sygn evening – 16/10/12 “how to survive general practice” use our gp website for: referral...
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SYGN evening – 16/10/12“How to survive general practice”
Use our GP website for:
•Referral forms•Online referrals•Consultant directory•Education meetings•Consultant presentations
www.spiregatwick.com/gpinfo
Bit about me
• Qualified from St Georges 2002• PRHO, 3yrs medical SHO, 1yr AE Registrar• East Surrey VTS shortened scheme Aug07-09• 2009 to 2011 ad hoc locum and salaried locum• Offered Partnership August 2010• Started full time Partnership September 2011
E-portfolio: It never ends!
• PCT decide which one you have to use• Surrey uses RCGP: currently free. • http://www.rcgp.org.uk/revalidation_eportfolio_home.aspx
• They will allocate your appraiser if don’t hassle them +++. Abigail Holm for Surrey [email protected] 01372 201 631
• CPD points, Courses, audits, significant events, PSQ, MSF, PUNS and DENS.
REVALIDATION STARTS NOW
Things you should already have• GMC: GP register, Local PCT: Performers list• HMRC registered as self employed + class 2 NI
http://www.hmrc.gov.uk/working/intro/selfemployed.htm
• Defence Union letter, CV, Letter about yourself
• A5 picture card for patients?• Calendar, Invoice program, Sat-nav• Doctor’s Bag
Job options
Locum• Choose what work• Choose pay• Holiday when want• Money better• Find long term job in
good place / trial
Salaried• Regular income• Sick, study, maternity
and holiday pay• Member of a team• Tax and pension
deducted before paid• May be tied to place for
length of contract
Locuming: The annoying things
• Still have revalidation• No sick leave or study leave and no pay if
don’t work• Have to look for work• Negotiating rates and work• Easy to work too much• Save for tax man AGHHHH
Getting Jobs• Ask your practice manager to spread word• Canvas local/wanted surgeries with CV + letter
to manager• Network with VTS to email if people needed.
Word of mouth is huge• Locum agencies• PCT locums• Out of hours
Future Job Options• Long term locum• Sessional locum: Work regular session like salaried but as locum
• Chamber locum: Group of locums who sell services• Salaried• Partner• Media doctor• Cruise Ship Doctor: Good pay, see the world• Private Doctor: In surgery or for companies• Pharmaceutical Industry• Go back to hospital• Rio 2016?
How to get ahead • When work make time to chat and get along with the manager,
reception and any non doctor staff. Manager will get your name out locally and if any jobs coming up in surgery you will get opportunity.
• If work regular get involved - go to meetings, education events, nights out. Take out extra duties - audit, practice meeting agendas - review of drugs/notes (these should be quick and not take up ages of “unpaid time”). Be willing and open to areas of need at the surgery - nursing homes, contraception, partners retiring in next few years, salaried Dr’s leaving / pregnant.
• By doing above people see you are interested and keen and easy to get on with. Bit extra work now pays later.
• WARNING: Practices can try to overburden you. Negotiate on rates, work and load.
RatesWeekly rate Day rate Half day inc
visits Two-hour surgery
In hours per hour
London £1,000-£2,500 £300-£700 £180-
£337.50 £140-£230 £40-£100
£2,473-£2,500 £450-£500 £200-£250 £130-£150 £60-£90
South East Coast £300-£520 £170-£350 £130-£200 £60-£90
£450 £200-£250 £70
Mine £410-550 £250 £200-225*
My rates: I charge ½ day or full day rates +/- visits. £50 extra for visits or “on-call”. Often when start locum job work is light then gets heavier and take on more duties. At that time may need to re-negotiate.
My jobs• 1st job at local surgery through my practice manager to
cover partner annual leave for few weeks. Extra shifts later for sickness and annual leave.
• 2nd job at my reg practice 6 month extended to 1 year maternity locum. Then asked to stay on with view to partnership.
• 3rd Job word of mouth via practice manager few days a week to permanent work. Heavily involved in partnership and took over EMI nursing home
• 4th Job via VTS mass email. One day then offered 4 months 1.5 days then more regular days.
Job number How Got Job AM Clinic Pm Clinic Half Day Full day
1 Prac manager 2.5hrs 2hrs £205 £410 or £450 with visits
2 Reg job 3hrs 2hrs £225 £450 with visits
3 Prac manager 2.5hrs 3hrs £200 £410 or £450 with visits
4 VTS e-mail 2.5 2 £225 £410 or £450 with visits
Overview of jobs
1+4: Low work load, easy job2: Heavy work but thinking long term job offer. Renegotiated £550 for full day with nursing home cover when days I work reduced3: Started off easy with large lunch break to go swimming but work increased and paperwork heavy, practice meetings, audits, took over Nursing Home would have been back up partnership practice. Renegotiated £450 a day with £500 if visits or on-call
Negotiating Tips Decide on your minimum worth If a job is quiet and easy review situation If thinking about job there, may take lower pay or do extra
for nothing If work hard, get involved, patients + staff like you (very
important and huge importance) you will be able to negotiate easily
If work load changes monitor and then discuss, they may prefer to take work away or pay more.
Write an e-mail or letter detailing matter Do not let it affect your work, it is business
Locuming
• Calendar, Invoice, Get paid, Pension A+B, if OOH C+D, mileage.
• Penny Perfect: £29 a year BUY IT-locumorganiser.com £12 a month
• Pension: Pay to Surrey PCT ND. Amount varies on income, added years ect. You can claim back tax on this with self assessment.
Tax Rebates
• REBATES: GMC, BMA, MDU/MPS, all subscriptions journals, work items (bag, steth, otoscopes ect).
• Phone costs• Stationary, printer costs• If have study used for work can claim % back
on heating/mortgage ect I would not.• Pension: Private and NHS (if locum)
Motoring expenses: http://www.hmrc.gov.uk/rates/travel.htm
• 2011-2012: 45p per mile for 1st 10,000 then 25p per mile (on your business miles not all). Work out your business to personal miles. Accountant get you to do typical month record.
• OR can claim all car costs ie servicing, MOT, road tax, RAC/AA, tyres, any service parts, Petrol - need to keep all receipts (VAT receipt on petrol). You then again claim back business %. Can claim depreciation or interest on loan as well depreciation max £3000 a year
In summary
• GMC, Performers list, Defence union• HMRC + self employed + self assessment• Best jobs word of mouth• Penny Perfect program• Get an accountant• Spend time with staff and have fun• Go to meetings and get involved• Have fun and enjoy life