent NHS posts. This is going to be different to doctors since converting this locum workforce into permanent is tad more complex.

teapot418
12th March 2017, 21:00
Thank you for the link I have come across this a few times this weekend. Apart from the usual moral high ground type of claims of how painful it is for permanent staff to work alongside much better paid temporary staff he introduces one important dictat which is to prevent permanent medical staff from other trusts to be booked through agencies allowing only bank type of assignments. I think he may not realise that tackling the temporary workforce this way is not going to change the general lack of supply of medical workforce. In itself capping locum rates has been relatively successful with non-medical staff and I have seen quite a few permanent locum ODPs taking up permanent NHS posts. This is going to be different to doctors since converting this locum workforce into permanent is tad more complex.

The whole thing has been ill thought out and badly implemented, across the board.

eek
13th March 2017, 07:49
Thank you for the link I have come across this a few times this weekend.

It's remarkable how far that little link has gone...

northernladuk
13th March 2017, 10:32
It's remarkable how far that little link has gone...

But not as far as a cute kitten video.. What a strange world we live in....

Moumunne
14th March 2017, 01:11
How about substitution ? Locum doctors are working anyway under "substitution" as in for example if unable to go to work your agency would send someonelse. So with with a legal substitution contract should be outside IR35

All Locums I know will take time off from April; I can only presume NHS will need to find alternatives. Getting payed as PAYE it gets you with half of the rate earned plus you can't clame expenses not to mention courses, apparaisels etc. So it's no point working as a Locum doctor since the only reason for getting yourself into this hassle is earning extra money.

It's been mentioned about CAP rates, that was only something that mostly agencies have taken advantage of it l have not been payed less after the CAP came up.There is no transperances in regards to the earnings and contracts so Locum Agency is simply your God. And this thing with Umbrellas Com it's a mit, it won't save you more money. Who is going to get out of his home weekends and nights and bank holidays for just couple of pounds extra comparative to a trainee doctor? Who is going to travel miles and miles away from home paying loads on petrol, car breakdown and putting up with all the rudeness a Locum doctor usually takes?

northernladuk
14th March 2017, 08:03
How about substitution ? Locum doctors are working anyway under "substitution" as in for example if unable to go to work your agency would send someonelse. So with with a legal substitution contract should be outside IR35?

That's temping. YOU have to source and supply the substitute. Plenty of articles on what substitution is so I suggest you have a look.

Aceofgas
14th March 2017, 14:12
How about substitution ? Locum doctors are working anyway under "substitution" as in for example if unable to go to work your agency would send someonelse. So with with a legal substitution contract should be outside IR35

All Locums I know will take time off from April; I can only presume NHS will need to find alternatives. Getting payed as PAYE it gets you with half of the rate earned plus you can't clame expenses not to mention courses, apparaisels etc. So it's no point working as a Locum doctor since the only reason for getting yourself into this hassle is earning extra money.

It's been mentioned about CAP rates, that was only something that mostly agencies have taken advantage of it l have not been payed less after the CAP came up.There is no transperances in regards to the earnings and contracts so Locum Agency is simply your God. And this thing with Umbrellas Com it's a mit, it won't save you more money. Who is going to get out of his home weekends and nights and bank holidays for just couple of pounds extra comparative to a trainee doctor? Who is going to travel miles and miles away from home paying loads on petrol, car breakdown and putting up with all the rudeness a Locum doctor usually takes?

Good thinking but you need to argue these points with NHS hospital HR and procurement managers. In the end they are going to classify you and me and everyone else as within IR35 since they do not wish to take any risks.

I agree with you there is going to be a little down time for some of us come April. Your agency may be your God now however this might be changing in the future: you can contract directly with hospitals ( aka bank doctor ) and the pay may be similar.

An umbrella may just be a requirement of your agency and truly when any of these companies are claiming they save money for you this clearly is not the case.

The expense of appraisal and training is not accounted for yet and I think the ensuing rates after April may help with this. ( I am guessing a lot here.)

LoughriggFell
16th March 2017, 17:46
BMA have issued their guidance regarding GP Practices - taken from BMA website.


From 6 April 2017 these obligations transfer to a public sector body (or recruitment agency where it uses one) which engages a worker through a PSC. For these purposes, a public sector body is defined as a "public authority" under the Freedom of Information Act 2000 or its Scottish equivalent, which includes not only NHS England, clinical commissioning groups (CCGs) and NHS Trusts, but also GP practices providing GMS and PMS services.

A locum GP contracting via an intermediary

Where a locum is contracting with a client or recruitment agency via an intermediary (such as a PSC), IR35 may apply. From April 2017 where a public sector body (including a GMS or PMS practice) engages a worker to personally perform services under arrangements involving an intermediary, the obligation to determine whether IR35 applies and, if so, account for the relevant income tax and NIC will be on the public sector body (or agency if it uses one). Previously these obligations were on the PSC.

Moumunne
16th March 2017, 19:22
yup. Nice one! There is an excess of doctors and GP practices in the UK so my only guess is that they to get rid of as many as They can :ladybags:


Waiting 4 hours in the A&E it is going to be a Fairytale :banana:

Aceofgas
18th March 2017, 09:41
The NHS and agencies are forming partnerships or at least the agencies are used to leak information from NHS Trusts to describe how the new world of post IR35 is going to look like.

Below is a link to Holt Doctors' article which describes this new world from the agencies' and NHS hospitals' perspective.

IR35 legislation - changes for PSC workers April 2017 - Locum Doctor Jobs - Holt Doctors - UK Locum Agency (http://www.holtdoctors.co.uk/doctors/payment-information/ir35-legislation-changes-for-psc-workers-april-2017)


"Our clients will be issuing amended Direct Engagement candidate terms and conditions to you for assignments to reflect the new processes and deduction of employment taxes and NI (including employer’s NI which will also no longer be payable to PSCs)."

Based on this quote I think they want to give us the impression that even after implemeting a IR35 changes by the NHS Trust it is still the contractor responsible for the employers NIC. You are taxed as employee when it comes to employers NIC you are still Ltd ?

Another interesting point they wanted to make:

"Our NHS clients and the Frameworks have also said that they expect to see support in ensuring that overall rates do not increase due to these changes coming into effect."

Agencies in the NHS market will not have to change a lot around these changes beyond relaying the new rules onto the workers and re-writing the contracts. As long as the worker continues working with them they have a constant stream of income unchanged.

The overarching idea is the contractor will bear the cost of all this. From the contractor's perspective one way of dealing with this mess may well be direct contracting with multiple NHS establishments directly and perhaps that may help agencies feel the pain a little bit.

eek
18th March 2017, 10:09
The overarching idea is the contractor will bear the cost of all this. From the contractor's perspective one way of dealing with this mess may well be direct contracting with multiple NHS establishments directly and perhaps that may help agencies feel the pain a little bit.

Where else is the money going to come from? Remember the previous statement said



"Our NHS clients and the Frameworks have also said that they expect to see support in ensuring that overall rates do not increase due to these changes coming into effect."

which leaves the only people able to pay being the agency (already restricted by previous changes into fairly low commission rates) or the contractor. So the contractor it will be as that is the only give left in the situation...

Of course the only way that works is if you can ensure different trusts do not compete against each other by raising rates which is why https://jumpshare.com/v/Et8z2DADOzCYGTJDFmHo and explicitly why the following bit


Local CollaborationNHS

I continues to identify significant differences in the rates paid by providers in the same local workforce market, particularly around escalation rates (‘break-glass’ rates). This must be tackled on a collaborative basis. Therefore, the NHSI agency intelligence team will be working with you to make the rates paid more transparent and agree local escalationrates that all trusts locally should support and stand firm on.

is so important.

LoughriggFell
18th March 2017, 11:29
Of course the only way that works is if you can ensure different trusts do not compete against each other by raising rates which is why https://jumpshare.com/v/Et8z2DADOzCYGTJDFmHo and explicitly why the following bit



is so important.


Local Collaboration, as yet, has never happened in the NHS.

An example of this is, I have been working on waiting lists initiatives, some trusts will approach me when their list tips 32 weeks (300+ patients) others 40 minutes away will, when their list is 3 weeks (25 patients). The individual circumstances of that service ( private companies circling, "at risk" services, threat of closure) determines the need and the rate.

Jim will have to have a very cunning plan to make it happen now.

Carl10
18th March 2017, 15:07
Local Collaboration, as yet, has never happened in the NHS.

An example of this is, I have been working on waiting lists initiatives, some trusts will approach me when their list tips 32 weeks (300+ patients) others 40 minutes away will, when their list is 3 weeks (25 patients). The individual circumstances of that service ( private companies circling, "at risk" services, threat of closure) determines the need and the rate.

Jim will have to have a very cunning plan to make it happen now.

I do agree with you. Patient safety risk first. I'm Sure some key locum contractors will be offered a bespoke solution to stay out of the scope of IR35. Otherwise the NHS will collapse.:bang:

Moumunne
19th March 2017, 04:19
Guys, something important to keep in mind, most of the experienced Locum will stop working for at least two months. After this some will take permanent positions and some will be working some hours but they won't be killing them selfs to travel miles , to do nights or weekends; simple math you get payed 50£ , you'll be taking home 25; oh and you are going to say, yeah but it's more than what a trainee gets' correct! But then you need to pay indemnity, training, appraisal etc.
So :once again, nights? , bank holidays? , last call shift? Neeeh :wave:

I am sure NHS will clench their buttocks; but for how long? I am sure they will do their best to state they can survive without agencies and Locums :bluelight;

eek
19th March 2017, 07:57
I think most people on here know that and have known that weekends and holidays are going to be a nightmare for months.

The only thing that matters now is who blinks first - the trusts by increasing payments or the doctors who accept lower pay.

Moumunne
19th March 2017, 09:02
Once again, with the benefits given as trainee doctor you will get almost the same at the end of the year, especially if you are on specific specialities as Oncology. So it doesn't make sense to work as Locum. The principle is " the more you work the more tax you pay"

perplexed
19th March 2017, 11:16
I think most people on here know that and have known that weekends and holidays are going to be a nightmare for months.

The only thing that matters now is who blinks first - the trusts by increasing payments or the doctors who accept lower pay.

Trusts won't blink.

Mate works in the finance department of the local Trust, pointed out to me locums have been taking the piss big time. It's not just locums he rails against, junior doctors and consultants are equally as bad. Reports abuses he finds, nothing gets done.

Moumunne
19th March 2017, 13:01
Trusts won't blink.

Mate works in the finance department of the local Trust, pointed out to me locums have been taking the piss big time. It's not just locums he rails against, junior doctors and consultants are equally as bad. Reports abuses he finds, nothing gets done.

You can't generalise! Of course you can have rubbish Locum doctors, working on low rates as well because hospitals won't keep them; but you can also have Locum doctors doing the work for 3 doctors and never leaving the ward until jobs are done. I've been a Locum for quite a while and always working for the same hospitals and always been offered training speciality positions but kept doing Locum work because up till now it worth from money point of view; obviously considering the new situation I will probably accept this time. It's probably difficult for you to accept but sometimes you'll find Locum doctors highly skilled within certain specialities , compared to a trainee.

Moumunne
19th March 2017, 13:27
Main problem will be when trusts will put pressure on their trainee doctors. At this moment I am filing the gap as Locum for a trainee position, will be unable to remain with the trust because its faraway from my home though they have offered. I've given a fair notice but they are unable to fill in the position so my colleagues will be in trouble. And unfortunately I am not the only one leaving the trust.

Aceofgas
20th March 2017, 15:32
Guys, something important to keep in mind, most of the experienced Locum will stop working for at least two months. After this some will take permanent positions and some will be working some hours but they won't be killing them selfs to travel miles , to do nights or weekends; simple math you get payed 50£ , you'll be taking home 25; oh and you are going to say, yeah but it's more than what a trainee gets' correct! But then you need to pay indemnity, training, appraisal etc.
So :once again, nights? , bank holidays? , last call shift? Neeeh :wave:

I am sure NHS will clench their buttocks; but for how long? I am sure they will do their best to state they can survive without agencies and Locums :bluelight;

I doubt NHS Trusts are going to flood the job market with permanent medical posts to recruit people from the full time locum market. This may leave the NHS with the same supply/demand problem. What I can see is the loss of market share for agencies. If the NHS Trusts are unwilling to negotiate a rate rise this will leave the locum doctor to pay employer/employee NIC and PAYE from the already established rate. The agency margin is ( guessing ) about 15-20%. To reduce the effect of you being held responsible for employers NIC you may wish to consider direct contracting with the NHS. In other words you may be able to negotiate on the agency margin with them.