A discussion about how to fund the GPnetworks service

From our communications with Practice Managers and Admin staff and with GP’s using the system, we can see that it is fairly unanimously accepted that GPnetworks offers a valuable service that has solved a problem and saves both time and money.

In 2010, there have been 9960 Practice logins, by 251 practices and 14375 logins, by over 350 GP’s.

However, as a result of the structural and fiscal changes taking place at the PCT level, next year GPnetworks will no longer receive any funding to operate its service.

This gives us two options:

  1. Close down the service
  2. Find an alternative way to fund it

We are therefore looking at developing the fairest possible model for funding the service via the two types of members that benefit from it:

  • Practices
  • GP locums

We are proposing to develop an annual subscription model that will allow unlimited access for a small fee.

We would welcome any views from members about this model and have created this anonymous discussion for that purpose.

Please read the views of other members before posting a comment.

Thank you

The GPnetworks Admin Team

50 thoughts on “A discussion about how to fund the GPnetworks service”

  1. I hope shutting down is not a serious option. This is a very valuable resource for both Practices and GPs. What revenues need to be raised to run/maintain the service?. Not sure if this is a “not for profit” or commercial business, either way excellent and hugely valuable.

  2. I am a Practice Manager at a single handed surgery and therefore locum cover is used from time to time. However, our PCT is proposing a Contribution per month of £25 per practice in the PCT (about 40 practices), and most of the other practices are unwilling to pay this. I think it is unlikely that practices will want to fund this facility as it is not used very much. One of the reasons that I only use GPNetworks when desperate is that the GPs tend to charge over the odds. A normal locum fee for a half day session would be about £220 but I have been charged up to £395 for half a day, which is really not viable. It would be a good idea if there was an across the board fee which locums were allowed to charge and I think the service would be more attractive.

  3. I am a Practice Manager and I would also like to see how much each locum charges. We have used your website when desperate, and have encountered locums charging very high rates, and often the locums don’t even email us back when we enquire if they can do some sessions for us. I know this is not under your control, but it would be very helpful if all the locums agreed the same fees, or advertised their fees where their skills are listed. I was also surprised to discover recently that the GP’s on your site have not been checked to see if they are on the performers list. For some unknown reason I assumed they had been. This would be useful.

    It would be a shame not to have this service as it has been very useful, but I don’t think our partners will pay for it unless it saves us some time on checking performers lists, etc, and the fees are listed to save us contacting someone who is overcharging for their services.

  4. @KC – hello. you said ‘the GP’s on your site have not been checked to see if they are on the performers list’

    they are checked for this – but that is as far as we go.

  5. I find this site extremely useful, however I only offer 2 regular sessions a week of availability. Would the charge for the site be the same for users regardless of the amount of work they get/earn?
    Do you have any idea of the fees you are considering?

  6. We use GP Networks a lot and find it invaluable. We would consider paying a small monthly fee but as we are already paying quite substantial locum fees this would have to be a nominal fee.

  7. Rates are negotiable –i am not willing to say what is a fair rate.
    Recently i have had to employ a surveyor —£135 per hour
    and a solicitor – £220 per hour.
    If gp networks vanishes it leaves the way open for an agency to take over —and i assure you their fees will be higher than mine.
    Perhaps people should pay a nominal fee eg £10 when using the service.

  8. i only do infrequent locums now but do keep some availability. if there were a flat fee for all locums regardless of number of sessions i would have to think again about using the service and keep in touch with surgeries personally. i do not think it realistic of surgeries to expect all locums to charge the same.

  9. Please don’t close the service down! I find it a very valuable service, it’s such a quick and easy way to find employment. As a locum I would consider paying a small fee to continue to use the service. I’m not sure how feasible it would be to charge different rates depending on the amount of usage.
    I don’t think it’s legal for locums to fix their prices! There’s always the options of putting in how much you’re willing to pay & not hiring the locum if they’re charging too much. I do always try to reply to locum offers as soon as possible & definitely on the day that the offer is made.

  10. This is SUCH a useful service. I’m pretty much a full time locum and get a lot of my work through GP networks. I think the proposed model sounds sensible, although I don’t know what sort of fee you’d be thinking of charging for a year’s access. Please please please don’t close it down!

  11. Depends on how much the charge to use is. I only seem to get about 10-15% of my work through GP Networks so not keen to pay a big charge. Maybe a % of work obtained is a good idea.
    I doubt most locums would agree that £220 for a half day is normal (assuming 4hrs session). £395 seems rather high though. I think there can sometimes be some negotiation on fees and I certainly display charges on my profile section.
    Joe ‘for profit -although not much’ can mean lots of things.Maybe you need to give more info about company’s profits if you’re needing extra income from practices/locums to keep going

  12. The idea of charging a percentage of work obtained through the gpnetworks system is a good one – but the system does not force practices to use the booking process provided. Often practices simply look on the system then call or email the doctor directly. We would therefore have no means of properly measuring the work obtained through the system (can anyone suggest one?)

  13. I have always found GP Networks most useful – please keep it going – don’t subject it to McCarthy’s Law (“if it’s any good, they’ll discontinue it”). I’d be quite happy to pay a reasonable membership fee, if the PCT can’t be persuaded to continue funding. Surely they can find other areas for economy.
    Michael Barley

  14. GP Networks is an excellent service and its very short sighted of the PCT so stop its funding. I would certainly pay a subscription. Practice managers complaining of being overcharged always have the right to set a rate for the work in their request. The locum then agrees the fee with the surgery when confirming the booking (or can always decline the booking if the fee offered is to low).

  15. I agree that GPNetworks is too valuable to lose – woud a sensible starting point be to find out how much it took to run the service last year and add 17% (agency-equivalent fee to fund improvements, hire competent staff etc), and then to split the cost between the users, both GPs and surgeries on a pro rata basis, with the option of having advertising up for discussion once the service is running? I agree with Andrew Surawy that GPs are significantly underpaid for the amount of training and degree of responsibility we undertake – try to get a solicitor, dentist, accountant or even veterinarian for less than a hundred and hour…

  16. @Michael – thanks for that analysis. One problem with your model is that, as the service grows in coverage, the cost of running it goes up and, at the same time, the number of members grows, which means that a dynamic fee model has to be found. This is entirely possible, but coupled with the idea suggested here that some users get less benefit from it than others and should therefore pay less, it starts to become quite a complex thing to implement.

    Three important facts:

    1. We can not measure the benefit derived accurately
    2. We measure usage accurately
    3. Usage does not necessarily equate to benefit

  17. Perhaps if this discussion could branch and cover a related topic:

    Ideas on how to quantify or measure benefit (in order to connect this to fair fees)

    Joe

  18. Please don’t close down the site, I find it SO useful for finding Locums, it’s easy to use, you can check out the details of the Locums easily and I have never had any problems. I do however feel that the Locums should be paying the fee towards the running costs, as they are after all advertising themselves …..

  19. I get almost all of my work through GPnetworks and am extremely grateful for it. I think it is worth highlighting the other models that operate and how GPNetworks has unique features:

    – practice manager has a list of likely locums and contacts each individually hoping they are available. How long does that take and how much admin time is consumed at £10 or £20 per hour?)

    – practice manager puts it out to an agency – the agency adds its own fee on what the GP receives – how much is that 15% extra? The GP loses as well by not getting their pension contribution from the PCT

    – practice manager contacts a chambers who offer a rigid menu of services for a fixed (and AFIK quite high) price. The GP pays admin fees from their fees (but does get the pension)

    When I try and explain GPnetworks to people I liken it to a dating service – it puts people together but leaves them to decide on the finer points – and I think that is a valuable (and low cost!) service.

    Personally as a locum who makes most of his living from GPnetworks it is a service I value and I would pay to be listed and I am think if you get the price point correct practices would as well. How about an annual subscription level and also a “short term” fee for practices that only need it occasionally?

  20. i work as salaried gp now but also do some locums on top of my part time work-i do feel that gps who may only do 1 or 2 locums/month via the site would feel it unreasonable to pay a flat fee the same as full time locums although it would be a shame to loose such a useful service. if surgeries are avoiding paying locum agency fees or the higher price of chambers then it would seem reasonable to contribute too?

  21. Hello
    We use GP Networks a lot and find it invaluable. Having worked in the veterinary profession where no such thing exists and having to pay agency fees I would say that a small monthly fee would still be cheaper than having to use agencies on a regular basis.
    Please keep it going

  22. Thanks everyone – we appreciate the support and useful comments. Its obvious that we need to get the price point right and also apparent that we won’t be able to please everyone whatever we decide.

    Perhaps a free type of account for GP’s that allows limited usage per month and an option to upgrade to a full unlimited account ?

    The problems with this are:

    1. Its programatically tricky to implement and manage
    2. It can create incentives for individuals to restrict their usage of the service (which is a shame).

  23. We find the service invaluable – I would not want to go back to the days of having to ring round all the locums and we will not pay agency fees. We feel that a membership fee would be an appropriate way to fund the continuing services of GPnetworks.

  24. GPNetworks provides a useful service for both practices and locums. I think it’s fair that all that use it fund it. I’ve used it as a locum and a practice needing locums.

    A flat fee of around £10 pcm seems reasonable for all that use it seems to me exceptional value. For those that only intend to use it for a short period perhaps a 3 month up front charge of £30 or one off £15 per single month. It’s all tax deductible it seems very cheap. Cheaper than the agencies at any rate…

  25. Thanks for the feedback – if we can integrate these options for different types of commitment perhaps it would be best for GP’s.

    ie

    3 months = 3 x £15
    6 months = 6 x £12.50
    12 months = 12 x £10

    GP’s could choose their commitment, make a single online transaction and payments would go out at the scheduled date each month for the duration of the contract period. After that the account would become inactive and availability no longer visible to practices. A notification would be sent out

  26. I have found gpnetworks a good way of advertising and managing my availability although a relatively small number of my bookings are made online via the gpnewtorks site. It can also be a good way to extend the range of practices for which one works, particularly when starting out as a locum.
    I would be willing to pay a fee to continue using it and the proposed scale seems a reasonable outlay in relation to the amount of work that is likely to result from using the site. If it were much more than £10 per month I would probably think a bit harder.

  27. I would be happy to subscribe at £10 -15 a month. Assuming it to be a tax deductible expense, its real cost to a higher rate tax payer would be £72 – 108 per year. Assuming you earn £200 a session, this is £120 after tax, so the subscription is paid for by less than a session.

  28. Wow! Ive just discovered I don’t charge enough! £395 for a half day?????

    On a serious note, I think this is a valuable service and would hate to see it stopped. However, I think if it is going to be a paid for service, then people are going to have higher expectations of what the website offers. This in turn is going to push costs up further and a vicious cycle begins.

    I would happily pay a monthly fee and it would surely be tax deductible?

  29. It’s different for different people. I have had a few enquiries but never any actual work from GPnetworks, as far as I remember. Once one builds up a group of local practices that hire one regularly the need for it evaporates.

    Any pricing structure has to reflect this variability. I imagine you could offer locums a free trial of say 3 months thereafter a repeating payment by Direct Debit until cancelled by the locum (the usual inertia sales technique). Or you could ask the locums to pay a modest percentage of what they charged the practice.

    As to price-fixing, that would be both unfair and illegal, whichever side it came from. I charge what the market will bear. Those who think my work is worth it hire me again, and those that don’t, don’t. If I need the work I’ll lower my rates, and if not, not.

    I didn’t want to be tied to the government’s meddling which is why I resigned as a principal. The price I pay for the freedom to fix my own rates is lack of job security.

  30. This is a very useful service. I qualified just over a year ago and have had all my work, bar the practice I trained at, from this site. I have done no other advertising of my services. It couldn’t have been more easy getting started! Most of the bookings I get now are repeats where I assume the practice checks my availability on the site and then gets in touch directly.

    I would be interested in knowing who made the decision at NHS Brighton & Hove not to fund the site anymore. As I do some work there I would be very willing to take this up. It would be helpful to have some ideas as to what people think the advantages to the PCT are having the site up and running. There are obvious advantages for practices and us but I’m not clear what the advantages are for the PCTs.

    I also do some locum work in London, where for some reason most practices seem to work through agencies – even though this site is available (though I’ve never got any work through it). I therefore work through an agency for a lower hrly rate than I can charge in Sussex and dont get NHS pension for that work! I would have thought the potential in London is just huge and wouldn’t the economies of scale mean the price charged per user could be lower. Perhaps there needs to be some equity injection to promote the service. Out of all the options for locums this has to be the obvious choice for everyone involved and I’m surprised it hasn’t grown more rapidly!

    Having said all this I am happy to pay a monthly fee. I just feel that there a huge potential for the service!

  31. Thanks Simon – some very good points made. You are right that an expansion in our service would mean economies of scale, lower costs and lower subscriptions for all. We have struggled to make serious inroads into london and cannot explain why. Perhaps it is our own incompetence. We are not marketing or sales experts by a long stretch.

    If anyone would like to offer to help us gain a better foothold in London, please get in touch. We would not be ungrateful.

  32. Q How much is the funding required to be replaced? This needs to be stated here please. Otherwise how do we discuss appropriate solutions without knowing how big the deficit in GPNs accounts.

    I am a GP locum and feel is reasonable to pay a small fee 20 pounds a year to list here. Then the locum should pay 1% of their daily rate to GPN. The way you monitor this would be to make it free to practices to use – encouraging them to only book their locum via the service. The practice is required to report back to GPN when it uses the locum from it’s site. The locum can claim part of the fee back via tax deduction as an expense and pass the rest on to the practice in 0.5% increase in charges which would be barely noticeable – thus everyones happy. Monitoring use and honest reporting by practices shouldn’t be too much to ask of the practice managers? 🙂

  33. @Jon – your suggestion makes a lot of sense and is a highly democratic approach. However:

    Although the site has great functionality to allow a Practice to find, Request and Book a locum, handling the logic and communications, it is not enforced and often practices simply look for sessional availability then contact the GP directly themselves.

    With this in mind, your ideas cannot be easily implemented…

    ie – you say:

    “encouraging them to only book their locum via the service. The practice is required to report back to GPN when it uses the locum from it’s site. ”

    For this to work we would have to remove some information from the site and try to force employers to use the booking system.

    Allowing them the flexibility to choose methods increases their chances if finding locum cover.

    If we could find a reliable way to measure bookings via the service, we could implement a fair fee model along the lines if the one you have suggested.

    Ideas welcome.

    joe

  34. I went through most comments:
    I notice the practices are being less enthusiastic while Locum GPs feel its a good website.
    I am a locum GP
    While I agree that its not always possible to advertise your sessional rates to the practices they should not confirm work until they have agreed a price….reason are as follows:

    some surgeries make you do everything eg for 1/2 a day your session will entail 3&1/2 hrs of session time followed by telephone attendance followed by 1-2 visits, signing some prescriptions and doing the lab reports and correspondences!
    While a regular GP might take 45 mins to go through that work a one time locum will take another 2 hrs to do the work after the 3&1/2 session. You are well into 5&1/2 hrs work!

    Another practice might just accept that you do your appoints and maybe take some telephone consultation and sign some script and finish

    You cannot reasonably or morally charge the same rate for the two surgeries

    Agencies will charge definitely more: they hand you a time sheet and make the GP sign for each and every work they did like sign script or did correspondence and time they spent doing it and charge the surgery accordingly. Personally I cannot be bothered to keep a time sheet so I don;t like to use agency for getting my work.

    Most GPs don;t charge without a real reason.

    It is acceptable that Surgeries should be able to expect that the GPs on the GPnetworks list have the following upto date:
    1. MDU
    2. GMC registration,
    3. Hep status,
    4. Appraised annually,
    5. Be On a Perfomers list (updated annually).

    I will be happy to pay 10 pounds/ month for a year.
    I think the surgeries should pay likewise.

  35. HI GPnetworks really great as I was new to the area and it helped me with getting work.
    How about using same principle like the pennyperfect and buying a yearly licence for a fixed price andrenewing every year.We have to keep it going It is great and original and should be the same for whole UK and would make life easier.

  36. We’ve used you for a while and have found the service really useful, and have never used an agency until last year when we needed to so had to try the pallant chambers agency which I have to say was excellent. They are a little bit more expensive but very effecient, especially when all the locums cost the same and when there was a problem is was fixed straight away and we even got a significant feedback report and they collect feedback on their locums. We tend to use them now if we can’t get our usual locum. Why don’t you become a chambers agency like them?

  37. I’m a GP locum and would consider paying a small flat rate for the year but not a % fee. However, as other posters have pointed out, the service is also of benefit to practices trying to find cover so any new fees should also apply to them too.
    I agree with the comments made by other locums regarding how the workload at different surgeries can vary vastly so that there isn’t necessarily a “standard half day”. Practices and locums are free to negotiate the workload and fee for any booking and it would be illegal to fix prices.

  38. Thanks for the feedback – our model will need to include fees for both Practices and GP accounts. This will keep the fee very low and hopefully not discourage uptake.

    We are also planning to add more usefulness to the site for both practices and locums

    For practices:

    Better locum staff scheduling tools and some useful admin features

    For locums:

    OOH employers (who will want to book locums for OOH shifts)

  39. I think gpnetworks is excellent. I used to locum before it existed and it has made things so much easier. I have got all my work via it. Most practice managers I know who use it and were around before it existed also agree. I would be happy to pay a monthly fee. Please keep the payment option simple !!

  40. I was midwat reading a really interesting messgae about the chambers and it suddenly disappeared. Can you explain why – has someone from here deleted it? Are we being blocked? Hardly fair and open!!

  41. Ah, looks like my post on the pros/cons of the chambers model has been pulled from the discussion. Oh well, i’m sure the moderators know where to come to if members of gpnetworks want to have an open discussion about this.

    Best wishes,  Richard

  42. Hello all – the post from Pallant has been removed from the discussion because it is really a separate discussion – on the Pro’s and Con’s of the Chambers model.

    We have opened a separate discussion for members to discuss this alternative model (link below) If members want to move to this model we are happy to look at this with Pallant. Please contribute to the new discussion and continue to contribute to this one. The more feedback we can get from you, the better we can respond to your requirements.

    New discussion here:

    https://support.gpnetworks.co.uk/a-discussion-about-the-pros-and-cons-of-a-chamber-model/

  43. I am really happy with the way gpnetworks currently works and would not like to change to a chambers at present.

  44. Manas posted this elsewhere:

    “Regarding fee structure, GP networks could just publish fees (what locum will accept and what practices will pay)”

    Could anyone give more detail of how this might work within the gpnet application…?

    Joe

  45. A few do pay an annual fee – but, at the moment, most are still PCT funded. ie. The PCT has paid a single fee for all practices in the PCT to have our service supplied to them.

    This is coming to an end as the PCT’s themselves come to an end. Hence this discussion to try to find a fair model for the future

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