Posts Tagged “GP”

Recruitment is becoming harder these days so in order to attract the best staff it’s worth spending a bit of time to write a great advert for your vacancy. If you create a template, some information will stay the same no matter what role you are advertising. Each time you need to recruit a new member of staff, you can simply slot the job specific information into your existing template.

1. Practice Name and address or location

Putting your practice name and address or location at the top of your advert is really important as it helps create a good first impression and makes it very clear where the job is. Imagine meeting someone and not introducing yourself until the end of the conversation, it just doesn’t make sense! It also means that the people who want to work in your area are immediately attracted to reading more about your practice and the role you have available.

2. Job title and hours/sessions

By putting the role(s) you are advertising and the hours or sessions near the top of the advert, candidates quickly gain an overview of the role. This allows them to decide early on whether they are interested or not. Providing as much information is important, for example, if the advert says at the top that the role is full-time and someone is looking for part-time work, they may not bother to read to the end of your advert where it mentions that part-time applicants will be considered.

3. Practice Description

Give a brief overview of your practice to allow candidates to imagine what it might be like to work at your practice. For example,

Our thriving, semi-rural GMS practice comprises 5 GP partners, 3 Salaried GPs, highly skilled nursing staff and efficient admin and reception team. We operate from modern, purpose-built premises and provide high quality care to over 7,000 patients. We are a high achieving, well-organised practice and use SystmOne. We are also a teaching practice for medical students.

In just a few sentences, you can provide a lot of useful information that gives candidates real insight into your practice and hopefully encourages them to apply.

4. What you are looking for

Next you could state what you are looking for in an ideal candidate. This could include relevant skills, experience and qualifications as well as personal attributes. Many adverts include generic terms such as ‘dedicated’ and ‘hard-working’ as if to put off potential applicants who are uncommitted and lazy!

It is important to be as specific as you can about any additional skills required for the role, for example, an interest in teaching is required as you are a training practice. Similarly, if you require the successful applicant to provide cover for other team members and be flexible about their hours, this is also worth mentioning and will help ensure the candidates who apply have what you are looking for.

5. What you can offer

Again, in order to attract applicants, you should set out what you are willing to offer the successful candidate. This might include salary and benefits, annual leave entitlement, development opportunities but also the type of working environment on offer, for example, a practice that values a good work-life balance, flexible working or a supportive working environment. You can also include whether you are a GMS/PMS practice and if you offer the BMA model contract. Some practices include humour to make their advert, and their practice, stand out.

6. Who to contact for more information

Providing a named person and their contact details is a great way of encouraging informal contact before a candidate applies. Many practices also encourage prospective applicants to visit the practice before applying so this can also be mentioned in this section.

7. Important dates

Many good adverts fail to include a closing date which can make it difficult for candidates to know whether it’s worth applying or not. You may also find that your advert is listed after the closing date and you continue to receive applications for a vacancy that no longer exists. Providing the closing date, interview date and ideal start date can help candidates plan and be prepared meaning that they are more likely to be available if they are invited for interview.

8. How to apply

Giving clear details for candidates on the application process is vital. Some practices prefer a handwritten covering letter, others are happy to receive applications by email. If your interview process includes anything additional such as simulated consultations then include this information here. Make it clear and wait for applications to flood in.

This article has been published in Practice Matters, a magazine for GP Partners and Practice Managers from MPS, full of useful articles and advice for your practice. For more information, please click here.

GPs are now legally required to have indemnity cover in following a Department of Health ruling to bring UK GPs in line with a European Union directive. Previously, GMC guidance stated that GPs were only required to have cover where necessary, the move comes at a time where the cost of indemnity cover is rising. An ANP in Weston-super-Mare has found her cover rising from under £900 last year to nearly £8000 this year despite there being no problems with her work over the last 12 months.

NHS Employers have said they will continue with plans to remove a supplement paid to GP trainees, which brings their pay in line with junior doctors working in hospitals, that could see GP trainees’ pay cut by a third. The RCGP has launched a petition to demand that the health secretary guarantees that GP trainees pay will not be cut. The implications of the new contract due to be forced on junior doctors have led to unparalleled numbers of doctors applying to the GMC to register to the certificates needed to work abroad. Tom Tugendhat, Conservative MP, has called for GPs to work for a set period of time, or pay off their training costs, before moving to work abroad. The proposed ‘return of service’ commitment would be similar to that of Armed Forces staff, for example, fighter pilots who have to serve 12 years before they are allowed to work in the commercial sector.

With the initial funding for the Government’s flagship 7 day access pilots due to run out this month, it transpires that 8 out of the 18 providers have either cut weekend or evening hours, or stopped running the service completely. Earlier this year, another 4 schemes reported similar changes meaning less than half of the pilots are still running as originally planned.

The Priory Avenue surgery in Caversham, Berkshire, one of the first practices to be placed in special measures, has now been rated ‘requires improvement’ following a re-inspection by the CQC. Meanwhile, Professor Field, CQC Chief Inspector has announced that practices rated ‘good’ or ‘outstanding’ may be inspected less frequently than every two years as planned.

The GPC has revealed its vision for the future of General Practice calling for practices to either federate into larger networks or build ‘super practices’ offering a range of services to patients. The GPC also called for the Department of Health and NHS England to increase GP funding, launch a campaign aimed at patients to reduce inappropriate appointment requests and establish an infrastructure fund to upgrade premises and technology.

The Chief Executive of NHS England has said that 7 day access is needed to reduce health inequalities as the current system discriminates against low-paid workers who cannot get time off for mid-week appointments without losing pay. Meanwhile GPC Chair Dr Chaand Nagpaul has said he is happy to discuss extending access as part of GP contract negotiations but will not agree to 7 day access. Conservative MP and former GP Dr Sarah Wollaston has said that 7 day access is ‘completely unrealistic’ whilst the RCGP has claimed that 7 day access could cost £1bn a year.

Physician Associate trainees will be guaranteed jobs at the end of their training under a trial proposed for mid-Wales. Official figures have revealed that Salaried GPs earn less than 10% more than Physican Associates with GPs earning on average £54,600 a year versus £50,000 for Physician Associates with two or more years experience. Labour MSP, Elaine Murray has said that scientists should be able to retrain as GPs via shortcut courses to help ease the GP recruitment crisis.

Figures have shown that practices’ use of Locum GPs has increased by nearly 20% over the last year with many GPs choosing to work as ‘career locums’ or supplementing their income via locuming.

The RCGP has called for A&E funding to be redirected to General Practice whilst 5 practices at risk of closure are looking to merge with local hospitals to secure their future. Practices in Wales are able to apply for support from the Welsh Government under a new scheme to help vulnerable practices at risk of closure. Meanwhile, practices in the south-west can access a sustainability assessment developed by the regional team to help them look at ways to increase efficiency and succession planning.

The Family Doctor Association (FDA) has found that indemnity fees for GPs have increased by a quarter in one year.  The BMA has hosted a summit to discuss the issue with NHS England making it a priority.

Another super-sized practice is set to be created in the East Midlands when 4 local practices merge with an existing large practice in the new year. The resulting practice will have a patient list of 100,000 cared for by 62 partners. The practice has further expansion plans to eventually care for around 300,000 patients.

The Government’s flagship 7 day access policy is in the news once again with a mixed response as to its efficacy. Official evaluation showed that A&E admissions were reduced by 3% and said the scheme was set to be extended. However, CCG leaders in Yorkshire have scrapped the pilot scheme citing poor take-up of weekend appointments as one of the main reasons for abandoning the scheme. A joint report by the Patients Association and the Royal College of Emergency Medicine has found that same-day GP appointments do not stop patients from choosing to attend A&E instead. Meanwhile, according to research by the financial regulator for the NHS in England, a third of patients find it difficult to get an appointment. Although a smaller YouGov poll found apparent public support for 7 day access.

One of the biggest stories this month was Jeremy Hunt’s ‘New Deal’ for GP which has prompted a backlash from GPs and a petition with nearly 3000 signatures. Remarkably, Mr Hunt has also called for GPs to move away from the mentality of clocking off at 7pm.

Staffing in General Practice is still a cause for concern with promises of 5,000 more GPs and 5,000 support staff including 1,000 physician associates by 2020. Although the Government has since distanced itself from the pledge for 5,000 extra GPs. In Leicester, the CCG is spending £600,000 to bring over 10 US-trained Physician Associates to work in local practices. Recruiters have said more foreign GPs are essential in order to meet this target. Whilst regulations were changed this year to allow GP training applicants who failed the Stage 2 exam in the first round to re-apply in the second round. The Welsh Government is investing £34million into GP recruitment whilst the Scottish Government has announced that a new £50million fund for GP recruitment and retention is to be spread over 3 years, replacing a one year £40million fund.

Also in the news has been practice closures. One doctor explains why she and her colleague were forced to resign from their practice after a replacement for the retiring partners could not be found. A practice in Brighton was closed with no warning, following a CQC inspection, leaving nearly 10,000 patients to use local walk-in facilities. The entire patient list was subsequently transfered to one neighbouring practice. In Essex, a third sector provider has been commissioned by NHS ENgland to take on an APMS contract for 12 months after all partners at the GP practice resigned. Meanwhile a practice in London has been saved from closure by local campaigners who persuaded NHS England to use locums to keep the practice open whilst looking for a new provider to run the practice. Jeremy Hunt has agreed to shadow a GP at a practice in Tower Hamlets, but Limehouse Practice is facing a funding crisis and may close before he gets there.

The RCGP has called for an immediate halt to CQC inspections as it emerges that nearly half of GP practices spend more than 20 staff hours to prepare for them.

A pilot scheme in Glasgow is to offer 30 minute appointments to its most vulnerable patients with researchers from the University of Glasgow measuring the impact on hospital admissions.

The Government’s flagship 7 day access pilot looks set to be abandoned by CCGs after NHS Canterbury and Coastal CCG found Saturday morning opening did not help local A&Es meet the four-hour target. Dr Maureen Baker, Chair of the RCGP, has described plans for 7 day access to GP surgeries as “coming from cloud cuckoo land”. The Chair of the BMA’s GP Committee, Dr Chaand Nagpaul, has also called on the Prime Minister to “jettison the political pipedreams of tomorrow”.

The Northern Irish Government is concerned about GP numbers with too few graduates entering GP training and only 33 trainees qualifying in 2014. Data released by the GMC shows that ‘elite’ university students shun general practice with only 16% of Oxford graduates applying for GP Entry. Researchers have found that the amount of time undergraduates spend in general practice has fallen by almost two weeks between 2002 and 2012.

A single-handed GP in London is suing NHS England after they terminated his contract despite loyal patients’ calls for the surgery to be re-opened. The practice’s 3,700 patients have been forced to register at other local practices at great inconvenience. In Derbyshire, a local hospital has stepped in after the closure of group of practices serving 27,000 patients. Another GP who has managed a 4,500 patient list for two years on his own, owing to problems recruiting a partner, has been hit with a breach of contract notice after going off sick from burnout. In the East of England, NHS managers are to identify practices at risk of closure owing to problems with finances, recruitment issues, sickness absences and applications for list closures. It is hoped that NHS England, working with LMCs, can offer support to practices and prevent closures. Over the past two years, 160,000 patients have been displaced by practice closures.

GPs working part-time have spoken out about how intense and draining the workload is and warned that GPs are ‘all out’. Whilst a report from Citizens Advice has found that GPs are spending nearly a fifth of their consultation time dealing with non-medical issues at a cost of nearly £400m.

One village surgery has hit the jackpot after a local businessman donated £1million to pay for new, purpose-built premises to prevent the practice closing.

Pharmacies are still in the news with worries that the closure of small pharmacies, particularly those in isolated communities, will increase pressure on GPs and A&E. Research shows that GPs prescribed 1.1billion items for patients in 2014, including a wide variety of over-the-counter medicines such as Lemsip and Calpol. Presciptions were also issued for unmedicated products such as toothpaste and suncream.

With more than half of GPs expecting to leave General Practice before the age of 60, NHS England is urging British GPs working abroad to return to the UK. Practices are also to be given incentives to take on GP Returners with an annual grant of £8,000. Incentives are also being offered to GPs to delay their retirement in an attempt to bolster GP numbers.

Golden Hellos are being used more frequently to attract GPs to practices finding it hard to fill posts. Groby Road Practice in Leicester filled a post that had been vacant for two years thanks to the scheme. The RAF is also aiming to recruit GPs and offers a signing bonus of £50,000. Hospitals are also after GPs to help them deliver new models of primary care with some offering salaries of up to £100,000.

Applications to GP Training are down by 6% this year and a third of vacancies remain unfilled after the first round of recruitment. The RCGP has released a video aimed at medical students to promote general practice and increase applications, however, GP leaders have said that students are being told by Medical School Deans that GP is a ‘second-class’ career option.

Despite the everyday pressures of General Practice, for many doctors, it still affords the best chance of a good work life balance.  An innovative campaign started by East Cumbria GP Training Programme #GreatBritishConsultations shows the beauty and benefits of rural GP life.

Hannah Dryden and Mahibur Rahman Working abroad as a GP

Over the next few years, the demand for UK trained GPs is set to increase dramatically. Working abroad can be a fantastic experience but there are also many things to consider. This article will explore what you need to think about when planning to work abroad as a GP.

Legal Considerations

It is really important to sort out the legal side of things well in advance; this includes visas, tax, NI contributions, conditions of employment, indemnity cover. This will vary from country to country. Most countries will require you to have a medical before you go and you may also need certain immunisations too.

For many people, part of the attraction of working abroad is saving money by not having to pay any tax. However, you might wish to pay national insurance contributions voluntarily as otherwise your access to certain benefits and allowances when returning to the UK can be affected, for example, your state pension.

Your conditions of employment might be quite different to what you are used to so it is important to read these thoroughly before signing. You should also check whether your indemnity provider will cover you whilst working abroad.

If you are planning on driving abroad, depending on the country, you might need to apply for an international driving permit.

Medical System & Qualifications

In order to work abroad, you will need to check if your qualifications will be recognised by the relevant organisations and whether you will be able to practise. For example, in Australia, you are required to submit an application form to the RACGP and also apply for primary source verification to the Australian Medical Council.

Another consideration is the difference between the way the NHS works and the public health systems in other countries. Some countries, like New Zealand, charge for consultations. There may be fewer home visits and a restricted list of drugs that can be prescribed. You will need to familiarise yourself with the new system that you will be working under.

Doctors with MRCGP and CCT from the UK can practise in Australia, New Zealand, and most countries in the Middle East without any further exams or qualifications, although you will need to register with the local medical council. To work in Canada, you will need to sit the MCEE examination with further examinations if you stay beyond one year.

Social & Cultural Implications

Aside from all the legal and practical matters, there are social and cultural implications too. If you are going with a family how will the move affect them? What are the differences in culture, climate, housing and education? How will you keep in touch with family and friends back home?

Even if you are going to an English-speaking country, you should expect cultural differences, whether this is more casual dress or subtle differences in language and food. The climate might be part of the attraction but make sure you do your homework! You might assume a country is hot but then find yourself in a city that has a cool sea breeze throughout the year.

Housing can differ a lot from what you are used to both in terms of housing stock, price and how the rental market operates. A lot of research is required to identify specific areas where you might settle.

If you have children, you will need to consider their education, both the school systems on offer whilst you are abroad and how they will fit back in to the UK school system when you return. For older children you may also need to consider what exams they should take or be prepared for.

Pay

Average salaries vary from country to country, in New Zealand, you can expect approximately £90,000 p.a. however in Australia, it can be £150,000 plus. In Qatar, a 40 hour contract will command a salary of £100,000 – £120,000 plus. In Canada, you can expect to earn over £100,000 per year depending on location and any additional skills you have. Pay in Abu Dhabi and Dubai tends to be lower than other Middle Eastern countries. In addition to pay, some companies will offer benefits such as free accommodation, school fees and relocation costs.

Summary

Working abroad can provide the opportunity to have a healthier, more active lifestyle (think sun and surf in Australia or exploring New Zealand’s incredible landscape) and the chance to gain different skills and experience to ultimately improve your practice as a GP.

We will be posting more detailed articles about individual countries with profiles of doctors who are working or have worked abroad soon.

Have you worked abroad? Share your tips in the comments below.

Hannah Dryden is the site editor of GPJobs.org. Dr Mahibur Rahman is a portfolio GP and the medical director of Emedica. He is the Author of “GP Jobs – A Guide to Career Options in General Practice”. He will be teaching at the Life after CCT: GP Survival Skills course which includes a session on working abroad, which will include popular countries for UK qualified GPs, pay and terms, additional examinations and recognition of MRCGP / CCT.

Dr Mahibur RahmanGP Locum Work - Doctors Bag

Many GPs now choose to work as locum GPs, either as their main job, or as part of a portfolio career. Here is a comprehensive guide to some of the pros and cons of working freelance:

Advantages

Flexibility

As a freelance GP, you can have more control over where and when you work.  If you wish to take time off for holiday, you are free to do so without asking a boss.  If you need extra money for some reason, you could increase the hours you work.  If you don’t like working at a particular practice, you can choose not to book more shifts there. On some days, you might choose to take a long shift at a walk in centre (8 or even 10 hour shifts are sometimes available), to allow you to have an extra day off later in the week without affecting your income.

Being self employed

As a locum, you are your own boss.  You can set your own rates, and most locums can earn more per day than most salaried GPs and some partners.  As a self employed contractor rather than an employee, you are also able to claim many more expenses against your tax bill, further increasing your take home pay.

A change is as good as a rest

Sometimes working in different environments, and being able to go in, deal with the patients then leave, without getting involved in internal politics or bureaucracy can be very refreshing.  It also allows you a chance to see different ways of working, to take examples of good practice from different places, and also to see what does not work well.  Working several sessions as a locum can give you a really good understanding of whether a practice would be a good place to work long term before committing to a salaried position or a partnership.

Income

As a locum, you can realistically make a £100,000+ a year working full time, and if you are willing to put in some hours covering evening or weekend shifts, or doing longer shifts in urgent care / walk in centres, it is possible to earn over £125,000 per year based on 40 hours of booked work a week including 8 weeks off every year.  If you prefer not to work evenings and weekends, you could still earn over £75,000 per year working less than full time. Working 24 paid hours per week at a realistic average rate in many areas of £75 per hour with 6 weeks leave, 2 weeks bank holidays, and 2 weeks study / CPD time (total 10 weeks without any earnings) gives an income of £75,600. Short notice locum work can be very lucrative (£100+ per hour), as can sessions that require additional skills or qualifications (e..g working in drug misuse, or in secure settings).

Disadvantages

Uncertainty

One of the big drawbacks with working as a locum is living with uncertainty.  There is no guarantee that you will be able to work as many sessions as you would like, or that practices will be willing to pay the rates that you had hoped to charge.  In some areas there many trained GPs fighting for both salaried posts and locum sessions, while in others there is no shortage of work.  Agency locum rates have gone down in the last year in some regions.  You may not know exactly how much you will earn from month to month, or exactly where you will work from day to day.  For some people this is not really a big issue, but others find it difficult to cope with a variable income when they have large fixed costs to deal with each month (e.g. paying the rent / mortgage, bills, childcare, schooling costs etc.).  Some locums will, over time get most of their work from a few regular practices, so that you might have a fairly fixed amount to your income, with the variation limited to the number of additional sessions that are available each month. Over the last 12 months though, there has been a marked increase in the amount and variety of locum work available all over the UK.

Lack of continuity

One of the downsides of working in many different practices can be the lack of continuity. You can miss out on the satisfaction of seeing a patient improve after making a diagnosis and initiating treatment, or the learning that comes from following up a patient that you referred or admitted. It can also be challenging getting used to new computer systems, or different ways of handling referrals (some practices ask you to dictate, others use Choose and Book, another will ask you to type the letter yourself). Doing visits in an area that you are not familiar with can also be more time consuming. Most locums find that they will establish a few practices that use them regularly (80% of my work is from 4 practices), with the remainder being more ad-hoc bookings.

Isolation

Being a locum can be very lonely.  In many practices, you will arrive for your session, be shown to your room by the practice manager or a receptionist, see 18 patients in 3 hours, then leave, without seeing or talking to any other colleagues.  This can be a bit of a shock to newly qualified GPs who have had the regular contact that comes with being in a training practice, as well as the pastoral benefits of being in a VTS group.  If you are doing the odd sessions in many different practices, it can be difficult to build relationships with the team.

No employment rights

As a locum, you are a self employed contractor, so you do not have any of the rights a salaried employee would have.  This means no paid holidays, no paid study leave, no sick pay, no automatic increase in pay and no job guarantee / entitlement to redundancy pay.  Of course you can take this all into account when setting your rates and calculating how much you will have to work in order to make enough to meet all your expenses and still have a decent amount of time for holidays and study leave.  You will also need to make provisions to cover your expenses if you are off sick or unable to find work for some time.

Continuing Professional Development / Revalidation

Working as a locum GP can make it more difficult to engage in CPD – for example, you may not have the opportunity to attend weekly clinical meetings or journal clubs.  Although the proposals for revalidation are not yet finalised, there are suggestions that it will be more difficult for any GP not working in a managed environment (e.g. salaried / partnership) to meet the requirements for revalidation.  Taking part in complete audit cycles for example, can be quite difficult if you are not working regularly in any one practice. There are ways around these though – netowrking, and joining a sessional GP group in your area can be a useful way to keep up to date, and it is not necessary to complete an audit – you can do a quality improvement project instead.

Travelling

In some areas, you may find that you need to be willing to travel quite large distances to ensure that you have enough work.  This can lead to increased expenses, increased tiredness and stress if you have to travel in peak times.

Summary

Like any job, there are both advantages and disadvantages to working as a locum GP. Hopefully this article is a good starting point to thinking about how this style of working might suit you.  If you are thinking of starting out as a locum and have questions, please feel free to contact us with any queries – we will always do our best to offer advice and support.

If you have been working as locum for some time, or recently started, please post a comment and share your tips and advice for new locums.

Dr Mahibur Rahman is the medical director of Emedica, and the author of GP Jobs – A Guide to Career Options in General Practice.  He is the course director of the popular Emedica “Life after CCT: GP Survival Skills Course” for GP Registrars in ST3 coming to the end of training and newly qualified GPs. It includes a GP Locum Masterclass, which will cover different ways of working as a locum, pros and cons of setting up a limited company, pensions and tax as a locum, how to find work and build a good reputation, setting terms and conditions and rates, and more.