After completing GP training a large proportion of you will go on to having a Salaried GP job. Without doubt there are many benefits to a role like this – continuity of care, employment rights, job security to name a few. Unfortunately however many Salaried GPs do not understand their rights or contract before accepting a role, which may lead to challenges further down the line.
In this blog I shall highlight my top 10 things to think about before accepting a role, ensuring you have terms and conditions and a contract that works for you.
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1) Is the practice a GMS, PMS or APMS contract holder?
Knowing which type of contract a practice holds is important to ascertain which rights you are entitled to – for example a Salaried GP in a GMS (General Medical Services) practice should not be offered conditions less favourable than the BMA salaried model contract. If a non-GMS contract however it is important to either seek advice regarding your contract, or compare it to the model contract and negotiate terms which are either better or at least match the model contract.
It is also important to remember that there may be less job security with non-GMS contracts – especially with APMS practices – as their contract could be terminated at any point with minimal notice- potentially leaving you without a job. GMS is generally much safer.
2) Has continuity of service been considered?
For many newly qualified GPs there is no break between end of training and starting their first role as a GP. It is important that your years of service in the NHS are recognised – make sure that a ‘start date of service’ is correctly noted in your contract. Advantages of having longer continuity of service include benefit entitlements such as more sick pay over a longer period of time if required in the future.
3) DDRB – is it mentioned?
DDRB refers to the Review Body for Doctors and Dentists remuneration – which advises the government on rates of pay for Doctors and Dentists. The DDRB should ideally be mentioned in your contract, thereby ensuring that you benefit from any increases in pay that the body recommends to the government. The last thing you want is for negotiations to end up in a pay rise, but you miss out.
4) Is my Job plan agreed in writing?
All Salaried GPs should have a job plan in place before starting work at a practice. This ensures both the Salaried GP and the practice are aware of each other’s expectations, as workload is agreed in advance. Many things should be included in a job plan eg how many visits, how many patients you see per session, types of appointments included in a session, on-call expectations, admin etc. Having your plan in writing can prevent you from being overworked or experiencing burnout, and can be a good basis for when reviews are needed. We cover key inclusions for a job plan in more detail in our Post CCT Max Online Course.
5) Do I have CPD time?
According to the BMA model contract a Salaried GP is entitled to protected CPD (continuing professional development) time during their working week. It is essential you have this discussion with your practice to ensure you can choose how and where you wish to use your CPD time. If entitled to a certain time period of CPD you may wish to split it up during the week eg have some time in between clinics, or you may choose to take it altogether – for example having an afternoon off. This time could be the perfect opportunity for you to keep up to date with appraisals or develop a new skill. Unfortunately many Salaried GPs don’t have these conversations and end up having no CPD time at all – either due to them or their practices being unaware of this entitlement. NB – in a non-GMS practice this would be something you would need to negotiate individually.
6) Working in large organisations – what is expected of me?
If you accept a Salaried role in a large organisation, for example a Super-partnership or federation, make sure you understand exactly what is expected of you. Some at scale organisations may state in their contract that their Salaried GPs need to work across multiple sites (practices) in order to fill in rota gaps, or may need to cover multiple sites whilst on-call. Whilst this may work well for the organisation, it may not be a set up you are comfortable with as you may not be familiar with how the other practices work – or you simply may prefer working at one site only. Alternatively, you may see this as an exciting proposition for you as you get a chance to network with other colleagues within your organisation, or even in the long run develop a service once you’ve understood your organisation’s needs. Whatever your preference it is important to understand what you are signing up for – please ask the question beforehand.
7) Have I really negotiated?
Having worked in the NHS for a number of years we become accustomed to having contracts handed to us and not thinking twice about what we would like in our jobs. For non-medics it is natural to consider negotiation as part of any job offer and it is important that before taking on a new GP role you think like this too. Don’t be afraid to negotiate what you feel are fair terms for you, and a pay scale that will keep you motivated. Ultimately if you are unhappy with the contract it is unlikely you will stay in the job for long – which doesn’t work for either party – so be clear of what you want and be prepared to negotiate.
8) Pay – what does it truly mean?
Most practices will advertise pay based on a sessional rate, which you can then use to determine you annual salary based on the number of sessions you work – for example if you are offered £9k per session and work 4 sessions then your annual gross salary would be £36k. However, you need to reflect on what this sessional rate includes. Some practices on the surface may seem to offer less compared to others but may offer additional benefits alongside their pay package eg a larger study budget or allowing you to keep any private work fees performed by yourself – another practice which ‘pays more’ may not offer these benefits. Hence look at the bigger picture and ask if there are any other benefits alongside the pay which may influence your decision – don’t base your decision on pay alone.
9) Am I planning for the future?
Whichever your chosen career path, try and plan your goals over the next five to ten years. It’s perfectly ok to change your plan along the way, but without thinking at all about your future, you may end up less motivated in your role – or even be more prone to burnout as you lose ambition. Think about what you would like to achieve in your role. Perhaps you’d like to lead a service, improve how the practice triages or maybe develop a new skill such as teaching with an aim to become a trainer in the practice? An advantage of a salaried role is that you have the opportunity to develop personally, as well as potentially contribute to practice development. Sharing plans and ambitions with the partners, so that they think of you when new opportunities present is important to introduce choice and options. Be proactive in your planning and you are likely to get much more from your role.
10) Have I protected myself?
Having once been in a salaried role where I needed to seek help to protect myself (whilst on the surface the role appeared to be straightforward and simple), I would urge you to not take this question lightly. During this episode, I sought advice and gained much needed help from the BMA and my LMC (Local Medical Committee). I would recommend being part of the BMA as a Salaried GP as they offer a free contract checking service and can support you with a number of areas including support during disciplinary or grievance procedures that you may face as an employee. LMC support for you as an individual is dependent on whether your practice itself pays the LMC – if so then their fees cover you as a Salaried GP, meaning you’re entitled to free advice from the LMC. Organisations can help you in your time of need – making sure you understand your protection routes before you need them is important for peace of mind.
I hope these 10 questions help if you are considering a Salaried role. I thoroughly enjoyed my own time as a Salaried GP but with hindsight wish I had understood some the above points before I started.
As always wishing you every success!
Dr Pooja Arora 🙂
Dr Pooja Arora is a portfolio GP based in Birmingham. She has held local and national roles in her Medico-Political background fighting for GP trainee and GP rights. Her roles have included:
– Vice Chair Birmingham LMC
– BMA council member
– BMA General Practitioners Committee elected representative
– BMA Sessional GP committee elected representative
– BMA National Deputy Policy lead working at scale
– HEE GP ambassador
– HEE GP stage 3 assessor
– RCGP Midland Faculty AiT representative
* Blogs written by Dr Aman and Dr Pooja Arora are not for professional or medical advice. Please seek appropriate professional, legal or financial advice where appropriate *