Differences between SS, VMO, locums

Differences between Staff Specialists, VMOs and Locums
February 2025

Key Messages:

1) Psychiatrists can be employed as Staff Specialists, Visiting Medical Officers or Locum Psychiatrists.

2) Staff Specialists provide clinical, teaching, research and leadership roles, as well as continuity of care, at a cost of $1,009 to $1,363 per day.

3) VMOs ($2,350 + GST per day) and Locums ($3,050 + GST per day) provide predominantly clinical care only, and cost significantly more.

Staff Specialist Psychiatrists (SSP)

Staff Specialist Psychiatrists are salaried senior doctors that are employed to provide clinical, teaching, training, research and managerial/leadership roles within the public health sector.

Most SSP will have a clinical role that involves seeing patients in emergency departments, medical and surgical wards, pregnancy and maternity services, transplant services, drug and alcohol services, community mental health clinics, prisons and youth justice centres.

SSP also have a leadership role, and most clinical directors in NSW are employed as SSP.

Training and education are core responsibilities of SSP. This includes training of registrars (trainee psychiatrists), medical students (student doctors), and training of allied health and nursing staff.

SSP are entitled to 5 weeks of paid annual leave each year.-Can be temporary or permanent part time or full time. Annual Salary Range for a Level 1 SS: $262,376 (Year 1) to $354,479 (Senior) per 1.0 FTE

Training and Study allowance up to $39,600 pa, proportionate to FTE, is available at the discretion of each Local Health District (LHD) and is spent for the purpose of benefitting the LHD, and therefore are not included as salary.

Most SSP are Level 1 (i.e., fully salaried). Staff Specialists in NSW Health can increase their income by electing to a receive a portion of Medicare (MBS) rebates in exchange for a reduced salary from NSW Health (Levels 2-5). Psychiatrists generally cannot generate sufficient MBS revenue to supplement their income to a level higher than Level 1 due to the high complexity of the case mix and low Medicare rebates for psychiatry compared to surgical, procedural physician, diagnostic imaging and pathology staff specialists.

Visiting Medical Officers (VMO)

VMO Psychiatrists are contractor senior doctors who are contracted to provide services as required by a public health service.

VMOs are paid an hourly rate based on hours worked only, with no leave entitlements.

Although VMOs are able to provide training, education, and leadership, most services do not utilise VMOs for these roles due to the higher hourly cost (currently $275.85-293.75/h).

VMOs thus tend to be deployed to high volume clinical roles (e.g., inpatient/community clinics).

Locum Psychiatrists

Locums are short-term contractor doctors paid at higher rates to fill shortages (e.g., leave cover, unexpected illness).

Locums are very common in NSW due to long-term staff shortages with some LHDs having been reliant on long-term locum coverage for multiple years.

Current market rates elsewhere in Australia range from $2,500/day to as high as $3,800/day.

Typically employed on short term contracts, so are least able to provide continuity of care to patients. Locums are usually unfamiliar with how each service operates, creating efficiency drag.

No expectation to cover teaching, training or leadership duties due to short-term contract. Usually do not provide on-call cover to attract people to these short-term roles.

Additional Costs of Travel, Accommodation, Locum Agency fees, add 12-20% to costs.