Locum, locum everywhere and not an employed vet to find. How close is this to the future reality of the veterinary workforce? The current recruitment and retention crisis facing the veterinary profession raises two questions: what can we do to improve the existing situation? and are there viable alternative business models to traditional practice?
There is a lot of anecdotal discussion in the veterinary press around the rise in locums and increasing difficulty in recruiting and retaining permanent staff. However, there is a scarcity of recent data of the numbers involved.
The BVA’s collaborative research with the University of Exeter looked at factors that influence motivation, retention and satisfaction in the veterinary workplace in general and the effect of gender discrimination. The SPVS Recruitment Survey 2017 cited low wages and vets feeling stressed or undervalued as contributory factors to the recruitment crisis. We need to work on these findings and encourage flexible and supported working in order to prevent the “skills haemorrhage”.
A recent survey by recruitment agency Recruit4Vets showed a rise in the number of applicants willing to consider locum work from 63 percent in 2018 to 75 percent in 2019. The majority of practices surveyed (80 percent) reported having a locum working with them at any given time, and the majority of these (55 percent) were longer-term placements of four weeks or more. Longer-term placements are more likely to be covering for staff shortages rather than periods of leave or absence. The most commonly cited reasons for becoming a locum were flexibility (83 percent) and pay (69 percent).
Better remuneration when locuming is the bottom line that grabs attention, with a lot of vets and nurses quoting poor pay as demotivating and a reason for leaving the profession. However, by the time the additional employment benefits are totted up, locum pay doesn’t always fare so well. As an employee, businesses frequently cover the costs of professional subscriptions and professional insurance. They provide CPD allowance, pension contributions, parental leave and pay, and sickness and holiday pay. Ambulatory jobs often come with a company car and fuel allowance. Locums will have to fund this themselves and in addition, locums are more likely to require accountancy support.
Employees are also heavily supported with rights against unfair dismissal and discrimination. There are fewer protections with locum work and an increased need for careful financial planning and consideration of income support protection. These additional factors should be carefully considered when calculating if locums are actually better off than employees.
Being masters of our own destiny and retaining control over work–life balance is an increasingly important motivator in modern society, with locum work often seen as the panacea. However, there can be trade-offs. There may be reduced continuity of care with long-term clients and less opportunity to develop working relationships with colleagues, clients and their pets.
Does this mean we need to look at alternatives to our business models? Should we look to more of a freelance business model in the UK? Self-employed individuals buy into shared spaces such as the chair in the hairdressing salon. Indeed, this is the most common model for dentists in the UK. Here, the surgery facilities are used and maintained by a practice owner with self-employed associates making regular payments in return for the use of the premises, equipment, materials and staff.
In our day job, this would require a deep mutual understanding of common practice scenarios, such as the unregistered emergency running in the door. Who deals with it? There would also need to be consensus with provision of out of hours care and holidays. Associate models have similar tax implications to locum work with grey areas around what is classified as off-payroll working (IR35 legislation). For both, there is a requirement to prove the possibility of substitution should the associate or locum be unable to work.
In the short term, agile veterinary businesses which can provide flexibility, support and attractive remuneration packages are more likely to recruit and retain the best staff. Moving forwards, we may have to do things differently. To quote Peter Drucker, “The best way to predict the future… is to create it.”
