Starting Locum Work as a New GP by Dr Matthew Beddoe & Dr Surina Chibber

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Hello!

Portfolio GP Finished VTS 2 years ago, sitting where you are now Decisions on what kind of career I wanted to create Flexibility, financial considerations, new skills I wanted to develop two years on 1) health tech/entrepreneurship, education and writing In the beginning I decided to start my career as a locum but it was difficult to know how to start Common pitfalls practice hadn’t paid, job has been cancelled last minute, also had to prepare for my tax return Record of all these quesitons and pitfalls that i navigated I found my locum admin built up tried different approaches but I use my phone like you all for everything from emails to internet banking and I wanted a similar solution for my locum work so I decided to explore my interest in health tech and create a solution I tried other options but like many of you I use my phone for emails, booking jobs, internet banking and I needed to help save me time and money Co-founded MyLocumManager Resources to help anyone wanting to get started this was my first health tech venture and I have now become in two others. One is improving access to mental health which I am working on collaborating with NHSE with. The other is a cardiovascular project for my local CCG Teaching Writing I am loving my career and I am really excited about the future, learning so much and really passionate about the work I am doing

I qualified in 2011, and have taken on a variety of roles since then. I started off working part time as a salaried doctor and topped it up with locuming. I’d really recommend this if you have the opportunity as it gave me some stability, but I was also able to see a variety of different practices and areas to find where I felt most at home. I got some really good locum experience during this time, working both around the local area where I trained as people knew me there, but also doing some agency work. The flexibility that this provided also gave me the time to pursue other interests. I got involved with the CCG improving physiotherapy services in the area, and also teaching. Since then I have become a GP partner and also a GP trainer. And alongside Surina, we have worked in the Health-Tech sector to create our website - MyLocumManager. We will show you how this can help you later on.

Overview Introduction Questions? Preparing for work Finding work - Agency vs Independent Setting pay rates Managing your finances and MyLocumManager Pension forms Common work problems & solutions Support

Preparing for work Up to date CV Certificate of Completion of Training (CCT) GMC certificate Performers list inclusion letter Certificate of indemnity cover (MDU,MPS, MDDUS) Valid DBS check Immunisation record References Copy of passport If you are planning to locum, there are a variety of documents that you need to have on hand for any prospective practice/locum agency. Some of them can take a little while to get organised, I remember as soon as I qualified I was desperate to get out there and start work, but couldn't until I had sorted out my paperwork - so the key is to do everything you can in the run up to getting your CCT so its all good to go. I’d recommend having this all scanned and stored on your computer, or even better, something like dropbox. This way, when you need it, you can easily just send all the relevant documents by email on your phone.

Stethoscope Pulse oximeter Urine dipstick Glucometer Auroscope Doctors Bag There is great variability as to what equipment will be available to you when you arrive at a practice, therefore always be prepared. What you need for a typical surgery and home visits. Useful items include: Stethoscope Pulse oximeter Urine dipstick Glucometer Auroscope Ophthalmoscope Tongue depressors Doppler Thermometer Peak flow meter Urine pots Lubricant Tape measure BP machine Gloves *Drugs

Finding Work Agency Vs Independant Agency: large work volume, lower pay, less flexibility, Cannot contribute to NHS pension* Independent: Varied work volume, more pay and more autonomy and flexibility Locum Chambers Commonly most locum GPs work independently then ‘top up’ with agency work during quiet periods

Key points for finding work: -Contacting practices directly (http://www.nhs.uk/Service-Search/GP/LocationSearch/4) Contact training practices on your VTS Local CCG (https://officelondonccgs.org.uk) Join the locum lists on your Local Medical Committee (http://www.lmc.org.uk) When you book work ensure both you and the practice are aware what the work will involve. Use a ‘terms & conditions of work’ agreement.

Key points for your work day Arrive 15 minutes early Introduce yourself to key staff Ask for the locum pack To ensure you are well prepared here is a useful checklist : What is the extension number for reception? Where is the panic button? How do I call patients in? How do I request blood tests and where are these done (on site or local hospital) How do I order X-rays and Ultrasounds How do I refer for physiotherapy and counselling Where are MED3, MATB1 and maternity exemption forms kept How do I create referrals After Work Invoice & Pension forms Learning points - Reflection & appraisal END OF THE DAY INVOICE PENSION FORMS REFLECTION APPRAISAL

Setting Pay Rates Pay structure depends on: Hourly Rate = 3 hour clinic (2.5hrs patients, 30min admin) Whole day package = AM +PM (+HV, oncall, lunch)

Admin (review hospital letters, blood results) Sign scripts Locum work involves: Seeing patients Home visits Admin (review hospital letters, blood results) Sign scripts On-Calls (duty doctor) Pre-booked Sessions: Clinics usually last 2-3 hours Should have 10 minute appointments Extra time for signing scripts and admin OnCall/Duty: Half or whole day package Patients + Admin + Telephone triage + HV Remember: Negotiate fairly with practices It is usually expected that you complete your self-generated admin within your allocated session time.

Managing your admin Up to date diary Invoices Pension forms Expenses Self-Assessment Tax* When you are working as a hospital doc/registrar/salaried dr. Everything is done for you your payslips come in with tax already deducted your pension is sorted When you work as a locum, you need to do all this yourself - it is imperative that you keep organised and on top of things. This is easy to let fall by the wayside when you have so much clinical work to do: I remember when I started, my diary keeping was definitely not what it should be and I ended up turning up to a practice on a Saturday morning ready to work and they had absolutely no idea who I was! So make sure you: Have an up to date diary Have a system to send and keep track of your invoices and payments www.MyLocumManager.com

Pension Forms Form A Form B GP SOLO

You cannot claim NHS Pension If you work as limited company For work over 10 week ago Agency work (exceptions are some online agencies) For private work How to contribute to nhs pension (1) invoice (2)PFs (3) cheque book Invoice date, your name and the practice name unique ref no. summary of the work done and amount you are invoiing for. If you are pensioning your work (England and Wales) you need to add a sperate charge for the employers contribution this is 90% of your invoice PENSION FORMS FORM A FORM B Solo form A The purpose of this is to certify the work done at a practice and the amount you earned Add the employers (practices contribution to your pension ) this is 90% of the invoice (you form b Is a monthly summary which records all pensionable payments recieved in a given month. You generate the forms according to the date you were paid not the date you worked you need to send off your pensioj forms to the PCO by thew 7th of the next month (within 10 weeks of being paid for the work) If I worked in June and was paid in July I generate a pension form B for July Form B contains the calculations for your employye contributions and the emplyer (practcie cotributions) where to send forms Primary care organisation for your local area team. cannot claim

Common Work Problems (and how to solve them) Computer systems Dealing with uncertainty Cancellations Late payments Time management

Support GP Life after VTS Facebook group Mentoring TGG Facebook group Other locum doctors CCG/LMC Locum forums RCGP First 5 Me! @dr_surina surina@MyLocumManager.com matt@MyLocumManager.com To be notified of any locum events, advice or useful articles Like facebook page

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