Locum - what do I need to know?

Re: Locum - what do I need to know?

An On MRCVS — Tue, 03 Dec 2013 09:07:21 GMT

Thanks for the honest advice everyone, I don't think I'm ready for locumming yet!

Re: Locum - what do I need to know?

bob lehner — Mon, 02 Dec 2013 15:10:19 GMT

[quote user="mariette asselbergs"]And be prepared to work with lots of different computer systems because it seems like no practice has the same and every practice has its own weird codes for things.....![/quote]

Indeed - for a small profession I am amazed as to how many computer software systems there are - and as you say every place you go to seems to be different.

As far as coding goes - it can drive you quite bonkers - take a simple thing like a dog vaccine. Might be any of: vac, v dog, vac dog, d vac, dog vac, p vac, puppy vac, vac puppy, initial vacs, puppy package, booster, dog booster, annual booster, full booster, part booster, DHPPi, lepto, Nobivac (or any other brand you can think of)..... ...aagh!

And don't start me on trying to find all the bleeding one hundred and one different dog/cat foods on the computer.

Re: Locum - what do I need to know?

Gerbil — Sun, 01 Dec 2013 23:30:34 GMT

I agree with Michael

In my first day as a locum I pinned a cats leg and did a thyroidectomy on another cat. Many situations you walk into as a locum are pretty stressed.

Get a job where your skills can be honed a bit. It sounds as if you haven't had much support. thats a shame. I think at the mo locuming may damage your confidence even more. You need to be a bit of a tough nut to do locuming well

Re: Locum - what do I need to know?

karen jones — Sun, 01 Dec 2013 22:04:26 GMT

I would try and do some surgical based cpd to improve your confidence. Cpd solutions do a good emergency surgery course. I am doing a medicine course at moment to improve my medical skills as I have tended to do surgical cpd as it's fun. Surgery tends to have an outcome while some medicine cases can really tax your brain. I not sure ur ready for locuming. As a boss I would expect a locum to cope with surgery especially as They are not a cheap item though necessary when needed. If you still want to locum and can still or want to do large animal work then you are as rare as hens teeth in my experience of getting a mixed locum !

Re: Locum - what do I need to know?

Francisco Gomez — Sun, 01 Dec 2013 22:02:52 GMT

[quote user="Michael Woodhouse"]

The majority need someone with a decent all round competence - ie you can leave them to whatever comes in.

My advice would be to find a new job where you can deal with your gremlins and build your confidence. Look at locum work once you are confident handling 99% of what can be thrown at you.

[/quote]

Re: Locum - what do I need to know?

Michael Woodhouse — Sun, 01 Dec 2013 22:01:41 GMT

A vet not confident in surgery and unwilling to do OOH sounds a difficult person to fit into a lot of locum jobs. The majority need someone with a decent all round competence - ie you can leave them to whatever comes in.

You can claim a whole £136 per week as maternity pay - I hope you don't have a lot of outgoings!

https://www.gov.uk/maternity-allowance/overview

My advice would be to find a new job where you can deal with your gremlins and build your confidence. Look at locum work once you are confident handling 99% of what can be thrown at you.

Re: Locum - what do I need to know?

Michael Woodhouse — Sun, 01 Dec 2013 22:00:13 GMT

You can claim a whole £136 per week as maternity pay - I hope you don't have a lot of outgoings!

https://www.gov.uk/maternity-allowance/overview

My advice would be to find a new job where you can deal with your gremlins and build your confidence. Look at locum work once you are confident handling 99% of what can be thrown at you.

Re: Locum - what do I need to know?

Linda Filshie — Sun, 01 Dec 2013 21:58:34 GMT

[quote user="mariette asselbergs"]

And be prepared to work with lots of different computer systems because it seems like no practice has the same and every practice has its own weird codes for things.....!

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^^^^ this is so true! I always try and get a cheat sheet out of them for common things. And when it comes to giving estimates I usually give one of the nurses a list of everything I would want included and ask them to do it because they're usually far quicker than me at finding things.

Neil and Francisco both make a very good point about whether locuming will be the right fit for you, and Mariette about case follow up, though I sometimes do text to ask about how my more interesting cases went on. At the end of the day you're there to ensure the veterinary aspect of someone's business runs as smoothly and profitably as possible, and you do need to be competent and confident to do that. And while it's perfectly possible to fake confidence, it's a lot more fun if you're actually feeling it.

Re: Locum - what do I need to know?

mariette asselbergs — Sun, 01 Dec 2013 21:53:27 GMT

HMRC do (free) courses about self employment, setting up your own company, taxes, self assessment ,the law etc. Very friendly and helpful (they love small entrepreneurs), and highly recommended.

If you don't do OOH you don't really need a car, which can save you loads of money. Train and bicycle works perfectly for SA work. If you do use your own car you cannot usually claim mileage for travelling from home to work, but you can put it on your expenses so it lowers your taxeable income.

What you need to realise is that you may miss the build up of a relationship with clients and their pets, you will rarely know what happened to your patients after you have seen them and left. I sometimes give people a pre-addressed and stamped envelope asking them to let me know how things went but it doesn't always work.

A good thing is also to have a bag with your own kit, stethoscope, headlight, thermometer, ophthalmoscope, elastic band to bring up a vein instead of depending on a nurse, etc. whatever that you like to use because you may not always find what you would like to use in a practice, or not of good quality. And your own books or apps!

And be prepared to work with lots of different computer systems because it seems like no practice has the same and every practice has its own weird codes for things.....!

And yes, no social security at all apart from what you organise yourself, privately. If you work through an agency then they will pay your taxes and NI, but if you work self employed then you have to do that yourself.

There are quite a lot of practices that do not want self employed locums, most of the corporates don't for example. They are scared to be liable if you don't pay your tax.

Other than that, your greatest asset is your freedom to take time of when and as long as you want!

Good luck,

Mariette

Re: Locum - what do I need to know?

Francisco Gomez — Sun, 01 Dec 2013 21:51:44 GMT

I have the same feeling as Neil.

Re: Locum - what do I need to know?

Neil Wheadon — Sun, 01 Dec 2013 21:45:15 GMT

The very fact that you don't like surgery goes hand in hand with not being able to do OOH work. Will the fact that you can't operate affect chances of getting work? Look at it from an employers point of view. Finding work at quieter times will be a lot tougher. Locumming isn't easy for case follow up either as you won't get this like private practice, not great for building your confidence. Costs VDS, depends on hours worked, give them a call. Mileage, no this isn't added routinely, work to a daily rate Maternity, you'll be self employed so no benefits as far as I'm aware. I've been a bit negative in this post, however a locum needs to be experienced and confident. There have been several posts on here that say it's easy. In my opinion it's not as easy as people make out. You need to be prepared to hunt work out and be prepared to travel a bit and I'm really not sure from your brief description if this is a good choice for you Neil

Re: Locum - what do I need to know?

Francisco Gomez — Sun, 01 Dec 2013 21:43:02 GMT

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I'll try to show how I set up my self (as a limited company). Although I am aware there are other options...

First of all: ask yourself this question: If you don’t like your job (this is just an assumption, maybe your decision is nothing to do with that!), you may as well get another. Do you really want to be a locum if you aren’t that confident at surgery? I’ve been a locum for two years. I have met loads of people but I haven’t develop myself forward because people need you to cover. If you are going to be a locum, cpd had to been funded by yourself, most practices aren't going to spend time in training you further. Most people that want you to locum for them will want you to do consultations rather than surgery (so as Linda said, it is doable), but some people will want you to do sole charge too: you would need some surgery and emergency skills for this. You also said that you don’t want to do OOH, well that’s probably Ok, but OOH had been a large part of my income. Do you NOT want to do OOH because you’re not that confident in that either?

Let’s talk about costs: There are a couple of ways to set yourself up as a locum vet in the UK: Self-employed and making your own limited company. Unfortunately, self-employed is quite nice but most corporates don't allow this, this is because (apparently) they run a risk with your taxes. If you don’t pay them, they become their responsibility (I’m not that sure about the law about this but this is how they put it to me). Well, I had (and I am) to set myself as a private (limited) company. It is also important to mention that as a ‘self-employed’, if you end in a big debt, all your possessions as a person are assets to it (i.e. your own house), but as a limited company, your debts can only run as deep as your company: they are 'limited' to that.

The costs of this are:

- - Accountant: Depending of how much an accountant will charge you, but forget about doing this yourself. You WILL need someone to do this for you, calculating how much you owe the Tax guys is not easy, and if you get it wrong, you will have a few headaches. (Plus, you might be open to an investigation from H&R). This can be a few hundred pounds a year, usually >£1000.

- - VDS. I usually pay about £400-£500, this would be the same as a practice, but practices would have a discount for having several people on it.

- - RCVS. You should know this one: same as usual. Is it £299/year now???

- Car/petrol. This is a a bit of a difficult one: You need to make the decision whether you buy a car with low emissions and everything related to your car count as a cost in your company. Or? You ‘use’ your own car (as if it was your employee car) and you claim petrol allowance from it. The petrol allowance (I think is 45p/mile now) will count as a cost for your limited company. But you still have to pay for it! [*edit* This is a bit complicated, I will develop further if needed: basically, your company will pay your employee (youself) 45p/mile for the first 10,000miles. This means that this money becomes a cost and, although you still pay for your own petrol, it becomes a cost of your company, lowering your corporate tax)]

- CDP. Any CPD you want to do to cover your minimal 105h/3years rule.

- Office costs: Gas, electricity, books, etc.

- Your own monthly wage. In a limited company your wage will count as a cost, but obviously this goes to your bank account as you are an 'employee' of your own company. Usually, your wage should be quite low, the lower it is, the less tax you will have to pay on it.

Finally you get all your ‘ins’ and subtract all your ‘outs’ and 20% of this difference has to go to Mr. Taxman [corporate tax]. The rest (dividends) is yours.

So, ask yourself: do you really want to be a locum? If you do, and want to do it like I set it up, your first step is to make an appointment with an accountant.

Re: Locum - what do I need to know?

Francisco Gomez — Sun, 01 Dec 2013 21:33:43 GMT

[quote user="Linda Filshie"]Sorry Francisco - was typing as you were posting obviously!

[/quote]

No probs Linda. I will give my view as well. :-)

Re: Locum - what do I need to know?

Linda Filshie — Sun, 01 Dec 2013 21:20:22 GMT

Sorry Francisco - was typing as you were posting obviously!

Re: Locum - what do I need to know?

Linda Filshie — Sun, 01 Dec 2013 21:18:20 GMT

Hi anon,

If you go to a practice which is sole charge you will need to be willing to do surgery, I would say. If you're not doing sole charge then it's a conversation to have with the practice when you make a contract with them. I've worked in a couple of places where I've been a (slightly grudging) consultation monkey so it's absolutely doable. I avoid OOH if I can - lots of SA practices have alternative arrangements now, certainly more than when I stared locuming 7 years ago. There's plenty of work available, more if you live somewhere like the SE or the Midlands.

Costs:

Obligatory are mortgage/rent, food, electricity, gas, water, car, VDS (about £300 for SA cover for a 'part time' year, in my case less than 150 days/year - I've got a cheap mortgage so I don't have to work full time), RCVS (there's another £300), CPD (I've spent a couple of grand but that's mainly because I'm off to NAVC in Florida in Jan -there's lots of free stuff out there though).

Optional: BSAVA, BVA

I've never added mileage to my fees, but will claim it back at self-assessment. I charge a fixed rate per day. You can go self-employed, as a ltd company or use an umbrella company - all have their pros and cons. As a self employed person you have no employment rights, so you need to factor in things like holiday entitlements, sick absence policy and maternity cover to your thinking. I honestly have no idea how maternity works for self employed people.

I love the freedom of it and being able to choose to take a couple of weeks off if I want without having to clear it with anyone. But it can be lonely being away from home, and sometimes the accomodation you are put up in is, shall we say sub-par and leave it at that. (Sometimes it's fab!). Sometimes staff/clients are great (actually I've found for the most part they are) but sometimes not so much.

Re: Locum - what do I need to know?

Francisco Gomez — Sun, 01 Dec 2013 21:11:25 GMT

Im going to answer this. It is quite long, so I hope the other locums don't get it first and then my post is screwed! :D