Locum dilemma: What do I do about a practice that hasn't paid me?

A practice owes me £2,500 for some sessions I worked a few months ago, but refuses to pay me because I had a complaint. What do I do?

Dr Richard Fieldhouse

Dr Richard Fieldhouse: Get someone to arbitrate the dispute

There are several issues here. Firstly, did they tell you what the complaint was, and were you fully involved in the complaints system? The practice should have let you know, and kept you fully informed throughout.

In the same way that CCGs don’t withhold practice payments when the CCG has been involved in a practice complaint, a practice should not withhold payment to a locum.

However, if you’d been obstructive, somehow caused the practice inconvenience above and beyond what would normally be expected, or had been found guilty of criminal negligence, then the practice may well then have good cause to withhold some or all payment.

In either case, you need someone to help arbitrate this dispute. Assuming you’ve already appealed to the practice directly, the next step would be to discuss this with your LMC. They will know the practice, and benefit from the experience of having dealt with disputes like this before. Ideally they will talk to the practice on your behalf, and find a way to lead both parties to a shared agreement.

If however your LMC is unable or unwilling to help, your next step is your local Citizens Advice Bureau or a solicitor, possibly advising on how to take this to a small claims court, where you can make claims of up to £10,000. Alternatively, your trade union - either the Medical Practitioners Union or the BMA.

Whatever the outcome, make sure you have a robust signed Terms & Conditions each time you work in a practice to help reduce the risk in the future.

Dr Richard Fieldhouse is chair of the National Association of Sessional GPs (NASGP) and a GP in West Sussex

Dr Daphne Hazell

Dr Daphne Hazell: Report the practice to CCG and/or GMC

I look at this possible scenario with trepidation knowing how much distress this one sentence would cause for me. As a full time locum, maintaining a constant cash flow is a challenge in itself and to be £2,500 down after a couple of months would be a looming family crisis.

I work in a chambers of GP locums and I think in this scenario it would be a whirl of activity at the chambers hub. My priority would be sorting out the complaint, and I would pass on responsibility for getting the money to the chambers’ finance manager who invoices and chases all the practices. Ultimately she would threaten to and then actually cancel, all future booked locums for this practice, report them to the CCG and/or GMC and place a claim at the small claims court on my behalf if they refused to pay. 

My plan of action would essentially be the same if I was not in a chambers, just all the negotiations done by me. 

Whilst this was going on I would focus on the complaint. When one of our chambers members gets a complaint in, we always discuss it at the very next chambers meeting, and it usually takes priority over all other discussions that evening. We discuss it as a formal significant event to learn from, but also acknowledging the effect it is having on us as an individual and also how it may be affecting current consultations. I would then meet with my chambers lead (also an experienced locum GP) and together we would work on my reply to the complaint. My chambers lead might attend with me any meeting I needed to go to at the practice, simply for moral support. Chambers colleagues would cover any surgeries I needed to cancel to attend any meetings and generally offer support in the same way partners in a surgery hopefully would.

If I was not in a chambers, having successfully sorted it all out on my own, whilst holding down eight to 10 sessions a week of work and of course finding the time to book more sessions in for the upcoming months, I would add ‘extremely resilient’ to my locum CV.

Dr Daphne Hazell is a freelance GP in West Sussex

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