Practice Structure and Organisation

1
Practice Structure and Organisation

• An Introductory overview

2
General Practice

• Independent Contractor
• Employed by LHA
• Provide General Medical Services OR
• Personal Medical Services
• Demand-led Service
• secure long-term contract
• taxation advantage

3
Independent Contract

• GMS or PMS
• Core Services
• Item-of-Service payments
• Target payments
• Drug/Dispensing payment
• Reimbursement

4
Partnership

• Partnership Agreement (contract)
• Teamworking
• Trust
• mutual support
• buddying
• covering duties
• sharing workload
• Rotas

5
Partnership

• Strengths/Weaknesses
• Roles
• Chemistry
• Numbers/divisions
• Bonding/cohesion
• Flexibility/tolerance

6
Holiday Rota
7
Structure
8
Roles

• Practice Manager
• Practice Nurse
• Dispenser
• Receptionist
• Secretary
• Data Clerk

9
Attached Staff

• District Nurses
• Health Visitors
• Palliative Care Nurse
• Midwife
• Podiatrist

10
Other close contacts

• Podiatrist
• Mental Health/Drug Abuse
• Gynaecologist
• Chiropractor
• Homeopath
• Audiologist

11
GP Registrar

• Roles Responsibilities
• Supernumerary
• Protected training time
• Self-directed learning

12
Premises

• Health Centres
• Cost-Rent Scheme
• PFI/LIFT
• Equity Partners
• Use of space
• Long-term return

13
NHS Primary Care Structure

• Department of Health (DoH)
• NHS Executive (NHSE)
• Regional Health Authority (RHA) (Trent)
• Local Health Authority (LHA) (Lincolnshire)
• Primary Care Group (Trust) (East Lindsey)

14
East Lindsey PCG

• Determines local health needs
• Deploys resources to meet needs
• Holds Prescribing/Staff budgets
• Clinical Governance

15
Taxation

• Schedule D
• self-employed
• expenses wholly and exclusively
• Schedule E
• PAYE
• tax code given
• expenses wholly and necessarily

16
Professional Expenses