How Much Should I be Charging As a Locum Pharmacist?

The issue of locums’ rates is complex. Whilst my personal opinion is from a locum’s perspective, a locum as an individual business has the right to charge whatever they like for the job they do. The reality is that we are in a marketplace and in this marketplace there are over 30k individuals who work as part time or full time locums. Each one of these people are individual businesses just like you and me. So, it's a pretty crowded marketplace. There are also other market forces at play here which include, most importantly, pharmacy funding, the DHSC, the government itself and those who can influence, or have the ability to influence, the ministers/MPs/Health Secretary etc., thousands of independent Pharmacy owners and let’s not forget the large multiples with very deep pockets. Your rate will depend on how all these market forces play out. It’s naïve to assume a handful of locums can force the market to pay double the average rate, as some claim. Just as it is naïve to assume one multiple or even a group of multiples can control the whole locum market. The average rate will be based on multiple factors so it’s a complex issue.

To give pharmacists clarity on the current average rate we have been collecting data through www.Syrkle.net. Unfortunately, right now there’s not enough feedbacks for us gauge what the going rate is in each region with a high level of accuracy. This can hopefully be changed as more and more people leave branch reviews. We need thousands of reviews from each region to get a clear picture of what's happening and what impact those rates are having on the surrounding region and on the country as a whole. The dynamics of locum rates is complicated to say the least!

For the last two years COVID played a huge part in ensuring rates remained high as more pharmacists were in needed to cover COVID clinics, sickness etc. Add to this a steady stream of pharmacists who moved, and are continuing to move, to primary care and the PCN’s due to an ever-increasing workload and poor working conditions in community. Many pharmacists who moved into the primary care sector and away from community pharmacy took almost 50% pay cut just to get away from community pharmacy. If conditions in the community sector improved and pay scales reflected the workload, we may see these pharmacists return to community, adding to increased availability of a workforce which will in turn lead to lower locum rates and lower salaries for employed pharmacists. Currently there is enough supply to cover all the pharmacies, although you must wonder why so many employed pharmacists are leaving their jobs to work as locums with less job security and no holiday, pensions, sick pay etc to speak of.

So, yes you can charge what you like BUT if you see yourself as a business then you’ll need to factor in all these issues and then set your rate. Whilst I’d love to say we all should be on rates that are akin to our primary care GP colleagues who locum, the reality is the current government funding doesn’t allow that. We ultimately need to work with pharmacy owners whilst also ensuring we have other revenue streams. The problem that I see a lot with locums is they rely too heavily on their locum income. Wind the clock back 20 years and this was not an issue. Bring the clock forward to today and placing your sole reliance on locum income is an issue. To locum full time, nowadays, is high risk/high reward strategy. There will be months when you'll have work 7 days a week at really high rates but then there will be weeks in between where you have no work at all. During December, January, and February there is usually very little demand for locum work. Go on holiday, do your CPDs and learn new skills in those months. Make the most of the down time as well as busy periods. For those who feel this is too risky I'd suggest having couple of regular days and keeping the rest for emergency locum work. Certain multiples tend to cancel locums on the day or with very short notice so I suggest only taking emergencies from them on the day and ensure to negotiate from the opening time of the pharmacy as some companies seem to be advertising later in the morning so they can save a few hours pay! 

Locuming full time is risky business and it’s not something I’d personally recommend. It’s better to have a part time/regular place of work and locum a few days whilst looking at ownership/partnership in a Pharmacy. I’d urge everyone to start looking at the pharmacy ownership, NHS payments, profit and loss sheets and find out what a pharmacy makes. Learn all about the businesses you work for. Learn about the Drug Tariff (my recent podcast on DT is here ( https://www.youtube.com/watch?v=M9etvgKb8gY&t=14s) ) and how a pharmacy is paid. Speak to current and ex-pharmacy owners. Think about the pressures you may have to face as an owner. How many staff do you think they needed for a pharmacy that you worked at yesterday? How much would it cost of hire that many staff and how much would the business have needed to cover that cost? How would you do things differently? If you would do things differently why hasn't the current owner thought about doing things differently? What can you learn from their mistakes? There are a huge number of questions to think about when you become an owner. Whilst it may all seem really daunting it can also be really rewarding so don't be put off by the idea of ownership. If you have questions, then feel free to reach out to me on the Telegram network. My username is @tohidul.

Whilst researching an idea I've been working on for past year or so I spoke to a few accountancy firms that look after both independent pharmacies and locums. Those firms confirmed that, right now, locums in some cases make more money than pharmacy owners. The pressure from wholesalers that have been allegedly profiteering, allegedly increased staffing cost, rising energy costs, increased cost of living, 30% real terms cut in pharmacy funding have all added to a very unhealthy profit margin. The current model is for community pharmacy is broken and we have very weak leadership within the representative bodies that are more interested in scoring points, likes and retweets than trying to unite the sector and profession. Add to that a negotiating body that no one including the government takes seriously.  There is money to be made if your savvy but even then, a very savvy pharmacy owner I know made less than an average locum last year and they didn’t even take a wage!

Some people will say “well that’s not our problem and they should have managers in place instead of trying run off locums”. Yes, that’s true but we do need to work with the people who employ us and create an environment where we both win. You can win 1 day or 2 days maybe even 3 but you’ll eventually lose if that owner can’t afford run his/her business. In the end we’ll all lose if we don’t work together. 

The best advice I can give anyone who has no interest in ownership right now is to upskill. Look at providing better service. Look at becoming an Independent Prescriber and developing your own skillset. Work out a deal with pharmacies you regularly work in. I know one pharmacy owner who pays all his pharmacist managers 6 figure salaries, and they get a profit share. There are employers out there who are good and will pay if you can improve their business, show that you understand how a pharmacy operates and that you can help them improve their service. However, it may be difficult in pharmacies that are heavily understaffed where they expect their locum pharmacists to do the jobs of the dispenser, tech, ACT and the cleaner whilst trying to the job of a pharmacist. Some pharmacy owners and even non pharmacist staff believe that locums should do everything in the pharmacy including taking the bins out and sweeping up. Anyone who thinks paying someone with specialist knowledge of medicine at triple or quadruple the pay of a dispenser to do their job really needs to take a nice long walk and not come back into the pharmacy. It's beyond beggars’ belief to pay someone £30-50 per hour and not use their skillset to bring in more business or have them do the job of 3 or 4 other people. It shows a clear lack of understanding of what a pharmacist does and completely disrespects our role. One of the most common complaints I hear from locums is that technicians, ACTs, or dispensers forcefully telling the pharmacist to dispense, check, label, hand out and then put stock away. None of these are clinical roles and you certainly don't need a degree for that. In my opinion, the ACT's job is to perform the accuracy checks - not a clinical role. The pharmacy technicians’ job is, by definition, technical, and not a clinical role. The dispensers’ job is to dispense – a technical role and again not a clinical role. Only the pharmacist can do the clinical part and can turn their hand to all the other jobs, but no dispenser, technician or ACT can do the pharmacist’s job. It takes 5 years of hard study to get a pharmacy degree. It then takes a further 1 year of intense training, study, and an entrance exam to be admitted onto the register of pharmacists. Anybody who thinks that they can acquire that skill set and knowledge base by sitting and passing a couple of NVQ courses should maybe see a therapist. In fact, they should definitely see a therapist. Message me and I’ll book the appointment for you.

We’re going through a seismic change in the sector and with potential upcoming changes in regulation, expect maybe another 1 1/2 to 2 years left for locuming at current market rates. Prepare yourselves so you can keep a stable long term income source. The best weapon you have is your knowledge. Keep upskilling. Keep your options open. Don't rely on a single source of income.  

Lastly please keep giving feedbacks on www.Syrkle.net. That’s the only way we can develop a clearer picture of the sector and wages. It benefits all of us.