Beyond VTS

1. Beyond VTS Dr David Derby MBBS, MSc, DRCOG, MRCGP

2. What do you want? • Partnership • Salaried • Locum • Time off • Others-military, volunteer, cruise ship, etc • Career change

3. Pursue your dreams • Nothing is impossible • Start your preparation now • Get advice, research • Start with what you have

4. First- PMETB • Get on the GMC specialist register • Get on the PCT performers list as a GP, you should be on one now as a registrar For Barking, Dagenham and Havering: contact Jenny Holmes, Becketts House 2-14 Ilford Hill, Ilford IG1 2QX, Tel: 02089265112 Require ORIGINALS of PMETB cert of specialist training GMC certificate Identity-Passport CRB check less than 6mths old

5. START • Saving • Updating/rewriting your CV • Applying for jobs-check bmj, pulse, gp • Knowing the surgery’s in your area of choice • Sending letters of introduction • Register/get forms of locum agencies

6. Where can I find work? • In a GP surgery • OOH • UCC • WIC • Polyclinic • PCT • London Deanery

7. LOCUM • 25% of fully qualified GPS work as locums (NASGP) Why so many locums: • Cost cutting practices-fewer partners • More GPs are choosing to become locums • Great way to get a feel of the area, staff and patients and eventually to find the perfect practice/job • Flexible and allows GPs with young children to choose when to work

8. How to get locum work • Send CV to all surgery’s in your choice area • Register with a number of agencies • Spread the word by word of mouth

9. Locum Essential • PERFORMERS LIST+GMC • MDU/MPS-appropriate cover • BLS certificate up to date • Register with HMR as self employed/Limited company • Class 11 + Class IV National insurance • Get an accountant • NHS pension forms • Join a local post graduate education scheme-PTI, EASE, New GP group • Keep appraisal/revalidation in mind always

10. FEES • Per hour • Per session • Salaried locum • Extras for on call, paper work, home visit, travel, additional patients • Negotiate well, be fair to yourself and the practice, be clear about what a session is- how many hours for consultation/paper work/visit • Payment at end of the week/same day/month if regular

11. Account • Keep a spreadsheet of all earnings, expenditure • Expenditure: subscriptions, running a car-miles/receipts for fuel, telephone, mobile, course receipts, pension, charity donations, keep all receipts • Get an accountant • NHS pension-Form A for each practice/month, Form B for each months cheque • Use a spreadsheet for all accounts • Ask for receipts from PCT • Write to pensions agency annually for statement • Susan Clark, NHS SBS, B&D/Havering PCT-02089265191

12. Etiquette • Locums are flexible, highly-trained professionals who can bring special skills and insights to practices that are disposed to take advantage of them • Once accepted don’t cancel-neither should they also • Be accessible through phone/email/text message • Get there on time-give more time if new surgery or new computer system • Learn more than one computer system- Vision and Emis most common , others- e.g. system one

13. Essential Skills • Locums require not only the standard clinical skills, but a special degree of flexibility and an ability to judge and manage risk. Partners work in the same place, use same system, with same people • Drs bag-have own BP machine, opthal, auroscope, thermometer, patellar hammer, tonque depressor, urine test strips, BNF(adult, paeds), leaflet file • Leave a consultation room in the way you found it, if untidy leave it that way-that’s the way he likes it, don’t leave your mug in the room-ask where to put it • Sign prescription you are comfortable with

14. Essential Skills • Ask for your own username and password so that a proper audit trail exists and no one can falsify another Drs notes • Adequate notes are essential to maximise patient safety, pts own GP may have made scanty notes. Write notes with the assumption that the patient may be a stranger to the next Dr who sees them • Endeavour to support the practice’s work on the QOF, enhanced services and local incentive schemes • Keep your valuables with you-theft occurs • Ask for a locum induction pack if available

15. You Can Shine • Locums bring a fresh eye that picks up problems that familiarity has rendered invisible and regular patients benefit from this • Fresh pairs of eyes not only for the patient but for the practice. Locums see almost every aspect of the practice and can spot the things that go unnoticed: out-of-date test strips, outdated BNF, wobbly stool, malfunctioning printer. A diplomatic way of informing the practice manager or partner will be appreciated

16. Appraisal • Contact your host PCT • Havering – Jan Black- 01708 465501 • Keep all certificates/thank you cards • Don’t keep certificate only- keep a record of learning points and reflections • Audit- difficult as a locum but possible- always be on the look out for opportunities, speak to practice manager/partners • Plan your PDP early and follow it through- don’t wait till last minute • Patient satisfaction survey • Look for opportunity to teach-nurses , medical student, FY • Keep all documents after appraisal- will count towards revalidation • Keep up to date-PTI, new GP group, onmedica, Gp notebook, courses, seminars, BMJ, pulse, GP magazine

17. Salaried GP • Prepare your CV to sell yourself • Model contract-BMJ • Negotiate, be clear what it involves-hours of consultation, home visit policy, paper work and fees for paper work e.g. insurance, • Leave • How many months notice before leaving • Always sign a contract before starting • Can check contract with BMA-one reason to join BMA • Superannuation, MDU/MPS

18. Future of General practice • Lots of changes coming through • Keep calm and look for opportunities • Pursue your dreams

19. Acknowledgement • Article by Dr Judith Harvey in MPS magazine • Article by Dr Richard Fieldhouse in MPS magazine • Presentation by Dr Elizabeth Howard

20. Thank you