What you need to know when you finish VTS

Guest posting by Dr Tehseen Khan

So you're about to qualify as a GP. After years of hard graft and having to endure that dreaded e-portfolio, the end goal is in sight.   Soon you'll receive that much coveted (and exploitatively priced?) CCT. Well done.

So what now?

After passing the CSA, trainees naturally get the jitters about what's to come after they fall off the conveyor belt. It's important to be aware of your options so that you make the best decision about working as a new GP. In this article, I've compiled a list of pointers and things I wish I'd known before I left training.

BE PICKY

You’ve worked hard, and have been trained up to do a specialised job.  Don’t just settle for the first role that comes along (unless it's your dream job, of course).

The miserable workforce crisis has had the effect of leaving posts unfilled.  There is an abundance of work out there to suit all personalities. You could work a three-day week doing regular GP work, mix it up with some out-of-hours or even try your hand at commissioning or research.

DON'T BE AFRAID OF LOCUM WORK

People often think that it provides little continuity and may leave you for periods without work. If practices like you, they'll likely book you again and again and let other practice managers know about your skills. Network Locum (now Lantum) has a bank feature, where if you've previously worked for a  practice, you can automatically book any future sessions.

Long-term locum posts do provide continuity.  Even ad-hoc work is something you can adapt to using skills you already have - the important one being safety-netting to manage risk and thorough documentation.

See: Pros and cons of being a locum to read more.

NEGOTIATE

Negotiation comes naturally to few of us, yet it is essential. You’re probably used to knowing what you'll be paid at the end of the month.  Now things are different. The onus is on you to learn to talk money without feeling awkward.

Know what the market locum or salaried rate is and use this to equip yourself.

CONSIDER A SALARIED ROLE

These have advantages such as including maternity pay and annual leave. Try and negotiate your surgery to pay indemnity, GMC and other professional fees. If they want you enough, you may just be able to convince them. Considering that your indemnity fees will be in the region of £5-6k for 8 sessions a week, you will soon realise the benefit of doing this.

Remember that these fees are professional expenses you can claim back from HMRC.

INDEMNITY

Get quotes from all three major providers: MDU, MPS and MDDUS. Decide if you want to do OOH and get quotes for different scenarios, for example, for doing one or two session of OOH per week versus no OOH cover. You may realise it’s not worthwhile paying the extra to do just the odd OOH shift.

See also: How to pay less for medical indemnity.

TERMS AND CONDITIONS

Write up some terms and conditions if you’re planning to locum - include your standard hourly/ sessional, on-call, visiting and admin rates. Also include the number of patients you want to see and if you’d like admin blocks in the surgery.

Be clear about your expectations from the practice, particularly with regard to payment timescales and cancellation of sessions.

CPD

There is a LOT of free CPD out there. Your local RCGP group will probably run monthly ‘First 5’ talks, specifically designed for new GPs.   Include any learning points from practice meetings/learning sessions and make these count towards the golden 50 points a year.

Private hospitals in your local area run educational sessions (the BMI group are very good).  In London, the Royal Marsden runs courses bimonthly. Sure, there’ll be some push to advertise their services, but the topics are usually still useful and up-to-date.

ACCOUNTING

Keep up to date with your accounts and expenses from the very first day you locum so you can offset these against your tax.  Websites such as www.locumorganiser.com can save you hours of time.

If you locum, get a good accountant- see Melissa and Will's GP Locum Group on Facebook group for recommendations.

ORGANISING DOCUMENTS

Set-up a cloud-based account such as Dropbox, and keep important files on there: local hospital numbers, guidelines, referrals forms and documents such as your CV, CCT, GMC certificate, DBS and safeguarding certificate. If you locum, you’ll need to send these frequently to practice managers.

PENSION

Stay in the NHS Pension scheme.  Many GPs set up limited companies to pay less tax.  The major disadvantage of this is that you can't pay into your pension pot. Changed as it has, the scheme is still one of the best around and any financial advisor will tell you this. Beware of agency work, as you generally won't be able to superannuate if you book through them. Network Locum (now Lantum) is different and allows you to claim pension for sessions booked through the platform.

Good luck trying to find your perfect role(s) and remember that you've got a lot to offer - don't sell yourself short!

Dr Tehseen Khan
General Practitioner
MBChB (Shef 2008) DRCOG DCH MRCGP DFSRH