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COVID-19: Should locum pharmacists increase their rates?

Locums say the increase in rates reflects an increased workload
Locums say the increase in rates reflects an increased workload

A minority of locum pharmacists have increased their hourly rates following the COVID-19 outbreak, sparking controversy across the sector

Pharmacies across the UK have faced staffing issues over the last few weeks due to the combination of a massive increase in demand for prescriptions and a rise in absences from team members self-isolating with COVID-19 symptoms.

According to reports heard by C+D, a minority of locum pharmacists have increased their rates during the crisis. The sector is divided on whether this is ethical, as some pharmacy professionals accuse locums of being “mercenaries”, while some locums argue the rate is just reaching a fair market level.

In mid-March, the General Pharmaceutical Council (GPhC) chief executive Duncan Rudkin kick-started the debate by warning locums against “profiteering to take selfish advantage” of the COVID-19 outbreak with rate hikes.

The Pharmacists’ Defence Association (PDA) responded by saying that “to refer a locum to the GPhC for simply negotiating a higher hourly rate would be an absurdity and an abuse of the regulatory system”.

The PDA said it “understands the sentiments” of the regulator, as vastly inflated locum rates during the pandemic could “undermine wider public confidence in the profession”. However, the GPhC has “no other legitimate regulatory interest in the commercial rates agreed between locums and their clients”, it said.

These feelings were echoed by many locums. Mitesh Patel, a locum based in the north of England, says: “I fear that by making such an erroneous statement, the GPhC has tarred all locum pharmacists with the same brush…it runs the risk of permanently alienating a very large segment of the register.”

Tohidul Islam, founder of social network The Pharmacist Cooperative, says that companies could misuse the GPhC statement to drive down locum rates.

“Locums are being abused – threatened unnecessarily by agencies and multiples for negotiating rates that were previously accepted as normal,” says Mr Islam (pictured below).

C+D put Mr Patel’s comments to the GPhC. Mr Rudkin responded: “We are in no way trying to suggest that all locums are taking advantage of the current emergency to negotiate higher rates or that locums cannot individually negotiate rates with their clients.”

Nevertheless, the GPhC didn't renege on its warning that profiteering from COVID-19 would not be taken lightly. Mr Rudkin said: “Neither pharmacy owners nor locums should be looking to profit from this situation by involving themselves in anti-competitive action.

“We will continue to take a balanced and even-handed approach to issues raised about some pharmacy owners and some members of the profession.”

The GPhC could not share any further details on the reports of “significantly higher rates” it had received.

C+D spoke to pharmacy professionals on both side of the debate to find out more.

£100 an hour

The average hourly rate for locum pharmacists across the UK was £21.99 last year, according to C+D’s Salary Survey, which ran between October 1 and November 14 and drew responses from 229 locum pharmacists.

While this rate may be the highest for seven years, the average locum rate steadily declined between 2010 and 2015 and has not yet recovered.

Recent reports of hourly rate increases received by C+D range from a £5 bump on normal rates to reaching a whopping £100 per hour. As a result, locums have been accused of taking advantage of community pharmacies already under immense financial pressure due to COVID-19.

Hemant Patel, the secretary for north-east London local pharmaceutical committee, says he has heard of requests for £60 an hour, when he expected the figure to be around £25.

“Some locums have taken the opportunity to raise rates with ‘danger money’,” says Mr Patel, implying that some locums expect higher rates as recompense for the danger of being infected with COVID-19 during the outbreak.

“There is no additional money coming into pharmacy to pay extortionist rates,” Mr Patel continues.

“People need to be reasonable and maintain relationships. Some are reasonable [but] there are mercenaries.”

Bernadette Brown, owner of Cadham Pharmacy in Glenrothes, Fife says that in this “time of crisis” she has found it “exceptionally hard to find locums”. The only one she was able to find for a shift in March offered her a rate of £40 an hour for a minimum of 11 hours, when she usually pays £23 an hour.  

The owner of an independent pharmacy in north-west England, who wishes to remain anonymous, says he recently looked for a locum who he would pay £25 to £30 an hour.

However, “the rates being quoted are £35 and over per hour, with extra time for travel. Many are quoting up to £100 per hour. I have therefore kept to my loyal regular locums and covered all the other shifts myself”.

Salim Jetha, CEO of the independent pharmacy support group Avicenna, says members of his organisation have also reported rates that were over £40 an hour. “The price of locums is going up,” says Mr Jetha (pictured below), which “hits our margins”. However, he said he could understand why there were increases, as when there is no work for locums, they have no income.

The manager of an independent group based in Gloucestershire, who wishes to remain anonymous, also believes the rate requests he has fielded of up to £45 per hour were reasonable.

“Rates reflect an increased workload and the genuine risk for what most feel is an undervalued and somewhat underpaid profession, it’s just supply and demand,” he says.

But an increase in the rates requested by locums does not mean contractors will pay them. One C+D reader says: “It’s important for locums to appreciate that cash flow nightmares for contractors means they simply cannot afford to pay the rates the market demands.

“Action is needed by NHS England, the Department of Health and Social Care and the GPhC to assist where they can.”

“Absurdly low” rates

Many locums believe the combination of extra risk during COVID-19 with historical low rates makes a strong case for increasing locum pay.

A locum based in London, Shahih Afser, stresses that rates took a “nosedive” in 2008, from which they never recovered. According to the C+D Salary Survey 2008, the average locum rate was £24, but in 2019 it was down to £21.99.

Mr Afser says the rate dropped because many locums, especially those who had recently graduated and some from overseas, were willing to accept “very low, disrespectful and frankly absurd rates”.

“I would be absolutely an advocate for locums to try and negotiate a higher rate. Once [COVID-19] has blown over, the rates will plummet back down to normal,” he says.

Locums are “more than deserving” of having “slightly higher rates” because of the risk to themselves from handling hundreds of patients face-to-face daily – some of whom could have COVID-19 – the stress of longer queues and medicine shortages, and the widespread lack of personal protective equipment, Mr Afser says.

“The added pressures and squeezing of budgets are leading the multiples to also act appallingly to staff," he claims.

Should the figure from 2009 have increased with inflation alone, it would be far higher than it is today. Locum Mitesh Patel points out how £10 in 2009 would be worth £13.51 in 2019 – an increase of 35%.

The downward pressure on rates may risk forcing locums out of community pharmacy. Tohidul Islam, a Manchester-based locum, says: “The rates are going lower and lower and it's causing pharmacists to leave the profession.

“Let locums negotiate fairly what they think they're worth. If you're happy to pay it as a buyer then that's free market rule, but don't bully pharmacists.

“If that happens then we will stop working for you. We won't allow private entities to threaten the profession or the independence of professionals just to make more profit.”

“The boot is on the other foot”

Many C+D readers support locum rate boosts. Tim is a retired locum who returned to the register following the COVID-19 outbreak. He commented on an article: “I will charge what I deem appropriate. If it is refused, then the pharmacy can always try elsewhere.

“The pay is way below what it needs to be to retain quality people who will ultimately vote with their feet. I am so cheesed off by being told that this is the rate, like it or lump it, and having to accept it because I needed the work.

“Now the boot is on the other foot and the big boys don't like it one bit. Please don't preach to me about national emergency, pulling together or community spirit, that has all been driven out of me by treatment received from contractors over the years.”

Another locum wrote: “Rates haven't been touched for the past decades to follow the inflation even the slightest. In fact, they have gone down in some places even though the [number of] services has increased and the workload is turning unbearable.”

Thamina Pinky, a locum based in Hampshire, believes the rates should reflect the new pressures from handling the impact of COVID-19. She commented on the C+D website: “In this current situation, the rate should not be less than £40…even a plumber gets paid £80 to £90 per hour in an emergency.”

The manager of a multiple branch in Essex agrees that locums deserve more money. “Going to work during a pandemic puts your life at risk, why would anyone want to do that for £20 an hour? I hope all locums put their rates up and keep them up.”

Many locums told C+D they have not increased their rates at all as they already had slots booked in, even when they were “dismal” at £21 per hour.

One locum in Scotland says he saw no need to increase his rate other than for emergency immediate cover, for which he added £5 per hour.

“My locum rate has not changed during this pandemic, more companies are just willing to pay my rate,” he says.

Although the rates of some locums have recently risen, partly to account for the workplace stress of COVID-19, this does not indicate a rise in the average across the UK. The rates have some way to go before they reach levels seen over a decade ago, but it’s up to contractors to decide whether they can afford an increase in such turbulent times.

How much are locum rates in your area?

Peed Off Superintendent, Superintendent Pharmacist

As a contractor being ripped off by our paymasters as they try to put us out of business I will suggest that it is not the locums fault that we cannot afford to pay them the high fee that their professional status warrants. Nice of GPhC to put the knife into locum pharmacists instead of saving the pharmacy profession from obliteration from ccutbacks, internet hubs and checking technicians.  Locums are self employed and can charge what they want... including additional  compensation for no paid holiday or bank holidays, job security and other perks that employees chose to accept.....  too expensive = less work...... I know of several locums who can command high short notice/ emergency rates through agencies and equate this with having more days off a week ....sounds good to me, but I guess salaries that recognise us across the profession are just a fantasy.

Wole Ososami, Community pharmacist

What £ value does a locum add to the pharmacy business?

The discussion we should be having is how can locums add value to their employers. Anyone expecting to be paid £25, £30 or £60 an hour to tick boxes on a dispensing label is probably not conversant with the current NHS contract.

The NHS is unwilling to spend money on procurment activities for which dispensing of medicines is now categorised. Locums have to be out on the shop floor engaging customers, offering advice and selling products and services.

Covid-19 risk is applicable to all who work in the pharmacy including the pharmacy manager.

All pharmacists including locums need to rise up to the new reality and come up with value added services or face extinction.

CAPT FX, Locum pharmacist

Mr Editor, I have an open question to Duncan Rudkin. He says here that the GPHC always takes a balanced view of whatever he said. Now since his appointment as CEO, what sanctions or penalties had the GOHC publicly enforced against a Pharmacy owner or multiple?
Now, we are talking about locum rates as if they are critical, yet the same Locum Pharmacists have worked in Pharmacies with no PPE in January, February and March. We work in Pharmacies which are unfit to be healthcare premises. These premises are inspected once in a lifetime and are given what seems like lifetime guarantees. Pharmacists have raised again and again the regulatory flaws with regard to Company owners and no one listens. Yet it comes to Locum rates and Duncan goes on the megaphone full blast.
There is more regulatory work that has to be done to turn Pharmacies into Healthcare institutions not corner stores.
The GPHC should stop, and I mean STOP meddling in employment issues

David Moore, Locum pharmacist

Straight forward law of supply and demand. The big boys were quite happy to slash rates when it suited them. Now there's a shortage of locums, the rate will naturally go up. This is not the concern of The G.Ph.C. unless a locum is cancelling an existing booking and trying to re-book at a higher rate.

Uma Patel, Community pharmacist

I didn't hear of any controversy when the rates were coming down

Robert Mitchell, Community pharmacist

Most locums I know are keeping their shifts they booked months ago at the poor market rate. 
However, one multiple who well remain nameless, has closed some of their stores and have cancelled bookings with less than a week's notice. The locum who has their shift cancelled then has to find another shift to cover their mortgage and will usually find themselves booking at an emergency rate. As with everything it's supply and demand but if the companies don't treat locums with respect then why should they expect it back in their hour of need?

Pharmacist Pharmacist, Community pharmacist

My argument is that multiples would be the first to hike their prices or reduce locum rates when it would suit them

Thamina Pinky, Locum pharmacist

From my experiences, I can go on writing how Locums are abused by other pharmacy team members who are surely highly encouraged to do so by pharmacy managers. Pharmacist needs to run like a chicken from doing deliveries, selling things over the counter to dispensing, as well as carrying out the roles of a locum pharmacist. Pharmacist are highly qualified to advice on medications over the counter and refer to gps or A and E based on the red flag symptoms. Doctors and nurses gets paid more than double than a pharmacist and that's not a problem to many. I won't say we are doctors or nurses but our knowledge about medications, side effects, contra-indications and many more makes us nothing less than other heath Care professionals. Our potentials have been identified and that's why we were proposed to put on training to become fast track doctors. I will request all pharmacist professionals that please work as a team, don't pull the profession down by accepting low rates even if u r an European or simply may be of finanacial reasons. There was a time when pharmacist used to decide rates and now it's us who has pulled the profession down by keeping on accepting low rates years after years. We must take a stand.

David Moore, Locum pharmacist

Well said, Thamina

Matthew Edwards, Community pharmacist

I can see this argument from both sides.  However the quoted figures of £60-100 are extortionate and the arguments of risk are an irrelevant point.  Do you think pharmacy staff, nurses etc are getting paid more just because they are on the front line.  To demand exorbitant rates is insulting to the pharmacy staff that locums work with and is profiteering.  However a reasonable adjustment to reflect the reduced number of pharmacists willing or able to work is a valid point and any locum who approached me for a discussion about rates would be considered on the merits of the argument.  Contractors have the right to refuse to pay locums rates and if someone came to me saying £60/hr I would be working my day off

Caroline Jones, Community pharmacist

If doctors and nurses were agency then yes, they would be getting paid more. For any job, it is supply and demand that determines the wages......way back in the ‘fallow year’, Pharmacists wages were high due to no pre-regs qualifying that year! This is also the reason a locus GO can demand (and get paid) £1,000 per is why medics from abroad work for our out of hours services at weekends for this kind of payment. Whilst I think £100/hr is excessive - a locum Pharmacist rate should probably be in the region of £35-£40hr in normal times - this is what locus opticians would get paid......

How High?, Community pharmacist


Supply and Demand.

Risk and Reward

Benie Locum, Locum pharmacist

What's the rate for Friday and Monday now PSNC have achieved extra b/holiday funding.

geoffrey gardener, Community pharmacist

Yes the big boys were quick to cut rates when there was a surplus of pharmacists, now we are in demand boot is on the other foot

Leon The Apothecary, Student

I raised my rates because I know companies will pay for them, because I know demand is exceptionally high in my area, and the supply is low. If I raised them too high, I wouldn't get work and I would need to lower them to afford to live. And I am kind of fond of living. 

Ultimately, I'm not forcing anyone to accept my prices. 

Benie Locum, Locum pharmacist

Idiots! I'll let you decide who's who.

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