Having decided you want to take on the challenge and rewards of working as an OOH GP, how do you decide who to work for?
The answer will depend on your location. There may be only one or two providers in your area. However, in London, there are a number of providers, each with their own ‘culture’ and support system for GPs.
Most OOH providers will offer you the chance to work in a variety of settings (Urgent Care Centres in hospitals, telephone triage from a base, visiting /car doctor etc). However there are a few distinct issues that can influence your professional experience and development.
Employed versus self employed
Some providers are prepared to employ you for a fixed number of sessions a week, with the accrued benefit of annual leave, indemnity contribution and income security.
Some providers are prepared to employ you for a fixed number of sessions a week, with the accrued benefit of annual leave, indemnity contribution and income security.
Performance reviews and targets
There is a greater focus on operational performance and targets for seeing patients per hour / shift with some providers. This can be helpful or disruptive depending on your perspective.
While we all deal with 10 minute appointments during the day, there is a wide variation in the time an OOH GP takes on the phone and during face to face consults. This is difficult to explain unless performance is tracked and normalised over a number of sessions to assess productivity.
This enables self-reflection for the clinician as to whether they are consulting in the most effective way, while also keeping patient safety at the forefront. A summary or clinical evaluation report can also be very helpful for appraisal but this not provided by every OOH provider.
This ties in very closely to the ‘corporate culture’, with some OOH providers operating as co-operatives / not for profit, while others are owned by US private equity firms, with a much stronger focus on profitability and accountability.
Professional development
Some OOH providers have a strong emphasis on CPD, regular teaching sessions (including BLS and other mandatory trainings). Others have also have diversified into providing GPs to prison services for instance. This may open up new avenues for some GPs to pursue and develop their clinical portfolio.
Pay and pensions
Some, but not all OOH providers contribute to the NHS pension scheme.
Hourly pay rates remain broadly similar between different providers and have remained static for the last few years.
Joining full time as an employee (where this is an option) can lead to defence fees being covered or partly covered by the OOH provider.
So what next?
Speaking to GPs working for different providers, and how they do assess and support doctors to realise their ambitions, is the best way to decide what is best for you as a GP looking to explore OOH work.
Good luck!
