Pension obstruction by bureaucracy for GP locums. Designed to frustrate..

The NHS pensions agency issues advice for both GP Locums (GP Locum Factsheet) and for Hospital Locums. ( 2014/15 Tiered Employee Contributions ) . In practice the locums find it difficult to contribute and claim all the pension rights they are eligible for. Rather similar to the “Individual Funding Request” forms for patients referred by GPs, the paperwork and system for pensions is designed to frustrate. It is yet another form of “covert rationing”. When locums are so hard to find (Neil Roberts 5th April 2016 in GP) , the system makes doctors tempted to opt out, and work through agencies who charge even more. (Unfair locum pay pushing NHS into deficit).

There is little flexibility, the system is antiquated and heavily bureaucratic and amounts to obstruction by bureaucracy. The Perverse Incentive for the NHS Pensions Agency to react to the current financial crisis is self evident.

Timings: contributions have to be paid in with the appropriate form within a week of the end of the month in which locums are paid by the employer. Thus a cheque made out on the last day of a month becomes a “pressure” situation, especially if the Dr is “away” for any reason.

Efficacy of the practice: If a doctor works for several practices in the same month he may invoice them at the same time, but he may be paid at completely different times of the next month.  practices are efficient and some less so. Practice managers may be absent themselves.

The process: Individuals need to invoice practices with form A, and they sign, stamp, date and return the form. This then has to be send to the Pensions Agency with the appropriate contribution.

Errors: Any error results in a returned form, without qualitative feedback, and of course by the time a new form is completed and sent in the post, the “allowable period” has expired!

Communication: There is no electronic communication. The Pensions Agency will not accept any form of payment accept by cheque.

In the past, before rule changes, there used to be a period of 10 weeks grace within which the forms and cheque could be made.

In Cornwall a new “Locum Chambers” could be beneficial because all invoices will be (ultimately) automatically issued on the same date.

The case of Helen Sanderson (died 2014), where the NHS Pensions agency’s  ‘exploitation’ of a loophole, has led to an injustice, is indicative of the current thinking and the dominance of the Perverse Incentive.

Lucy Thornton on 4th September 2015 in The Mirror reported: Family of GP who died aged 40 won’t get £110k pension – because it happened on her day off 

Sally Nash reported 16th June 1915 for Pulse: Family of GP locum who died on ‘day off’ denied death-in-service benefits

           

Charlie Brinkhurst-Cuff reports on 11th Feb 2016 in The Guardian: Are locum doctors and nurses really bankrupting the NHS?

Anjlee Sheth writes in 2007 on  Becoming a freelance GP: the rules have changed somewhat since then, and NHSreality wonders what he would write now.

 

 

 

 

 

 

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This entry was posted in A Personal View, Perverse Incentives, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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