Locum PGDs will help pharmacies offset the cuts, agency says

Dipesh Patel: An untethered travel PGD would allow locums to administer vaccinations in any pharmacy
A locum agency is backing transferable patient group directions (PGD) for locums to help employers “increase revenue immediately”, C+D has learned.

Online recruitment agency WeLocum is creating new "untethered" PGDs, meaning locums are no longer “tied” to a pharmacy and can perform “vital” services without having to rely on the pharmacy having a PGD in place, director Dipesh Patel told C+D last month.

“Our PGDs are registered to the locum so wherever you go, whatever [branch] you work in, you can run that PGD,” he said.

WeLocum introduced eight oral PGDs this week – including antimalarials, emergency contraception and smoking cessation  which can be renewed each year.

“We’re trying to support locums,” he said. But locums with their own PGD can increase the quantity of services, and “increase that employer’s revenue immediately”, Mr Patel added.

Locums more concerned with rates than cuts

The new PGDs are one way locums can help contractors offset the 12% drop in pharmacy funding in England, Mr Patel said.

However, many newly qualified locum pharmacists are more concerned about falling pay rates, rather than the overall impact of the cuts on the sector, he added.

“I would say it is the older generation of locums that are more influenced by the funding cuts. Locums at the moment are quite rightly concerned about earning £20-21 an hour,” he said.

As the effects of the funding drop become more apparent, pharmacists – locums and employers – should work more closely together to improve services and patient care, Mr Patel urged.

“Pharmacists, including locums, should really be looking at how to support the pharmacies that they work in,” Mr Patel said. “Rather than [saying] ‘you should be paying me [this much]’, [locums] should be saying ‘how can I help you to help me?’”

36 Comments
Question: 
How else could locums help pharmacies offset the funding cuts?

Dipesh Patel, Community pharmacist

We are committed to providing a service that works for the benefit of both pharmacists and pharmacies and have noted many of the comments made on this feed.

Whilst some of these are inaccurate, it is important that we take on board any feedback as we continue to develop our business.

As working pharmacists, we understand some of the challenges our sector faces. Our aim is to build an agile digital platform which helps to serve the flexible and changing needs of the profession.

We are always looking to improve and believe in total transparency; that's why I am more than happy to speak to anybody who has any further queries about how the platform works.

I can be contacted via email: dipesh@welocum.co.uk

I look forward to speaking with you.

Pharm Pharmboi,

“We’re trying to support locums,” how?

Locums at the moment are quite rightly concerned about earning £20-21 an hour,”  (NOT QUITE)

Locums are earning £16-£19 per hour in today's reality due to desperation. Locum dispensers earn £10. 

4 years of study at uni + pre reg year; to earn £16 an hour with the risk of losing your job if you make a dispensing error?

Locums get reimbursed for spending £89 per year spent on training? any plan about payments for the services provided by the companies you work for?

These agencies work for the companies not locums. 

 

Jey Siva, Locum pharmacist

'Pharmboi' there is a "risk of loosing your job" in any job so that is not what should be paying us more. I think you are mistaken and clearly dont think we deserve the money due to our knowledge and ability to help patients. Plus this shows as you dont support services which is what pharmacy is about on top of dispensing, not just labelling and signing a box with "the risk of losing your job" 

Again another person attacking an agency. You should treat everyone as an individual just like patients. If you dont like an agency dont work with them, but not all of us can find work on our own easily. If they help people like these guys are trying to do then you should really be supporting them. Look for a cheaper option and promote that if you can, maybe then you might be helping us!

Asim Mirza, Superintendent Pharmacist

 

I'm having serious difficulty with the negative comments on this. WeLocum are providing a means for Locum pharmacists to access training and accreditation that will ultimately make them more valuable to one of their prospective customers. There is no obligation and prices are more than reasonable. Previous tethered PGD's meant that locums were only able to provide the services in pharmacies running the service. How about thinking 'outside the box' and considering where else and how else you could offer your newly acquired untethered service. Alternatively, if you don't like it, don't make use of it! 

 

Veetal Kerai, Pharmacy owner/ Proprietor

This is a great new opportunity for locums as well as pharmacy owners. As a pharmacy owner myself, we are constantly looking for ways to improve service provision to our patients. In the current climate where we are forced to look at ‘efficiency’, we need to work together and it is great that WeLocum are providing support for the changes we need to make.

With the major NHS cutbacks, we need to look at options to increase our private revenues. I would embrace this opportunity to employ and work with locums who can provide both private and NHS services at my pharmacy. Of course, in return we would be working together within an agreed profit share scheme. These ‘untethered’ PGDs are a step in the right direction.

Peter Taylor, Locum pharmacist

Veetal Kerai, I can agree with your major points. If the NHS is paying the pharmacy a figure that includes a percentage given to cover training costs that should ultimately end up with whoever paid for the training, plus a (in all likelihood small but fair) amount to incentivise the pharmacist to perform the service. Clearly a lot of the worry from the locums here is that companies are beginning to expect advanced and enhanced services for free. I think both you and I would agree we need to avoid the adoption of that attitude

Kate Jones,

I also disagree with the way this is being done. There must be a way of doing it so that locums don't have to pay another expense simply to keep up with the ever-increasing demands of the job.

 

Rob evans rob.evans123456@gmail.com, Locum pharmacist

you guys have just ganged on an agency that the few of you clearly dont like. guys didnt we pay for our mur and flu jab accreditations? why we making such a big fuss of this? i think this service is more targeted at locums for independents than multiples and i believe that independents will be more willing to pay for the extra service providing locums can deliver. i think the pressure being applied on welocum may even stop them providing the training!  i think its a great option to have. we talk about increased workload and pressure if we start providing these pgd services, but its down to the locum whether they feel they have time to provide the service? we can refuse if we feel there is absolutely no time for it and the patient is able to wait! at the end of the day, with the cuts and the threat of 3000 or so pharmacies closing means providing services like these and others could be the difference between saving them and not. think about 3000 less potential employers - it becomes an even more saturated market, doesnt it? 

why do we think £89*5000 locums equals a great amount of money? 1) they wont be getting 5000 locums to do the training 2) we havent even taken into consideration the training costs involved? venue costs? staffing costs? instructor costs? I think this is as cheap as it could possibly be so i really dont think they're making much margins on this

Sham Kiani, Community pharmacist

Rob I disagree, I Locum mostly for a small multiple who paid for me to attend my Flu training and also for the PGD. Once they get Locum's who have done training themselves they will not pay for me to do the training again and expect me to pay for it out of my pocket. It sets a dangerous new precedent. It increases competition amongst Locum's and will never equate to an increase in remuneration. I have been a Locum for long enough to know that the rate only goes one way. These PGDs only mean extra work load for Locum's and no extra incentive. I would oppose any agency that starts this practice. The current PGDs already allow you to carry out flu vaccinations at multiple sites, so this offers nothing new, just an extra expense to the Locum.  

 

Jey Siva, Locum pharmacist

I don’t really agree with your statement. Rob has a point. Just because there are locums who will buy these PGDs will not mean your employer no longer wants to pay for your training, you are being pessimistic and scaring other locums for no reason. You are dismissing the fact that unless we speak to the pharmacies we wouldn’t know if they will pay us for a service or not. I get paid for every private service I do in my regular pharmacies and other nhs services, because I asked!

You are always in competition, don’t be naive. You may be one of the lucky locums who have a permanent job but not all of us do. So see it from someone else’s point of view, why would a pharmacy pay them to locum to cover you when he will lose money from selling eg Malarone in an area with demand for travel clinics? He would just do the job himself for that day. What would you do if you owned a pharmacy?

Personally for £89 I would do these PGDs as it is much cheaper than anywhere else I have seen and plus others PGDs don’t work for locums. I was lucky enough to have my training paid for too but that doesn’t mean I wouldn’t buy it myself if I had to, as I know I would make money from it as I locum around independents.

You seem to be attacking an agency not its service. If a flu vaccine provider started to provide a free locum agency would you say they had a bad motive? Clearly you have not looked at the PGDs either, they have nothing to do with flu. And on that point flu vaccine training costs and we are still made to attend that every other year.

Basically you’re saying you are a locum and you conduct under PGDs right? If you haven’t negotiated a payment for conducting a service that is a lack in your negotiating, not welocum for providing the service. If anything your employer could buy your PGDs cheaper from them, is that a bad thing??

You shouldn’t be putting a service down if you are doing it yourself. You are bringing down the profession not improving services in pharmacies or for yourself.

Rahul Gogna, Pharmacy Asistant/ Medicine Counter Assistant

I think this article has been misinterpreted by many. The point is to make sure you have work. This is like have a tick in the box and making you more an appealing Locum to employ. That's all. Increasing the owners venue and thus your own after negotiation. If you feel the owner is not being fair then you don't do it. Quite simple. No harm in having an added skill, that you can take away with you if Locum at multiple places. Makes sense really.

Peter Taylor, Locum pharmacist

Well said, Mahdi Heshmati Rafsanjani. I also want to pick up on a point made by Lana Locum regarding the flu jab service.

We are all aware of the pressure that companies are putting on locums. We were told that the companies would simply not hire locums who could not provide the service- that we would have pay for that training ourselves, and perform the service for them without any additional pay or incentives. These proposed locum PGDs will make that situation the norm. 

I stumbled across the below yesterday- which really opened my eyes. Pharmacies are obviously making profit for providing the service, which is fine- but that NHS payment has been deliberately calculated to include training costs. Training costs that the companies are not incurring!

 

"Contractors providing the Flu Vaccination Service will be paid £7.64 per administered dose of vaccine plus an additional fee of £1.50 per vaccination (i.e. a total of £9.14 per administered vaccine). The additional fee is in recognition of costs incurred relating to the provision of the service including training and disposal of clinical waste. Such costs are not reimbursed elsewhere in the CPCF."

 

http://psnc.org.uk/funding-and-statistics/funding-distribution/advanced-service-payments/

Mahdi Heshmati Rafsanjani, Locum pharmacist

I would advise everyone to seriously re-read Tohidul Islam, and Stephen Penman's comments. Could not put it in any better terms. Truly the reality of this scheme. Peter Taylor and Angela Channing, absolutely correct.

Dipesh mentions locums having the 'choice' to negotiate their terms. No. Locums have the choice to reject an offer of £18 from your or someone else's agency. Many don't out of the fear of going out of work. It's called oversaturation of the market yes, but also exploitation for personal greed/gain by the agency and contractor. This is exactly the same situation. You claim to offer people a 'choice' whereas you know exactly what their choice is due to the unfortunate circumstance they are in. Exploitation again. If the company turns around and says 'I'm only paying a flat rate of £18, take it or someone else will', that's when the locum is forced to accept and that's where the contractor has exploited, and that's where you have provided the platform, and gained huge training fees and pocketed large lumps. It's not giving them a choice. Kind of remind some of the movie 'Saw' :)

So here is the answer to the long awaited mystery puzzle of 'how does WeLocum pay their staff and expenses, and make money as a business'. By offering free services to all. Gaining the trust and relationship of contractors and locums on mass scale, then going all out on locum PGDs (which obviously locums pay for out of their own pocket). So to anyone on this platform or using WeLocum ad a contractor or locum, you do the maths. Let's say 20 PGD services, 5,000 locums, £89 each. How much revenue is that?

Jey Siva, Locum pharmacist

To be honest it does not matter if you use an agency or not or go direct. A pharmacy will only pay what they want to or you negotiate and show that you are worth more. Any other sector job is the same, the better you are the more you get paid. We have a base rate and should be paid more for extra services. Full stop.

Peter Taylor, Locum pharmacist

It sounds like a way of legitimising and encouraging pharmacies to offload the costs of their business onto locums. Services are seen by a lot of companies as a way of conjuring profit out of thin air. They make pharmacists pay for the training, and do it in their own time. They make pharmacists identify and enroll the patients to perform the service to. The pharmacist provides the service and personally takes on the added liability of performing the service. They make the pharmacist do the paperwork to submit to NHS/BSA for payment... then the company keeps all the money while simultaneously squeezing the locum hourly rate as low as possible.

In short- the pharmacist is being expected to take all of the costs while the companies take all the profit.

Sham Kiani, Community pharmacist

Well said! I agree with everything you have just said

Ben Merriman, Community pharmacist

In principle, a great idea.  In practice, it relies upon services actually being commissioned!  I work in areas where people won't pay for paracetamol suspension, will they pay £22 for Levonelle One Step if it's not available on the NHS?  

And I shan't mention having SOPs sorted for these services....

Tohidul Islam, Locum pharmacist

I think this is very bad idea. Here you have a Locum agency trying to cash in on the already battered Locum market. The rates are going down year on year. When the profits were up did pharmacies pay higher rates? No. The only reason we had higher rates in the past was due to supply and demand. This poorly thought out idea of untethered pgd for locums will ensure companies get more from us for less money as no multiples will pay for the extra services. They don't really care as long as you're happy to take £17-£18/hr. What Welocum are doing is just trying to make extra cash from those locums who are worried about losing work to newly qualified locums. If companies want unity and support from pharmacists then maybe they should put their money where their mouth is. Now there's novel idea.

Dipesh Patel, Community pharmacist

Hi Tohidul. Thank you for your comment. I hope that you would not see this as a money making scheme as this is not our intention. At £89 for a year it is considerably cheaper than other PGD packages. While we acknowledge that it would be difficult to negotiate any remuneration with a large multiple, this would not be farfetched with a small independent or chain. I would encourage locums to have a conversation with employers about offering extra private services at their pharmacies and to ask if they would be paid extra for such services on top of their normal rate. 

lana locum, Student

ya thats easy to say for the person trying to pocket £89 from over 10000 locums. How many of us do you think work for indipendents? Of those how many indipendents do you think are willing to pay anything? Most locum agencies are just extensions of the company these days and from what i heard about WeLocum you guys are no different. I think Tohidul makes a valid point here. Majority of pharmacies are owned by multiples so A. this pgd is useless as they will never pay a penny and if anything will use these pgds to make us do more work for less pay. B. any locum who thinks this will help the profession only needs to look at how flu jab worked out C. why do locums even need agencies these days? Locums can just go directly to companies and negotiate their rates. As long as we don't sell ourselves short we dont really need agencies. Besides its about time pharmacists started working together to improve the situation and not relying on agencies "help us to help owners" for pittence 

Sham Kiani, Community pharmacist

Perhaps this agency will pay for The pgds to train up all its Locum's free of charge so they can help contractors make more money?

Sham Kiani, Community pharmacist

I am happy to do any PGD as long as the employer pays me to do the training and reimburses me a fair wage. But this agency has lost the plot of it expects Locum's to pay out of their pocket to do PGDs for pharmacies who pay minimum rates.

Dipesh Patel, Community pharmacist

Hi Sham. Thank you for your comment. As a typical locum you are self-employed meaning you are not tied to any one employer. These PGDs are only here to give locums the opportunity to offer extra private services in hope to make a better income on top of their normal wage. If you locum at a regular pharmacy it is a possibility your employer would pay for your training as you would be providing a continuity of service for their business.

Sham Kiani, Community pharmacist

Would your agency encourage multiples or independent  pharmacies to pay extra for Locum's who have done these pgds compared to the ones who haven't? Or would it merely be used as a way to give preference to those Locum's yet offer them no incentive? 

 

lana locum, Student

then more and more locums will do the pgd and then start competing for work at lower and lower rates. so more work less money.

Olukunmi Popoola, Community pharmacist

I like the idea having locum PGDs. It would enable me provide extra services anywhere I go. I am services oriented and face obstacles when trying to provide services in different areas. For example I participated in Flu vaccination in Newham CCG but could not provide the service in Swale CCG. If this service were based on a Locum PGD I would have been able to do it anywhere

Stephen Eggleston, Community pharmacist

I think there may be the germ of a good idea here - not about locums paying to support contractors but about untethered PGDs - to make the whole thing more flexible

Angela Channing, Community pharmacist

So locums need to help the people who have seen the global sum increase by nearly one billion pounds over the last decade or so, give or take, and not shared hardly any of it with us! But you propose we now do more work in our own time, to make them money to offset their cuts!!  Hmmmmmm !  I'm going to have to think about that one. 

Jey Siva, Locum pharmacist

The fact is that these cuts will force closures unless revenue is made elsewhere and who else can ensure a pharmacy is running as a profitable business? Its us the pharmacists. I am sometimes concerned about my wage and as he said so are a lot of other locums, but we can increase that and share profits from a private service like this. I already do with some of the places that I work in. I have heard a lot of places now incentivise for MUR/NMS so why can we not also share private profits? I think this is all good stuff for us.

Shaun Steren, Pharmaceutical Adviser

As opposed to only ever making an intervention on a purely clinical basis? Net profit obsessed shopkeeper/ target obsessed corporate slave or a clinician? I think I know which end of the spectrum community pharmacy is heavily weighted towards.

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