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Working as a locum and as Salaried GP

Working as a locum and as Salaried GP. nelg- North-east employed &locum GPs. What you need (I):. Inclusion on PERFORMERS LIST (supplementary list) MDU/MPS – appropriate cover CLASS II NATIONAL INSURANCE contributions. 084591-54655, www.inlandrevenue.gov.uk

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Working as a locum and as Salaried GP

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  1. Working as a locum and as Salaried GP nelg- North-east employed &locum GPs

  2. What you need (I): • Inclusion on PERFORMERS LIST (supplementary list) • MDU/MPS – appropriate cover • CLASS II NATIONAL INSURANCE contributions. 084591-54655, www.inlandrevenue.gov.uk • Join NELG- networking, and to get work • Accounts ?+_ accountant • NHS Pension forms

  3. Why join nelg ? • Peer support- and experience • Wide range of professional careers • Getting work, inside knowledge • Political representation- LMC and PCTs • Social community • Educational network- with GP tutors • Website- receive alerts about vacancies, lectures, etc

  4. membership • Apply on line (discount) or on paper • Fee £20 (£15 if online application) • GMC cert • Inclusion in list/ JCPTGP cert

  5. Learning to manage your work • Being clear about bookings: (workload, times, paper work, fees and “Extras”)- on phone • Decide holidays well in advance to avoid cancelling • Confirm in writing ** • Produce invoices and pension forms for signature on time

  6. Picking your practice • training ? • Rural/urban • PCT • Asylum seekers-transitional care • Single handed • Paperlight • Computer system • branches

  7. Bookings • Always in writing- (NANP has standard, NB NELG terms) • “NELG terms”= 16 +2v+16 plus own letters only • Visits= routine<12pm • >12pm=“late” calls (extra fee) • Payment will be expected by … (NB some PCT practices) • Dates, times, • “add on fees”- extras appts visits, on call, Prescriptions, reports ? • Ask for induction pack

  8. Longer term locums • Agree in writing • Workload • Fixed days • Fee schedule- for extras ?on call • Holidays/ cancellations notice/ cancellation fee • Induction • When you want paying • Salaried v LOCUM

  9. Pensions • Form A for each practice/ month • Form B for each months cheque • Use a spreadheet !! Easier • Ask for receipts from CSA or PCT • Write to pensions agency annual for statement of contributions

  10. Working out your fees • Costs: (MDU, running car, sickness protection, telephone, mobile, etc) • Expected weeks of income- allowing for annual leave and study leave and “wasted” slots, and admin time. (NANP ready reckoner) • How much principals earn minus ? x% • Work out daily rate • Extras for: travel, on call, additional pts, visits

  11. Challenges (a) • Badly stocked rooms/no password/ No induction pack • Staff who don’t understand your booking terms e.g. extras, on call, late visits • Consistency versus flexibility (e.g. repeat prescriptions, delegated tasks)- managing risk • Functioning as a team, handovers, sharing plans, discussing problems • Door closed !! (at lunch) • No directions • Payment delays

  12. Challenges (b) • Diary management: Peripatetic v longer locums • Avoiding isolation • Loss of NHS benefits (12 months for sickness and 3 months for maternity) • Difficult to follow patients through on short terms locums • Deskilling in chronic disease, baby clinics, ANC, computer skills, etc. • Remember “black boxing” in nelg

  13. ScHARR report on NP appraisal • Responsibilities of PCT, deaneries- to include NPs “in the loop” • Responsibilities of practice to include Nps in educational meetings- professional exchange, induction packs, etc • Improve flow of funding for CPD • PCT to appraise Nps on their Suppl lists • NPs responsible for keeping up to date and participating in appraisal (GMP)

  14. Receiving information • BNF and NICE- NHS response line • DTB • Public Health Alerts, e.g. cascades from CMO- ask for your details to be added by emailing icdb1@doh.gsi.gov.uk. They will ask you to complete a form. • Department of Health Bulletins and RCGP newsletters- these are distributed to drs who sign up on doctors Net. • Department of health Primary Care bulletin-- To request the bulletin each month on e-mail please send your details to: gpbulletin@axismediaservices.co.uk • Journal content alerts- register with each one • Curr probs pharmacovigilence

  15. New model salaried contract - 1 • Full time is 9 sessions- implications for: • Pensionable service • Seniority • Golden hello • CPD allowance • Bank holidays • Protected CPD time 1 session/wk fulltime, pro-rata PTime • Whitley maternity and sick pay & Continuity of service

  16. New model salaried contract -2 • Workload defined (job plan) explicit (e.g. out of hours, meetings, administration) • Salary range but no automatic increments • LMC levy paid at source • No restrictions on work outside of contracted hours. • Additional hours only by mutual agreement between employee and practice and remunerated or time in lieu • Extra statutory holidays (like hospital staff) • NB: SENIORITY, & PMS

  17. Types of Salaried posts • PMS posts • Career start • Flexible Career Scheme/ Retainer • PCT non-principal post (usually rotating) • PCT salaried principal-employment

  18. pensions • Final salary pension= • Years of service x final salary • Years of service e.g 5 sessions for 20 years under new contract is 20x5/9= 11 years Versus 10 years service under 10 sessions contract Or 9 years under 11 session contract.

  19. PMS Salaried posts • Often based on partner role but can feel open ended commitment to cover their interests inside or outside the practice • Know where you will work and with who • Can feel second class in practice • Short term 2-3 years • Golden hello

  20. Career Start • more time for CPD • Peer group • placement may be a lottery- and part-timers, pregnant may get second choice • Sabbatical • Locum style working – less control and just as much isolation • Good terms and conditions (Whitley) • Some get golden hello

  21. FCS and retainer • more defined workload- session=4hr, No O/C but may feel second class, pay worse • Retainer 5 years (10) • FCS 3-4 years (golden hello) • Model contract based on national model • Educational superviser • CPD time as per model contract • Minimum standards for practice

  22. PCT salaried non-principal • Desperation !! To bail out problem practices • May rotate –again to problem practices • Sweeteners- sabbaticals, CPD etc • Golden hello

  23. PCT salaried principal • Management responsibility • No financial liability • Employment benefits (sick pay etc) • Easier to leave than partnership • Can feel like worst of both worlds • Better paid than Salaried NP

  24. Looking after your CPD • Register for HPE- do your PDP now • Monthly non-principal lectures at NGH 1st wed of month • Make sure your GP tutor for NPs knows about • Join NELG – more info and less isolation • Start your appraisal folder NOW- see appraisal page NELG website for toolkit

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