It’s not that they don’t like the job or the patients or the staff – it’s often because they feel they’re being (for want of a better word) exploited by their employer.
We’re not suggesting here for one minute that their employer is necessarily wicked or greedy or nasty; it often transpires that they’ve just not necessarily prioritised the welfare of their salaried GP colleague; a conspiracy of ignorance, perhaps. After all, general practice isn’t renowned for the cutting-edge management of its personnel.
Booking fees £15/session.
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Amongst other things it includes:
It’s been illegal to otherwise do so since 1st April 2004, with PMS practices coming on board in 2015). NHS Professionals partly administer the scheme, and can turn down a practices/PCTs application if the model contract is not being used.
The BMA Salaried GP Model Contract covers annual leave, study time and CPD, parental leave (maternity and paternity), sessions and job plans. It’s a useful document, as well as an essential one.
Although PMS practices don’t have to offer the BMA Salaried GP Model Contract, don’t forget that you DO NOT have to sign anything that you’re not happy with.
NASGP advice remains that a salaried GP should never accept anything less than the BMA Salaried GP Model Contract.
Why is the new model salaried GP contract worth asking for?
Because amongst other things it includes:
This will be stated in the written contract. The private fee can either be entirely subsumed within the normal, regular work of the salaried GP, or there could be a provision for private work to be undertaken over and above the their usual work, stating how much of the fee they receive (bearing in mind the practice’s overheads.
For locum GPs, there is no issue as to whether or not a freelance GP can perform private work in a GP practice.
The practice and locum will need to agree beforehand whether their normal clinical caseload will contain private as well as NHS patients, with adequate time given for the private work in line with what other GPs in the practice would expect.
The practice and locum will also need to agree between them whether private work is charged at the same rate as NHS work.
If you’re doing any sort of locum work as part of your portfolio career, you’ll definitely need your own personalised Terms and Conditions to help protect both you and the practice you’re working for.
NASGP’s model T&Cs has been specifically developed for NASGP members by a specialist employment law firm. It allows GP locums to not only fully adopt all its recommendations, but also to add any necessary clauses and tailor it to suit each locum’s personal needs.
LocumDeck’s T&Cs generator allows you to set:
As an NASGP member, go to your T&Cs generator, choose your settings and then save. You’ll then be given a unique link, “View my TCs” which will automatically be added to your automated invoices, confirmation emails and session request emails, or you can paste the link into your own GP locum website.
As an added bonus, GP locums can update their T&Cs as often as they like on LocumDeck. Each change is saved in an archive, accessible by practices, for extra confidence.
In our experience, if private patients are seen within the usual agreed hours then the locum would not expect to be paid any extra. But if seen outside the usual agreed hours, the locum would expect to be paid the full private fee, with any practice overheads being offset by the additional service being offered by the locum. It makes the paperwork easier too.
A recently retired partner was becoming a salaried GP, and wrote in for some advice.
Fifteen minutes is standard in some places – you can certainly negotiate longer. Whatever consultation length you finally agree to, it must be one that lies within your personal competency and fits in with your professional boundaries.
Absolutely – it’s entirely up to you what you finally accept as your contracted hours and breaks. If you settle for something that you’re not going to be happy with, you won’t last long there.
Again, it’s up to you to agree how much time you need to feel comfortable performing this work in the allotted time, within your professional boundaries.
There are no fixed rules here – if you’re having to rush a visit, you’ll put yourself at risk. It’s up to you whether the terms fit your own safe working standards and are within your professional boundaries, only accepting what you know to be safe.
You are entitled to at least 20 uninterrupted minutes, although we recommend at least 30 minutes. It can be paid or unpaid, which is down to you to negotiate. If you don’t take a break, your performance in the afternoon would be equivalent to having drunk a few glasses of wine – it’s always in an employer’s interests to ensure all staff have at least 30 minutes for lunch, and a good employer will insist on it.
Depends on you, and a sensible employer should be realistic about the time you’ll require. Some GPs are comfortable to skip through these sorts of tasks quite quickly, others prefer a lot longer. Our experience is that a lot of salaried GPs end up being dissatisfied with their post because of mounting paperwork, and the longer you remain in post, the more the paperwork becomes, so be realistic about the time you need.
Our rule of thumb is that, on average, practice-based GP consultations generate five minutes of paperwork on the day, and a further five minutes over the following months. Double this if it was for a visit. So if you’re seeing 18 patients in surgery in the morning and 12 in the afternoon, it would not be unusual to within a few months be working an extra five hours on top of the scheduled 5 hours you were actually contracted to work as part of this job.
Salaried GPs may claim for journeys undertaken wholly in the performance of their duties. Where the practice reimburses a doctor for visits (pretty rare!), then salaried GP mileage reimbursements up to 45p per mile (assuming less than 10,000 miles a year) are tax free. Payments in excess of that (sometimes seen in payments by hospital trusts) will be treated as taxable benefits and should be shown on form P11d at the end of the year, and must be recorded on the employment pages of the tax return.
If the practice reimburses less than 45p per mile, the difference can be claimed as an expense of employment. If there is no reimbursement at all, the then full 45p per mile can be claimed as an expense of employment. Where miles exceed 10,000 per annum then the reimbursement rate drops to 25p.
The above rates relate to car travel; motorcycles can be reimbursed/claimed at 24p; cycles at 20p.
Allowable journeys for salaried doctors would include patient visits, meetings (necessary ones as part of the employment), and travel between different sites, but see the caveat below.
Home to work journeys are not allowable.
Additional mileage may be claimed in restricted circumstances such as:
Note on the other hand that if Dr E was employed on a temporary basis for the maternity leave mentioned above, home to work mileage would not be allowed because surgery Y would be his main (and indeed only) workplace.
Travel between sites cannot be claimed in the following circumstance:
The practice was running 20 sessions a week above budget, according to minutes from a meeting in December.
A portfolio GP Locum and Community Sub-Dean for Peninsula Medical School in Somerset, Dr Speller explains how she started locuming, how she built up her portfolio and her tips for starting out as a locums or portfolio GP.
Dr Bramall-Stainer told GPs: 'This regrettably falls far below what we realistically need to keep our heads above water.'
"I love getting an email to say 'a new GP locum has linked with your practice', especially when the offer of sessions is just what I’d been needing and it’s just dropped into my lap! It’s great to have everything in one place and be able to download documents so easily. LocumDeck makes the terms and conditions of each locum really clear, and I’ve built up a really good amount of offers from different GPs. It’s easy to keep track of invoices and pension forms, and it’s great that it’s free for practices to use too."
Jennie Dock, Practice Manager, Hedge End Medical Centre, Southampton, Hampshire
