orthopaedic plaster cast related content

Saturday 1st April 2017


Locum Staff     


The current situation with regard to the change in regulations for agency locum staff is likely to have a significant impact on the availability of agency workers. They are frequently used to cover periods of extended sick leave and exceptional staff absences caused by retirement. Less frequently, agency staff are used to provide cover for annual leave. In a plaster room with an establishment of three permanent staff, there will be  a period of time where the department is knowingly understaffed for 24 weeks of the year.


The new update to regulations from HMRC (IR35 regulations) refers to intermediaries providing work to public authorities. I provide my work through various agencies and I work through my own limited company. In the HMRC jargon, my company is a personal service company and the rules are applied automatically. This means that I can no longer claim for legitimately incurred expenses. Previously, I have been able to offset them against my taxable income. I believe that the ability to claim some expenses for working anywhere in the country is reasonable.


I recently undertook a three month locum tenens contract some 320 miles from my home address. This is too far to commute to work one way (6 hour drive) and too much time on top of the working day to be considered safe practice. A 12 hour commute and then an 8 hour working day would only leave 4 hours for sleep and no other activities could be undertaken. In this particular case I stayed in a bed and breakfast guest house and claimed my accommodation and subsistence expenses as a part of the essential expenditure in completing the work.


Hospitals throughout the UK tend not to keep property for on-call local staff any more. Keeping accommodation for locum staff to stay in while filling essential posts which have fallen vacant, is a vey low priority expenditure. I am not paid holiday pay, sick pay nor is any of annual mandatory training paid by the NHS. I supply my own tools and uniform. I work wherever the vacancy has appeared and for a little or as much time as is required. I provide an essential service but can no longer claim the expenses.


If the most recent work had extended for one year, my unavoidable and necessary expenditure would have totalled more than £31,000. No ‘employees’ should have to pay that much money just to enable them to obtain work. I accept that it comes with the turf of providing a service and my salary was reduced by two thirds because of the exceptional circumstances of location and staying near to the hospital. Now that I can no longer claim these expenses, the obvious and inevitable corollary is that I can no longer take on that work.


The agencies have all been required to obtain medical malpractice insurance from the temporary worker before permitting them to work. This insurance can be obtained for a price and I have had several quoted from around £4,000 to about £11,000 per annum. The sum must be paid before the insurance can begin and the excess of £3,500 is levied before a claim is processed. As a non-regulated worker, the NHS employer’s website states that I do not need medical malpractice insurance yet the agencies are insisting upon it. This is one more reason that I can no longer work at my specialist role with more than four decades of experience… the corollary is that I must stop working because I cannot afford to subsidise HMRC, the NHS or locum staff recruitment agencies.