Locum doctors at Northampton hospital cancelled A&E shifts at short notice because new tax rules cut pay

Deputy chief Deborah Needham revealed the hospital may facehaving to take outpatient appointments and elective procedures down to compensate for cancelled shifts.
Deputy chief Deborah Needham revealed the hospital may facehaving to take outpatient appointments and elective procedures down to compensate for cancelled shifts.

Some stand-in emergency department doctors cancelled their shifts at Northampton General Hospital because new tax rules led to a decrease in pay.

The decision is detailed in a report to the hospital’s board members, which said the actions led to difficulties replacing the locum medics at short notice and risked affecting cancer treatment and operations.

Dr Michael Cusack, the medical director, said that a noted change took place in locum doctors’ behaviour in March ahead of the April tax rules shift.

He said: “Doctors have not been booking onto shifts within ED and urgent care with a small amount of doctors cancelling previously booked onto shifts.”

The hospital says it has now resolved the problem by successfully encouraging staff to sign up to its staff bank, which still allows them to work on an as-and-when basis while providing consistency to patients.

But deputy chief Deborah Needham revealed in the board papers that the hospital may face having to “take outpatient appointments and elective procedures down” to compensate for cancelled shifts

The tax change affects the pay some locum doctors - and other stand-in medical staff such as outpatient nurses - receive across the NHS.

In effect, agencies offering locums are now compelled to make sure the doctor is taxed personally rather than through a ‘company’, which is a lower rate.

The trust had written to all locum doctors affected months earlier, but the refusal to work A&E shifts occurred en masse in a single week.

Janine Brennan told the board that her finance team had gone out and “explained the new rules to the locum doctors”.

A spokeswoman for Northampton General Hospital said: “This had an impact through April, but our staff worked additional shifts to cover gaps, demonstrating yet again their commitment to providing safe care to our patients.

“We’re working hard and with emerging success to encourage more of our own doctors onto our in-house staff bank, which reduces our reliance on agency staff.

“That’s alongside our ongoing recruitment for medical posts.”