Locum vs. Salaried GP

1. Locum vs. Salaried GP Fran Fieldhouse MBChB, DRCOG, DFFP, DTM&H,MRCGP

2. Aims • To discuss the differences between salaried and locum GP jobs, and enable you to decide which route to take and how to go about it.

3. My profile • Qualified Manchester 1998 • Stand alone SHO jobs in London (O+G, A+E, paeds, medicine, palliative care, GUM, psych) • Voluntary work in Zambia, Tunisia, Sudan • GP Registrar year in Camden, North London 2005 • Salaried part-time at training practice and Gray’s Inn Rd • Full-time at Grays Inn Rd • Locum in Oxfordshire from 2008 • Salaried GP at Nuffield practice Witney 2010

4. Salaried GP Job plan • Clinical duties: appointments, visits, dealing with telephone queries • Administration/paperwork: whether arising directly from this caseload (referrals, investigations, results) and indirectly (reports, medicals, etc). • Primary care team meetings: formal or informal, essential to the delivery of team based care, discussing clinical practice standards, developing practice protocols, mutual professional support for the individual practitioners, audit, significant event analysis, meetings with colleagues in the locality, care trust etc. • Personal CPD (continuing professional development) time: This may include a mix of in-house meetings and events, time away from the practice, either in private study, attending educational events or time in lieu of attending educational events outside of normal working hours. • Time for personal mentoring • Specific specialist roles in the practice: e.g. medical student or registrar teaching or training, responsibility for particular areas of practice development, Quality and Outcomes Framework (QOF) areas of responsibility, 'Practitioner with Special Interest' etc.

5. Salaried GP • GMS Contract • Sessions of 4hr 10mins • Holiday 30 days • Minimum salary £52,462 for 2008/09 • CPD-equivalent 4hrs per week • Maternity pay • Sick leave • PMS-not obliged to offer the model contract

6. Considerations • Pay (according to experience/other GPs) • OOH work • Subscriptions paid? • Bonus/yearly pay rise • Study time, educational meetings at work

7. How to get a salaried job • BMJ • Pulse etc • Word of mouth • Training practice

8. Pros and cons • Ideas?

9. Pros and cons • Job specification and regular income • Benefits of being in one place: continuity/training/other opportunities • Feedback/presents • Route to partnership • Status • Not a partner-wage/responsibility/opportunities • Conflict w partners/risk of exploitation

10. My experience

11. Locum • BMA very little guidance • Unable to recommend pay • Eligible for NHS pension scheme • Work either sessions or hours • Paperwork/visit vary • Long term locums

12. Considerations • No holiday pay • No sick pay (state) • No maternity benefit (state)

13. How to set up as a locum • Agencies • Word of mouth • Sending c.v. • Oxnog

14. Oxnog.org

15. Administration • Helps to be organised-GP bag, record of log-ins, knowledge of different systems • Invoicing • Pension • Expenses

16. GP Locum A form

17. GP locum B form

18. Invoicing, pension, tax

19. Pros and cons • Ideas?

20. Pros and cons • Wage • Flexibility • Holidays • Other interests • Experience different practices/computer packages • Different type of medicine • Training • Status/Christmas parties • Administration • Overheads

21. My experience

22. Other stuff • Out of hours • Young principles group

23. Thank you • To discuss the differences between salaried and locum GP jobs, and enable you to decide which route to take and how to go about it. • Hope it helped!