A recent article in Pulse contained some worrying statistics on GP numbers which will undoubtedly lead to upward pressure on locum costs.

The responses that such articles generate can be also be depressing.  Comments such as ‘Young GPs should not sign up to a dying profession as a partner and either be salaried or even better leave the UK for better prospects elsewhere’are not uncommon.

We all know that statistics can be manipulated to prove almost any point.  Even so, there does seem to be a consensus that practices are finding it increasingly difficult to recruit and retain partners which is leading to a rise in locum costs and recruitment costs.  

Although the total number of GPs is up since 2001 (from 31,835 to 39,780) there has been a 2.5% fall in the number of GP partners.

·         Pulse’s survey of 220 practices showed an average vacancy rate of 7.9%, up from 4.2% in 2011

·         Pulse’s survey of 216 doctors revealed 107 were thinking of retiring early

Pulse also reveals that their surveyed practices had experienced a 9.5% increase in locum costs in the past 12 months, coming on top of the 9% rise in 2011.

There are many reasons that could explain why this has come about:

§  excess of hospital specialty posts

§  increase in numbers wanting a ‘portfolio’ career

§  concerns about the effects of commissioning on general practice

§  spiralling practice workloads

§  impact of GPs taking on responsibility for commissioning

§  ‘box-ticking’ culture

What we don’t know is what the continuing effect will be on locum costs in the coming 12 months.

So it’s worth checking whether the level of cover you now have in place – and which you may have had in place for some years – is going to be enough.

A practice which insured Dr A for a weekly sum of £400 many years ago will find that, today, this isn’t even enough to cover 2 sessions. 

With the cost of locum insurance still so low, it’s a false economy for a practice to cut the amount of cover just to shave a few pounds off its locum insurance premium ... as those who have done just that will know when they’ve had to make a claim.

Author: Lynda Cox, March 2013

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice. 

Today's big news

Locum insurance – one man’s meat ...

Talking to GPs about their locum insurance, it’s obvious that the policy feature that one GP thinks is essential is another’s total waste of money. 

Want cover for HIV contracted through work?  How about jury service?  Would you need a policy which pays towards home modifications, hospital trips and childcare costs if you’re injured in an accident?   Do you want permanent cover that won’t be withdrawn no matter how many times you have to claim?

Offering our clients a choice of 3 different levels of cover, we have found that 47% choose the policy which covers them only for illness and accident, 36% of clients go for broader cover which includes jury service and suspension, while the rest choose the most extensive range of cover which includes all of the above along withphased return to work, home modifications and so on.

Then, when it comes to permanent cover, it’s almost a 50/50 split between those who think a permanent policy is vital versus those who prefer an annually renewable policy.

It’s crystal clear from our experience that no one type of policy suits everyone. With that in mind, we’ve made sure we  can even accommodate group practices where the GPs each want different cover.   After all, we wouldn’t want to force anyone to take something that’s ‘another man’s poison’.

Author: Lynda Cox, January 2013

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice.

We have seen eye-wateringly low locum insurance premiums in the past few weeks which, in our view, are simply not economically viable.

I was pondering this when I went to a networking meeting the other day and spoke to someone about his commercial buildings insurance. He shopped around at the last renewal and moved to one of the cheapest providers he could find.    He liked the premium,   was signed up quickly and all went swimmingly until he had to claim.

That’s when he came unstuck. 

There was no support, no response from the provider, phone calls not returned.  In the end, he had to go to the Ombudsman. 

Now that everything has died down and his claim was – finally – paid, his policy is again due for renewal.  His view?  ‘It doesn’t matter what it costs, I’m going back to my previous broker.’

So, having heard what my networking friend said, maybe it’s time to consider a quote from art critic, philanthropist and social thinker John Ruskin:

“It is unwise to pay too much. But it is worse to pay too little. When you pay too much, you lose a little money; that is all. When you pay too little, you sometimes lose everything because the thing you bought was incapable of doing the thing it was bought to do.”

Worth bearing in mind, when you’re offered a premium that looks too good to be true?

Author: Lynda Cox, November 2012

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice.

Locum insurance – can you have too much choice?

We’re assailed from all sides by choice.  We’re persuaded by retailers, educationalists, the media and so on that choice is good. But can this mean needlessly adding complexity to something which should be simple?  Can offering a choice deter people from making a decision?  If a potential customer knows he or she wants to buy, say, locum insurance, do we deter them by asking if they want this, that or the other from a menu of benefits?

It reminds me of when insurers were falling over themselves to offer the best critical illness insurance.  Instead of making sure that the cover they offered was competitively-priced, well-administered and that clients who claimed were compassionately and fairly treated, competitive pressures resulted in insurers publicising ridiculously long lists of the number of increasingly esoteric conditions covered by their policies.  This, of course, meant that the next insurer had to publish an even longer list.

When it comes to locum insurance, more choice is coming into the mix. Do you want cover against being summoned for jury service or being suspended?  Do you want a payment if you return to work after adoption leave?  Although our experience shows that those who buy don’t all choose the same from the menu being offered, what about those who don’t  buy?

Maybe these are people who would have been very happy to pay around £40 a month for a policy which would pay out £1,000 a week towards their locum costs if they fell ill or had an accident but who ran away screaming when faced with a vast array of unexpected choices.  

These people may very well end up with no insurance, simply because what should have been a simple purchase was over-complicated.

Author: Lynda Cox, September 2012

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice. 

What to look for when choosing a locum insurance policy

 In a nutshell:

How long will the policy pay out for?

How much cover do I need?

When will it start paying?

Are there any restrictions on what I can do with the money?

Can I buy a policy on my own or does it have to be through my practice?

What if I have pre-existing medical conditions?

What if I’m over 70?

If our practice buys a group policy will the younger lives end up subsidising the older lives?

Making an informed choice

Locum insurance is a specialist form of insurance so you should always talk to a specialist company with extensive experience of working with medical and dental practices. Practice Cover Ltd exists to provide practices with locum and/or overheads insurance and to support Independent Financial Advisers with their medical and dental clients.  We know what we’re talking about. 

Be aware of what exactly is covered

Locum insurance policies should cover you against being unable to do your job.  Make sure that’s what your policy does.

Some policies only pay out if you employ a locum and not if the practice decides to cover any absence in-house. Make sure you know what you want to cover and what you are paying for.

Permanent cover

Decide whether you need permanent cover –some practices do and some practices don’t. See our blog which looks into this further:   “Locum insurance and continuity of cover ... to have or not to have?”

Insuring support staff

Did you know that you can insure the Practice Manager, nurses and other staff, giving you the means to meet their sick pay if they can’t work?

How long does it take to set up a policy?

We ask each person to provide their medical history and this can be done over the phone, taking about 5 minutes.

Our underwriters then assess the information given and we are usually able to offer an underwriting decision within 24 hours.  No medical reports, no delays. More than 84% of clients have been  accepted on standard terms*.

If you'd like to discuss this in more detail, just call 0800 028 5633.
*as at 12^thJune 2012

Isn’t that always the question when it comes to insurance?  No-one wants to buy insurance, and no-one wants to claim but everyone wants to be sure that, should they have to claim, the policy will cover what they expected it to cover.

Sometimes this means making a choice as to whether to pay extra to include an optional benefit within the policy you’re buying.  Should you cough up for windscreen cover when you take out motor insurance?  What about the legal expenses cover that your home insurance company offers?  Is it worth the extra premium?

Locum insurance, too, offers choices and, as with windscreen and legal expenses cover, clients need to work out whether the extra cost gives them something they feel is essential or is it something they could easily do without?

One of our selectable benefits, ‘Continuity of Cover’ means that clients will be able to claim repeatedly for recurrences of the same medical condition without it affecting the cover under their policy.

What does this mean in practice?

Let’s assume that ABC Practice takes out cover for its 4 GP partners (or dentists, or vets, or opticians, for example).

The policy starts on 1^st June 2012 and they elect to include Continuity of Cover.

On 1^st January 2013, one of the partners, John, is diagnosed with an illness necessitating 4 months off work.

The policy pays the weekly benefit for 3 months (after expiry of the 4 week deferment period the practice selected when taking out the policy).

John returns to work in May and the practice renews the policy in June 2013.

Continuity of Cover means that no matter how a person’s health deteriorates after their policy starts, their cover cannot be withdrawn or changed by the underwriters.

So when John has a relapse at the end of 2013 and claims again, the policy pays out again (after expiry of the selected deferment period).

For as long as the practice continues to renew their cover while John remains a partner, the practice can continue to claim for John’s repeated bouts of ill-health. 

What if they hadn’t selected Continuity of Cover?

If, in the above example, the practice had not selected Continuity of Cover, only the first claim would have been paid.

At the subsequent renewal date, future recurrences of the ‘claimed for’ condition would have been excluded from the policy.

So is Continuity of Cover always essential?

No, it is not always essential.  Some practices want a policy that pays for up to 12 months in respect of John’s first illness only.  Their view is that, should John suffer repeated bouts of illness, he would leave the practice. 

In this case, they determine that there is no point in paying the higher cost associated with Continuity of Cover if they would never make a claim for second and subsequent bouts of illness.

Other practices see it as a small cost for the peace of mind in the event of unanticipated recurrent illness.

Whatever your answer is to the question ‘what price peace of mind?’, locum insurance from Practice Cover can meet your needs. 

Author: Lynda Cox, May 2012

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice.

When a GP is ill and can’t work, what will the Primary Care Trust pay towards any locum costs that the practice may incur?

The answer to this should be pretty straightforward.  It’s all in the GMS Statement of Financial Entitlements , a 391 page document available at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_112959.pdf  which  says that the PCT will pay eligible practices up to £987.91 for the first 26 weeks of a GP’s absence and half that for the next 26 weeks.

Many practices assume that this is what they would receive and budget accordingly.

At Practice Cover we have spoken to a number of PCTs to ask what they are currently paying.  The answers varied around the country from 100% (i.e. the full £987.91), to 50%, to nothing.

So, once again the postcode lottery comes into play. To be fair, many practices will know what the stance is of their PCT and will make locum insurance arrangements accordingly.

But last week we came across a practice which thought it had done just that. They had insured their GPs for locum costs, taking into account their PCT’s contribution i.e. they insured for the shortfall.  

When one of the part-time GPs became ill, locum costs amounted to £1,200 a week.  The GP – in an eligible practice – was insured for a few hundred pounds a week, meaning that the practice looked to the PCT to make up the shortfall.

The PCT’s response was that, because the practice had arranged locum insurance, the PCT would make no payment at all.

Had the practice not arranged locum insurance the PCT, due to its published ceiling on reimbursement, would not have met the locum costs in full. 

So where does this leave practices which are trying to ensure they won’t be out of pocket?

The only option appears to be to ‘go it alone’, ignore the PCT and consider  insuring for 100% of locum costs.

Author: Lynda Cox, April 2012

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice. 

Back on the theme of ‘continuity of cover’, what if you have decided you need continuity of cover and you find a cheap locum insurance policy which claims to offer it?  Are all policies the same? Well, as every good shopper knows, buyer beware.  If a policy says it offers continuity of cover, fight your way through the eye-catching headlines, the guff and bluster, and read the small print.  If the ‘continuity’ safeguard applies only if a set of complex and long-winded conditions are satisfied, make sure you understand what those conditions actually mean.  For example, if a policy says that continuity is subject to a ‘claims ratio of x%’ does that mean the policy is likely to pay out or is not likely to pay out?  

We thought long and hard about how to word our locum insurance continuity of cover and we came up with a wording that is clear, concise, unequivocal and gives clients the safeguard they want:

“The terms applying at the Effective Date shall continue for as long as the Insured continuously renews this policy.”

Don’t get fazed by the smoke and mirrors.  Put your locum insurance provider on the spot and make sure you know exactly what you’re paying for.

Author: Lynda Cox, April  2012

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice. 

What’s this:  

It’s a long list that will look familiar to any dentist running his or her own business.  It’s the costs that have to be met, month in, month out to keep the business going.

Many dentists will have an element of Income Protection and, of course, keeping their family fed and housed in the event of their ill-health will be most dentists’ priority. But how many know that, over and above their IP arrangements, they can also insure up to 100% of their business overheads?

For up to a year, the dentist’s proportion of the overheads can be paid – up to a maximum of £3,000 a week – if the dentist is off work due to ill health (or having to do jury service or being suspended from practising).   

Overheads insurance means the dentist’s business can keep going in his or her absence: the bills won’t pile up and the staff will be paid.  When the dentist has recovered, he or she will have a business to go back to and if ill-health means it would make sense to give up work altogether, the decision to sell the business doesn’t have to be rushed.

As claim payments are limited to a maximum of 52 weeks, overheads insurance is far cheaper than IP. A dentist wanting to insure overheads of £1,000 a week, with a 4 week deferment period, would pay less than £500 a year.  And you can claim tax relief to reduce the cost even further.  

It’s not just dentists.  The same considerations apply to any fee-earning business owner: vets, opticians, accountants, architects ...

For a quotation, call (freephone) 0800 028 5633 or023 8051 3286.

 Author: Lynda Cox, April  2012

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice.