Frequently Asked Questions
One of my colleagues will be on leave within the next few weeks and I am concerned that this will mean there will be a big increase in my workload and working hours. What are the rules regarding the provision of locum cover and locum pay?
The 1997 conditions of service agreement for NCHDs, negotiated by the IMO and the Department of Health / Health Service Employers Agency, has clear rules in regard to locum cover and locum pay.
In the first instance, hospitals must endeavour to find locum cover for all leave periods where doctors are absent. The responsibility to secure and supply locums rests solely with hospital management and is not a duty of NCHDs to undertake. It is vital that doctors offer as much notice as possible of their intention to avail of leave to facilitate the securing of locum cover. With 1:4 or more onerous rotas, full locum cover must be provided for all leave periods (annual leave, sick leave, study leave etc.). The Hospital is obliged to make arrangements to find locums and will do so having consulted NCHDs and Consultants.
If a locum cannot be found, those NCHDs in the rota team who will take on the work caused by the absence and which would otherwise have been done by a locum must be paid at time and a half for the additional agreed overtime hours. Some Hospitals/Health Boards have stated that the provisions of the 1986 and 1997 contracts regarding 1:2 rotas and locum cover no longer apply. This is incorrect and the aforementioned provisions remain in place and the employer is obliged to abolish all 1:2 rotas and ensure full locum cover for all leave periods.
If your hospital refuses to adhere to the terms and conditions of various agreements, contact IMO House immediately.
Under the terms and conditions of employment for NCHDs, should locums be appointed when one or more doctors from a team are away?
Under the terms and conditions of employment for NCHDs, locums should be appointed when one or more doctors from a team are away. Many hospitals do not appoint locums, leaving the remaining NCHDs with extra workload. It is vital that when a member of a team knows that they will not be available for a specific length of time that they notify administration well in advance in writing (one month in advance if possible) requesting a locum to be provided for the dates in question. A reminder should be sent 2-3 weeks prior to the dates in question again in writing. You should contact the IMO as soon as you are aware that a problem may arise which will require the hospital to supply locum cover.
As an NCHD you are not obliged to provide cover to the hospital which is in excess of the recognised roster. If one of your team is unavailable for work, in most instances, the hospital must provide locum cover. All NCHDs must ensure, when cross-covering for one of their colleagues, that written confirmation is received from the hospital stating that you will be paid for the additional hours worked at the flat rate. Many NCHDs of Senior Registrar or Registrar level may be requested to "act up" as locum consultant. The current locum rates payable to consultants are based on a formula of the overall consultant package. Further information on the latest rates is available from the IMO House.
It would be important to get written confirmation of 'acting-up' status as the state indemnity scheme limits an NCHD to 20 days 'acting-up' for indemnity purposes. Some Hospitals and Health Boards attempt to incorporate built-in locums into some NCHD positions. It is important that when attending interview for any position that you enquire as to whether or not the position is a built-in locum or not. Employers cannot unilaterally alter your contract of employment once it has commenced, however, this does not preclude NCHDs from providing cross-cover in absence of locum.
What does the IMO website say about Locum cover?
All parties to the 1986 Agreement were committed to the provision of locum cover for all NCHD leave, where practical. Furthermore, it was agreed that in the case of 1:4 or more onerous rotas, full locum cover for all leave periods would be assured.
In the course of the implementation of L.C.R. 11840, agreements were also reached which sought to incorporate permanent locum cover in certain rosters. Local arrangements for the provision of locum cover were also agreed between the Irish Medical Organisation and the employers. Locum cover for NCHDs leave will continue to be provided in accordance with the above agreements. Employing authorities will make arrangements to secure and supply locum cover. This includes actively advertising and making all reasonable attempts to secure locums for all planned leave periods. Such local arrangements will involve consultation with NCHD and Consultant medical staff. To facilitate any arrangements, NCHDs must give adequate notice to the employing authority of their intention to take annual/study leave. In the event of agreed locum cover not being available, those NCHDs in the relevant department undertaking work which would normally have been carried out by a locum should be remunerated at the flat rate of time for the additional agreed overtime hours undertaken on a pro-rata basis per NCHD. It is agreed that NCHDs engaged as locums be placed on a salary scale taking into account incremental credit obtained through previous recognised hospital experience.
The hospital has asked me to procure my own locum, should I?
While it is in everybody's interest that they offer whatever help they can in securing a locum, the ultimate responsibility for securing a locum rests with the hospital. You may well be asked to assist in finding a locum, but the final responsibility rests with the hospital. Obviously, it is imperative that all doctors offer as much notice as possible of when they wish to take leave. We do not want to be left in a situation where locums cannot be found because the hospital has not been given reasonable time to seek a locum.
The hospital says it will only get locums for a 1:3 or 1:2 rota, is this right?
No, hospitals are obliged to ensure locum cover for all leave periods and guaranteed full cover for 1:4 or more onerous rotas. If they continue to insist that this is not possible, for funding or any other reason, then contact IMO House immediately. The responsibility to secure and supply locums rests solely with hospital management and is not a duty of NCHDs to undertake.
The hospital say they will not get locums, what will I do?
Contact IMO House immediately. The Organisation is committed to ensuring that all contractual entitlements are passed on to NCHDs and will ballot doctors for industrial action if this is what is needed to ensure that agreed provisions on issues such as locum cover are applied.
There is supposed to be six of us in our rota. One colleague is going on maternity leave and the hospital says we will now be working a 1:5. There have been no talks on this, where do we stand?
Hospitals are committed through various agreements to ensuring locum cover is provided for all NCHD leave where practical. Hospitals must endeavour to find locums.
In the cases of leave where there are 1:4 or more onerous rotas, hospitals have no choice but to arrange locum cover or pay locum rates. In this instance, the hospital has a contractual commitment to ensuring that locum cover will be provided for all leave where practical. We would therefore expect that the hospital would pursue the provision of locum cover to the greatest extent possible. Obviously, it would make our case better if we ensure that the hospital receives as much notice as possible.
A colleague has called in sick on my day off. Am I obliged to cover, and if so how will I be paid?
While there is no obligation on you to cover, we all know that next week it may be your turn to call in sick. Maybe the colleague you cover for today could then return the compliment next week, thereby making things more bearable for our colleagues who are likely to be left to pick up the extra workload otherwise. You should be paid at the cross-cover rate if you agree to cover for your sick colleague.