So What Happens Next

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So What Happens Next?

• By Katie Weedon

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Plans

• Locum
• long term e.g maternity locums
• short term
• Salaried Work
• Partnership
• Other
• OOH
• Specialist clinics e.g. Family planning, GPwSI

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What do I need?

• GMC cert
• PMETB cert
• To be on the medical performers list
• You can only be on one areas list, but can still
  work in other regions
• CRB check
• MPS/MDU subscription
• Necessary immunisations

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Locuming

• Pros
• See how different practices run
• Find out where is good/bad to work
• More knowledge about local services
• Flexible

• Cons
• Unfamiliar practice/staff
• Unfamiliar referral catchments
• No breaks
• Lonely
• No follow-up on patients
• Sometimes no feedback
• No paid leave

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LOCUMING

• Many options of ways to work
• Per hour
• Per surgery
• Per session, with or without visits
• Per visit
• Per day, with or without visits and duty
• Per week
• Will you be covering for
• Paperwork
• Duty
• Extended hours

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How do I get setup?

• First tell Rosemarie Merridew at the PCT your
  plans.
• Get registered as a locum
• Register with the pensions department
• LET THE TAX OFFICE KNOW YOU WILL BE SELF
  EMPLOYED!!!
• Pay NI directly
• Sort out suitable MPS cover

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How do I find work?

• Locum agencies
• www.team24.co.uk
• www.medacs.com
• Local bulletins
• www.lmcs.info
• www.gpnetworks.co.uk
• Word of mouth
• Mail shot

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Barriers

• Computer system knowledge
• Vision/Torex/Healthy
• Ask someone you know to give you a tutorial/ ask
  the practice
• Not knowing local area policies and who to refer
  to
• choose and book
• locum packs

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Have a guess at the following

• Locum wages
• per hour
• per session
• per visit
• per day

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Rates as reported Dec 09MedEconomics survey Feb
2009 Responses from 446 GPs
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Locuming

• Per hour
• 60-70
• Bear in mind surgery lengths
• Distance to travel
• Per session
• am (incl visits) 200
• pm 150

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Locuming

• Per day
• 300-400
• So per week
• Based on 8 sessions - 1400
• Or per month
• 5600

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How does it work?

• Prepare to have no money for the first month!
• Need to invoice surgeries and wait for cheques

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BUT...

• Also need to factor in professional indemnity
  Group 1 GP partner Group 2 GP locum/salaried
  (MPS 2009)

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Pension

• 6.5
• Need to calculate your own each month
• Send one pension form A to each practice with
  invoice and ask to return
• Calculate pension on pension form B
• Send AsB to pensions department with cheque,
  within 10 weeks of locum

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Paperwork

• Keep good records, as now self employed you are
  compelled to fill in a tax return at the end of
  the tax year
• Consider keeping back a percentage of money
  earned to pay the tax bill at the end of the year

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The bottom line is.

• If you are earning approx 5600 as a locum less
  40 for tax and pensions
• Take home is in the region of 3360

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Permenant Work

• Pros
• Familiarity with patients/staff
• More control over the way you work
• Choice of practice
• Less travel
• Regular income
• Paid leave/benefits
• possibly paid MDU/MPS

• Cons
• Less flexibility
• Stuck if you dont like it

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Where to look for a permanent job

• Adverts
• BMJ
• www.lmcs.info
• Pulse/Doctor mags/newpapers
• http//www.pulse-i.co.uk
• www.healthcarerepublic.com
• Word of mouth
• Mail shot

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Whats the market like?

• Decreasing number of permanent jobs
• Decreased funding for practices
• less replacement of retiring partners
• less taking on of salaried GPs
• more nurse practitioners
• Start looking ASAP
• practices will wait for the right candidate

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What does that mean for you?

• Practices are getting high numbers of applicants
  for each vacancy
• Can be highly specific about what they want from
  the candidates
• More competitive salaries for practices

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Salaried - what to look out for

• If doing sessional work
• What paperwork will you be expected to do?
• Will you be expected to do visits?
• How does the practice work?
• Will you be on your own in the surgery?
• How long will your surgeries be
• Will you get any breaks
• Will you be job sharing, how will that work?
• Will they pay your medical indemnity

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Average wages

• BMA recommendations minimum should be 52,462
  79,167 pro rata
• So per session 5819 - 8796
• National audit office
• Average salaried earning 46,905
• BUT average work is 23.8 hours per week
• Equivalent to 74,000 per year

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Useful information

• Excellent document from BMA
• http//www.bma.org.uk
• National Association for Sessional GPs
• 73.40 to join
• www.nasgp.org.uk
• Newsletters etc..
• Free BNF!!!!

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Partners

• More difficult now to walk into partnership from
  reg jobs
• if vacancy where registrar
• if you happen to have skills required
• good relationship
• salary

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What to look out for

• How does the partnership work
• do all partners work equally?
• if not how is profit divided?
• How long before parity?
• Is there a get out clause?

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Salary

• Much more difficult to determine,
• National audit office doc 2008 states
• Average GMS 110, 054
• Average PMS 121, 375

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Interesting,.?

• 1 in 10 GPs are now salaried
• Compared to partners...
• Generally have higher morale
• Less likely to have a drop in income
• report less infringement on home life
• BUT... 1/2 wish to become a partner over the next
  12 months
• Taken from article in Doctor (MED Economics)

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More stats

• The number of GP partners fell 5.6 between
  2005/2006
• I.e. 1 in 20 not replace
• The number of salaried GPs increased by 58.9

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OOH

• How to get on
• Depends on co-op and area
• some advertise and interview
• others will take on principles/non-principles
  from practices in the area
• Thames Doc / Susdoc

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Rates

• Weekday evening 50/hour
• Weekend 65/hour
• Bank Holiday 80/hour
• Varied shifts Base/Car/mixed

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Other Options

• GPwSI
• Contact local Consultants
• Look for ads
• Word of mouth
• Will they pay your surgery/you?
• How will your training and work be funded?

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Other Options

• Non-GP work
• Non-medical work
• Private work
• BUPA healthcare clinics
• Private OOH
• WIC/TV/AE work

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Useful websites

• Healthcarerepublic.com
• job adverts, wages/rates
• BMA
• general advice for locums, salarieds and partners
• www.gpnetworks.co.uk
• locum work and jobs
• www.lmcs.info
• local PCT vacancies
• BMJ
• Job Adverts

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Contacts

• Rosemarie Merrydew
• Medical Performers List Administrator
• Tel [phone]
• Sara Bailey
• Primary care pensions administrator
• Tel [phone]