The Life of a Locum GP

1. The Life of a Locum GP Lynda Carter

2. Objectives YOURS • how you personally had gone about finding locum work/getting yourself and your CV known etc • any forms you needed to fill in/who you needed to liase with to be above board and legit! • if your 'technique' changed or if you would do anything differently should you do it again • financal aspects of being a locum

3. Objectives MINE! • Pros and Cons of Locuming • Models Of Working • Getting Started • Branding your career • Career development

4. The Plan! • Pros and Cons • Models • Finding Work • Organising: terms and conditions rates • Administration: paperwork and equipment • Finances: tax, NI, pension • Getting Started • Career Development

5. Why Locuming Works For Me • FLEXIBILITY!!! • Variety – location, type of work • Discontinuity (Less to take home)

6. Why Locuming Might Not Be For You • Insecurity • Lack of benefits • Isolation • More new patients • Loss of continuity

7. Models of Working • Self employed as freelance • Agency work • Locum Chambers www.pallantmedical.org.uk www.yorkshiremedicalchambers.co.uk • Limited Company (no NHS pension)

8. Finding Work • Use your practice manager! • Network – meetings / friends • Consider personal phone calls / visiting practice managers • Business cards / own website? • www.gplocum.org – Lancs / Manc / Cumbria • Susan.Gibson@eastlancspct.nhs.uk • mary.mackenzie@yorlmcltd.co.uk – Bradford and Airedale and N. Yorks • Leeds Sessional GP Group kdpollock@doctors.org.uk • www.locum123.com • Agencies

9. Organising Work – Terms and Conditions (or none?) • Bookings –email / mobile / diary / online • Booking form – parking / phone number • Sessions – appointment length, number of appointments, administration from consultations, visits • Repeat prescriptions (NASGP article) • Non NHS work • Late cancellation charges / late payment charges

10. Organising Work - Rates • Negotiate – think hols / SL / sick leave / indemnity • Short term vs long term work • Off peak vs peak

11. Local rates • Competition Act1998 – Office of Fair Trading • MedEconomics survey Feb 2009 – GP • Yorkshire Daily £340 - £700 Half day £200 - £350 2 hours £120 - £198 Hourly £60 - £88 • http://www.healthcarerepublic.com/search/management/private_fees/news/937332/Locum-Rates/

12. What You Need To Get Started • CCT • GMC • Primary Performer’s List confirmation letter • Medical Indemnity • CRB check • CV! • Serology

13. Equipment • Doctors Bag • Drugs • Computer • Phone / internet

14. Finances • Get an Accountant! • Banking – get a business account • Use software - Penny Perfect www.pennyperfect.co.uk • Register as self-employed with HMRC (within 3 months of starting work) http://www.hmrc.gov.uk/working/intro/selfemployed.htm#1 • Complete DD for NI class 2 • NI class 4 gets paid when tax is paid • Sickness insurance / income protection

15. Financial Records Income Expenses • Car – mileage (home to practice / visits / meetings) or insurance, breakdown, repairs, tax • Equipment • Home as office • Telephone / internet • Computer • Courses (abreast of developments) • Indemnity / GMC / BMA / RCGP • Pension / Gift Aid

16. Pension • From 1 April 2013, GP practices will take on the costs of locum employer’s pension contributions in England and Wales, which have until now been paid by Primary Care Organisations (PCO). • The current funding for General Medical Services (GMS) practices will be transferred into Global Sum Equivalent payments. An average GMS practice with around 7,000 patients will receive an extra £1,000 a year as a result. • It is for the NHS Commissioning Board (NHSCB) to decide how locum pension costs will be handled for Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) practices

17. Pension • The new Locum form A clearly distinguishes between the actual fee, the pensionable pay (which is 90% of the fee), and the employer contributions which are 14% of the pensionable pay. This is so that it is crystal clear to all parties that the 14% employer contributions paid by the practice from 01/04/2013 are separate and in addition to the invoiced fee/pensionable pay • http://www.lmc.org.uk/visageimages/newsletters/GPC/LocumEmployersPensionContributions.pdf?campaign=wizemail&dm_i=JW0,1DC91,6NF9B7,4NA2O,1

18. Pension • Form A – one from each practice http://www.nhsbsa.nhs.uk/Documents/Pensions/GPLocum_A_(V7)_-_03.2013.pdf • Form B – one per month (needs to be submitted by the 7th of the following month to WYCSA or equivalent) http://www.nhsbsa.nhs.uk/Documents/Pensions/GPLocum_B_(V7)_-_03.2013.pdf

19. The start of each Session.. • Arrive early • Locum Pack • Computer system and Passwords • Check room – pxs, sick notes • Calling patients • Bloods • CXRs • Referrals • Who do you ring

20. Career Development • OOH / prison work / AE / medical journalism / education • Appraisal / Revalidation • PDP • Medical Update and other meetings • LMC • Leeds Sessional GP group kdpollock@doctors.org.uk • BALM Alison.Baker@bradford.nhs.uk

21. Branding your career / USP What a Personal Brand is about • Self awareness • Authenticity and personal integrity • Developing your unique selling point • Helping you gain a competitive advantage

22. What do I wish I’d done differently? • Computer record keeping • Accountant • Business account • Not worried about not getting enough work • Don’t accept too much work • Negotiation re pay • Sickness insurance

23. Resources • lyndamunro@doctors.org.uk • NASGP www.nasgp.org.uk • Robbie Coull - Locum Doctor Survival Guide https://www.locum123.com//index/html/survival_guide • Penny Perfect www.pennyperfect.co.uk • LMC www.yorlmcltd.co.uk • RCGP www.rcgp.org.uk • Medicalupdate.co.uk