A description of a current Chambers model from Richard Fieldhouse
Like GPnetworks, we are NOT an agency and all locum work is superannuable and taxed as self employed.
ALL our members have ALL of their work booked through the chambers (it’s basically like a locum co-operative) by our chambers managers. Our rates within individual chambers are the same – they’re fixed – separate “single undertakings” (i.e. conventional independent locums) can not covertly fix their prices between them, but because a chambers is a “single undertaking”, locums within it can as rates are expressed overtly and trading is done collectively through the single undertaking.
We have a flexible range of sessions that practices can choose and each session is a fixed price. Practices LOVE this – they can budget ahead, know exactly how many hours of cover they can afford, all billing/invoicing and pension forms is done centrally (and on the same day each month!) – they can see exactly what they are going to pay for and there are no surprises when the invoice arrives.
Members love the simplified & standardised sessions too, and our 5 chambers managers ensure that both practices and locums understand fully what each and every session entails.
We have a sophisticated IT system that handles all the complexities of every booking (availability, confirmation, billing, locum/practice preferences, IT system, superannuation forms etc). Our chambers managers pay all the cheques for the full amount for each session direct into our personal bank accounts.
The prices each chambers charges for the locum sessions are around the same or around 10% higher than other locums, but this rarely seems to put practices off (quite the opposite – year on year we’re turning more and more work away, and across all our chambers we need to recruit 50 members just to cope with demand!).
All members are interviewed, and all members must attend at least 50% of their local chambers meetings (attendance is actually around 70-80%). At these meetings, significant events are presented, feedback to practices is organised, decisions are made, bookings etc etc are discussed. Summer parties, skittles, events all organised. Central information system collating all useful local info.
Members are now also being involved in a new professional scheme within the chambers – partnerships. These partners, or group of partners, are developing a specific-, general- or non-clinical area of autonomy and expertise with the aim of benefiting the rest of the chambers community. We also find that because our members aren’t professionally isolated, they usually more attractive to practices looking for salaried GPs or conventional partners.
Our chambers managers pay all fees from practices direct to our bank accounts, they organise the meetings and Ocado delivery for pizzas etc, personally teach all new members how to use our IT system, organise feedback from practices for appraisal and handle ALL our paperwork, including organising our IT system log ins at every practice and our smart cards.
Members are charged an average of 10% + VAT of their locum earnings for all of this. Some – the leader of each chambers – 5%, and new recruits in an EXISTING area 15% for first 150 sessions, 10% all else. All this is fully tax deductable. Because of the slightly higher rates, efficiency and dedication of our 5 chambers managers to book as many if not all available sessions (chambers managers have direct access to every members delegated availability) through their fantastic working relationships with practices, these fees seem to be more than offset by higher net earnings. Thay can also offer much better continuity of bookings too for locums and practices, so even more better value.
Whatever pricing structure locums go for to pay for their service, my advice is to use one that practices are prepared to pay for that delivers very easy, fast, effecient, simple, standardised sessions using the least number of different quality-assured locums who all know each other and really enjoy what they do.