Medical Rostering

Medic rate card for additional work

(please refer to the SOP below for definitions)

Liverpool University Hospital Medical Locum Rates:

Current active LUH rate card
(Oct 25)

The rate card above is currently available for all additional work across all areas and gives a more equitable approach to Additional Clinical Capacity (ACC) and locum payments. It provides standardisation of rates and a move away from local agreements & variance and supersedes all previous arrangements.

The following definitions are to give clarity to the type of work being undertaken. Any exceptions to this must have HLT approval

Relevant mandatory request/booking forms can be found on the Workforce Governance Processes page here.

Premium pay definitions and guidelines – medic and non-medic

For all additional work required the following process should apply:

• TOIL
• Bank
• Overtime with pre-approval by HLT
• WLI planned sessions

Internal locum / bank payments are made in circumstances where there are gaps in the establishment and thus roster that need to be met by offering staff additional hours. These gaps will normally be in relation to vacancies or sickness, maternity and paternity leave. This should avoid the need to utilise agency workers for these shifts. This work may have previously been termed Additional Clinical Capacity. All additional clinical work must be undertaken within the overall divisional financial envelope and will now be termed Bank work.

A bespoke rate card has been produced for medic locum payments at the Trust, as above. 

The approval proforma requires the detail regarding the reasoning for the gap and in the instance of absence, the name of the individual unable to fulfil the duties so that there is clear trail of the rationale for cover.

Where a bank worker is filling a consistent gap, this has often been termed locum work. Consistent gaps should be reviewed for the best and most efficient approach. A Fixed Term appointment should be considered.

Waiting list initiative payments (WLIs) This defines a situation where additional clinical activity is required due to an unmet need arising from demand over plan and a decision has been made and approval given to support this demand through WLI. Due to the nature of this additional activity, these MUST be arranged and pre-approved at the HLT level prior to the additional work being undertaken.  WLIs are expected to be worked outside of normal business hours. Where WLIs are arranged within business hours, there must be full assurance that any individual being paid via this route is not being paid for the same work twice .

WLI requests must be clearly documented and state what the activity will achieve. This will be monitored through the workforce controls process and will be reconciled against job plans and performance targets. 

AfC staff will be paid at AfC terms and conditions.

All additional clinical work must be undertaken within the overall divisional financial envelope.

Medic – Available to Work but not working – sometimes called non-resident on call / NROC/Standby will be paid locum rates based on the rate card above (which are 50% of the ‘working’ rate). The principle of this rate is that workers who are on-call (available to work) but are not rostered to be delivering patient care, are paid a lesser recompense as to those workers who are on-site (or working from an agreed location including their home) undertaking direct clinical care.

For the avoidance of doubt ‘working’ includes travelling to hospital premises to work, being on hospital premises, or actively undertaking clinical work at an agreed location which includes home – see below.

To clarify, albeit not exhaustively or exclusively, the difference between being available to work (on-call) and working (including whilst not in the hospital);

· Where a doctor stops simply ‘being available’ and commences work accumulatively for more than 5 minutes in any hour (including the activity of recording the work), they will be paid that hour at the working rate.

· Work is any activity relating to patient care including (but not exhaustively) – reviewing/writing clinical notes, making or receiving telephone calls, responding to or receiving queries/emails or messages, communicating with colleagues.

· Where the worker is called into work (either on-site or at an agreed location), the recompense is escalated to the ‘working’ rate for the complete period, including travel time.

· Compensatory rest requirements – where a night shift is worked, consideration should be given to the need for compensatory rest periods https://www.bma.org.uk/media/l0si2usn/bma-compensatory-rest-guidance-september-2024.pdf

The detail of work undertaken should be logged on the claim form. The claim form does not need to contain details of every call during every hour as a single episode of work lasting >5 minutes during an hour = 1 hour of work.

The point of origin of the phone call is not relevant. It is recognised that communications with other doctors may be telephone or digital messages/e-mail, incoming or out-going, or may be a planned event e.g. writing in the clinical notes. Regional services have complex communication.

Agenda for Change (AfC) overtime rates can be offered to non-medical staff where there is a short-term need for additional hours to be worked. This must be approved as part of the workforce control processes.

Consultants – Time off in lieu (TOIL) can be taken instead of payment of the rate card. Consultants and SAS Doctors “Acting Down” is covered by a separate policy.

TOIL exchange rates are:

· Monday to Friday 7am -7pm (3hours=1PA)

· Monday to Friday Evening 7pm-11pm (2hours=1PA)

· Saturday and Sunday 7am to 11pm (2hours=1PA)

· Night time 11pm to 7am (1.5hours=1PA)

· TOIL to be taken in line with annual leave policy.

A maximum of 5 days of TOIL can be accumulated in this way. If more than 5 days are accumulated and the needs of the service precludes the leave being taken, the TOIL can be changed back to pay at the hourly rate that would have been applicable at the time.

It is a professional obligation that colleagues continue to undertake their contractual SPA activity, displaced by extra paid clinical activity. This does not attract extra payment even when undertaken in premium time at an individual's discretion.

Where an SAS/Specialty Doctor undertakes ACC work at the consultant level (ie on consultant rotas/working autonomously) they will be paid at the consultant rate from the rate card. All other SAS/Specialty doctors undertaking ACC work will be paid at the Registrar (IMT3/ST3+or equivalent (see rates above)

Where consultants or SAS/Specialty Doctors are working at an STR l/junior level then they will be paid based on the ‘acting down’ agreement.

Please find below more information on Medical Rostering.

• For a guide on Health Roster View Only (to navigate around) Please click here for more information

• For a guide on Viewing & Approving Annual Leave - Please click here for more information

• For a guide on MedicOnline (Computer/Laptop); Requesting Annual/Study Leave etc - Please click here for more information

• For a guide on How to Add MedicOnLine as a shortcut on your home screen on your mobile (Android) - Please click here for more information

• For a guide on How to Add MedicOnLine as a shortcut on your home screen on your mobile (iPhone) - Please click here to watch a short video clip

Medical Locum Information

How to Book/Filter Locum shifts & submit timesheets:

Booking Shifts: CLICK HERE

Adding Time sheets: CLICK HERE

Our Team

Head of Medical Systems - Grant Howland 

Medical Systems Team Leader - Andrew Powell

Medical Systems Coordinators - Bethany Jones, Mark Parr, Joseph Hart, Laura Mason & Kate Williams

Support Assistants - Leeanne Evans  - RLB Ext. 11508/11507/3157

Contact Us

E-mail- medical.roster@liverpoolft.nhs.uk

If you are having problems accessing the system, or would like any assistance regarding training or rota amendments, please contact the above email address.

If your enquiry is regarding swaps, annual leave or study approvals please discuss with your department rota master.

Internal Ext: 11507 & 11508 & 3157