1. Nick Pendleton

3.  LOCUM TENENS, Latin = Place holder  ‘In Place of’  A person who temporarily fulfils the duties of another.  All the duties?

4.  What will you do and how much will you charge, will any particular duties incur an extra charge?  Hourly rate, sessional rate, home visits, cancellation fee?  When and how do you expect to be paid?  Agency or find your own work, local or distant?

5.  Confirm and reconfirm bookings  Keep a diary  Do you know the computer system?  Can you find the surgery?  Will you be alone or working along side others?  Do they have a locum pack?  What should be in a locum pack?  What do you need to know before you start the surgery?

7.  Even if you have a contract as a salaried GP, the part of your work done as a locum or Out of Hours GP is counted as separate self- employment.  Therefore you will need to fill out a Tax Return.  The income you receive as a locum is untaxed  So you will need to pay tax on it!  National insurance & NHS Pension contributions also need to be paid!

8.  Make a simple spreadsheet on your computer and log the income as it comes in.  As the money comes in to your account transfer 30-40% of it into a separate easy access online savings account.  This will be needed to pay your tax bill.  Depending on what you earn and whether you also have a salaried job, you may end up with a surplus after paying your tax bill. This is better than finding you are thousands of pounds short!

9. Date received Origin of incomeGross income received Tax set aside (40%)Pension contribution made Jan 28 2011Medical Centre 1000400Yes Feb 2 nd 2011Insurance Report 6024No (not NHS) DatePayment made February 201167.50 INCOME LOG Log of pension payments made for Locum income

10.  Ask a GP colleague for a recommendation  Explain your situation to them  When it is time to fill out a tax return, they will ask you to send them details of what you have earned and they will work out a tax payment plan for you.  They can also keep an eye on NI payments and pension contributions  The cost of an accountant equates to less than one days pay as a locum, so this is well worth it!

11.  These are the forms you need to fill out at the end of each month to send to LASCA.  You send them with a cheque for a pension contribution for the work you have done.  You must declare any NHS work done as a locum and make a pension contribution.  Fill out a separate Form A for each practice you work for in that month: http://www.nhsbsa.nhs.uk/Documents/Pensi ons/GPLocumA.pdf http://www.nhsbsa.nhs.uk/Documents/Pensi ons/GPLocumA.pdf

12.  The Form A needs to be signed and stamped by the practice who paid you.  The details from all your Form As should be summarised on one Form B  http://www.nhsbsa.nhs.uk/Documents/Pensi ons/GPLocum_B_(V6)_-_02.2012.pdf http://www.nhsbsa.nhs.uk/Documents/Pensi ons/GPLocum_B_(V6)_-_02.2012.pdf  On the Form B, you work out what you should contribute and send it with a cheque and the form As to LaSCA (address on next page)

13.  This organisation administers pension contributions for the region.  GP Pensions Department  LaSCA (NHS)  3 Caxton Road  Fulwood  Preston  PR2 9ZZ

14.  10% allowance for expenses – Deduct 10% from your gross income, and calculate the pension on the remainder.  8%, 8.9%, 9,9%, 10.9% pension contribution?  http://www.nhsbsa.nhs.uk/Documents/Pensi ons/Tiered_Employee_Contributions_2010- 11_Factsheet.pdf http://www.nhsbsa.nhs.uk/Documents/Pensi ons/Tiered_Employee_Contributions_2010- 11_Factsheet.pdf  Your contribution is based on your estimated income for the coming year  Ask your accountant for help with this!

15. Total gross NHS locum pay£6000a Professional expenses deduction (a x 10%) £600b Net NHS Pensionable Pay (a-b)£5400c Pension Scheme Contribution 8%, 8.9%, 9,9%, 10.9% £480.60d Added years------------e MPAVCS------------f Grand Total£480.60g 5400 x 0.075 = £480.60. Write a cheque for £480.60 payable to LaSCA NHS And send it to them. Try to get it there by the 7 th of the Month following the Month you are filling in the form about.

16.  Are not taxed, so your accountant will need to know your contributions so they can lower your tax bill accordingly.  (You could send them copies of your Form B for the year)

17.  These are complicated as there are different types of contribution depending on what type of employments you have.  If you employ an accountant, you can ask them to administer this for you.  You can opt to pay monthly or all at once at the end of the year

18.  These are the forms used for Out of Hours work pension contributions. In Bolton these are completed for you and sent to you for signing & returning each month.  They will need to know what rate to deduct (5, 6.5, 7.5 or 8.5%) see earlier section.  You also need to save a copy of these forms to help with tax return completion.

19.  This is any private work you do, not for an NHS body, eg. locum agency or payment for insurance reports etc.  You need to pay tax on this income, but you cannot make pension contributions on this type of income.

20.  Generally society memberships and fees paid in order for you to do your job can be deducted from your taxable income.  MDU/MPS  RCGP  BMA  GMC

21.  You must pay tax on all the income you earn, including for completion of reports, payments for taking part in surveys etc.  HMRC may pick you for investigation and then failure to pay appropriate tax could be treated as a criminal matter

22.  They need to know if your employment situation changes. They definitely need to know if you are going to be doing locum/Out of Hours work, and if also if you later get a new salaried Post.

23.  This is a free service.  You can join the BMA and then un-join when you no longer require their services.  You can send them a contract you are considering signing for a salaried post and they will advise you of the implications of the contents.

24.  Join a local Non-Principals Group for support and ideas of how to meet the requirements  It is harder to collect evidence as a locum, but not impossible, you just need to think about it and plan how you are going to do it.  Eg. Give practices you have been working with a feedback questionnaire. If you work in 1 practice often, ask if you can do a simple audit.

25.  Locum work can be risky  Plan to arrive early so you are not stressed  If you have never used the Clinical IT system before then, find out how to use it before you have your first patient in the room with you.  Be polite, friendly and professional to the staff.  Ask if they have a locum pack.  Consider going to practice meetings, if you are working with a practice often.  Ask for help if you need to.  Be careful of doing too much work!