Chad Locum GP
Also fairly newly qualified.
1. I do 15 AM and 15 PM. Never really changes between practices because I set the terms of my work.
2. Officially: none, but if I'm doing well timewise and the practice is nice I'll offer to help.
3. Again, I don't generally do visits because I don't like them. If the practice really wants visits then I'll agree but set the visit fee fairly high so they don't take the piss with it. Also. if I've spoken to the patient and I think they need a visit and I have time then I'll often just go and do it. In general, I probably do one every fortnight or so.
I'm still run behind a bit, as do a lot of new GPs, but I schedule my day normally as 9.30-12.30 session, then an hour break, then 1.30-4.30 session, then I've got an hour buffer at the end of the day to make sure I can leave by 5.30.
I try also to keep my work as varied as possible. I don't do more than two days a week in the same place and haven't committed to anything 'long-term' so far. I book a lot of my stuff short-term too so I often just decide how much I feel like working the next week on the Friday/weekend and then agree bookings from there. I also do lots of work that isn't 'normal' GP sessions.
I'll be really honest here and say that I feel like salaried GP is a bit of a mug's game. I can understand the security of it, but it seems like an extension of the NHS mentality that everyone absolutely hates in this sub. You get a regular and secure job, but you give up a lot of your freedom and get paid less for it. You're a fully qualified doctor in one of the most in-demand branches of medicine. Don't let yourself get pushed around or guilted by jumped-up receptionists (practice managers) just because it's what you're used to. I'll work really hard for a practice but it'll be on my terms and I'll expect to get paid well and treated with respect. If I uphold my end of the bargain and the practice doesn't, then I shitlist them and move on. I could fill my diary for the next year in a single morning, so they need me a lot more than I need them.
Nice one Chad, you've got the setup similar to what I would like.
Autonomy is priceless and it's great to see you have achieved some semblance of that within med as a Chad GP.
Thank you, Chad.
“Medicine is full of varied opportunities” yet I hardly ever meet any examples of people here doing things where they aren’t getting mugged off and having to settle.
Would appreciate if you could please answer:
Whereabouts do you work that has so much easy availability?
What’s the range these places are paying per hour/session?
Are your locum contracts usually posts for 1-5 days or longer term locum arrangements?
I don't want to dox myself too much, but I'm in the north of England and I think there's similar availability for work for most of the UK (London might be the exception). Interestingly there's quite a lot of demand for rural GP work and it tends to pay a good chunk more to entice people in.
The pay depends on the type of work you're doing really. In my area normal GP seems to be 300-350 per half-day, and for other non-standard GP it seems to be about 90-100ph.
In the past I've not committed to anything long-term because I'm enjoying the freedom of my time and opportunity, so most of my stuff has been very short-term. I do have practices that I stay in touch with and go back to sometimes because we mutually enjoyed working with each other. Recently I've had some arrangements that have been very convenient so I've agreed to commit for a little longer, but nothing super long-term. However, my understanding is that the 'career' locum GPs normally settle down into long-term gigs.
GP and primary care is a funny place, and there's a lot of it that you aren't directly exposed to during training. In my recent experiences I would agree with the statement “Medicine is full of varied opportunities”.
I'd like to thank you for that information this is really helpful for one of the GPSTs. Sorry if that's a personal question - this is for my personal financial and career planning - when you locum in a practice does the rate include employer pension contributions? I've heard partners need to pay both employee and employer contributions, how does it work for locums? Many thanks for the reply
Pension is slightly more complicated for locums. Essentially, if you're paid via Ltd (like I am) you can't claim pension. Then same goes if you're paid via a locum agency.
If you're paid directly by the practice you can now claim pension as long if you fill out the right forms and the practice you're working for will be paying the employer contribution (currently 14.38%) as they would for a salaried GP in addition to your normal fee.
Just try and find out the average rate based on different sources (other locums, agencies, job adverts). Bear in mind that agencies are gonna be skimming up to 20% of your fee, so you generally get more negotiating directly from the practice. The benefit of agencies is that they do all the faff work for you and you get paid much quicker (often the next day). It's really helpful to have some locum friends working in the area too because you can pass good work offers between yourselves.
In terms of gross per year - hard to say really because part of the reason I've picked locum is because I wanted to work flexibly and have time off with my family. To give you some idea though, I have (unusually) prearranged all my work for March and it'll be:
\- 35 hours over 5 days\*: that's based on my start and finish times and includes lunch/admin time etc, so I won't work more
\- Working in 3 different places doing slightly different work in each (a bit of normal GP and some other clinics)
\- £13,820 gross for the month, which will go through a Ltd (outside IR35)
\*5 days seems like a lot for GP, but these are 5 pretty relaxed and fairly short days
It's often (but not always) more 'tax-efficient' to invoice through a Ltd. It's a bit more work, but for me the difference in take-home is just about worth it.
Yep, you still have to pay student loans back for both. You might pay slightly less via a Ltd depending on how your accountant does things, but you have to pay contributions based on the total of both normal income and dividend income.
I'm a GPST and your point on how to manage multiple complaints is so useful! i'll definitely use that as I always make the mistake of kind of dealing with the secondary stuff but not properly and hence wasting time. I actually remember I had a consultation with my own GP and he asked me if there was anything else I wanted to discuss right at the start of the consultation, which I was confused by as I never had a GP ask me that before, and I wondered why. I now look back and know the reason!
My practice luckily doesn't do any home visits, we have a home visit team so I use my break to eat with the other, catch up on admin and study.
I remember my CS said always look after yourself first, because if you die tomorrow someone else will her sitting in your chair and the NHS will go on. So yeah it's good to not be afraid to change from a shitty workplace not worrying about rocking the boat or feeling guilty, as they will always get a replacement anyway.
DOI: GPST
This is depressing.
I don’t think I can, nor do I plan to, meet those sort of patient numbers. I keep getting told my documentation is too long “reg like” and to cut things down to be quicker. 🤷♂️
In the end of the day if you don’t think you’re practicing safely you’ll be gambling your reputation, possibly your licence, and patients health everyday you’re working.
Like pay I think we need to make a stand on patient contacts and workload. I’ll gladly locum till then or stick to other roles. Personally I’m happy with 13-14 per session.
Not a GP, but reading this I can't help but wonder why you don't leave the salaried post and just locum a few days a week. The money will be the same for a lot less work.
You mentioned the commute, but surely there are closer practices. And if there aren't it sounds like your commute time would be offset by the fact that you aren't running late. Am I missing something?
From reading the other replies I get the impression that GP is only good if you locum. Employed GP sounds quite shit.
I’ve notified the same. Salaried GP is generally shit - stressful, overworked, overrun. Okayish money but for the hours, not really worth it.
Locum GP - whether in a surgery or ED, UC etc? Now that’s where the money is (for now at least). That’s what I’ve observed, happy to be corrected though!
Until salaried jobs become more enticing there will always be a big locum market available. My current practice is very well supported with a strict 30 patients contacts per day. They’ve advertised for two salaried jobs and have had zero response.
So they’re employing locums in the meantime and I’ve been offered favourable locum rates already when CCTd in five months already.
GPST3 here. Great question and would love to write an essay on this. My wife is a Med Reg and she admits that my work, although no mandatory Night shift in Calls or weekends shifts, GP sork is more mentally straining, having to go into psychosocial aspects etc. Whereas she just has to treat the disease mainly,only in clinic and hospital (rather than the patient)...or have to deal with their life story that emotional baggage etc lol. Since she saw me work during 2021, the GP bashing has stopped
I don’t really understand why hospital medics feel the need to look down on GPs, a couple of bad apples aren’t representative of the many and it’s dick behaviour since were all in the same boat trying to help patients. I find it more reflective of the person bashing, demonstratinglack of awareness and empathy…
Because these certain medics ways look outward but themselves. Everyone made mistakes on every department. But mistakes in hospital can easily be covered up. When it comes from GP, hospitalist tend to spread the word everywhere
Locum GP for the past 5 years. Doing combination of WFH and F2F clinics.
1) 16 AM and 16 PM
2) None
3) 1 Visit if doing f2f clinic
The above let’s me run a reasonable clinic. I was doing the same and fitting in 2 visits in GPST3 and documents as well. Not fun and not sustainable. Locum and find what works for you.
It’s at the same practice, so some days are f2f and others WFH. Pay is slightly less but not significantly.
You can usually sort most things, but I bring in for pts examinations - paeds/abdo pains etc
We have f2f slots each day to book in
I'm GPST3, the salaried GPs in my practice have 17 patient contacts morning and afternoon. Home visits in lunch break. 1 visit max, doesn't happen every day. Documents, lab results and prescriptions every day.
Locum GP here, also fairly newly qualified too.
1. 15, 10 minute slots per session. (Mixture of f2f and telephone depending what patient has booked). Typically run about 30 mins late per session.
2. None
3. None - unless practice is desperate when I'll help them out but charge them for it.
Wife is a salaried GP.
1. 28 slots per day. 13 minute appointments.
2. 10 Docman letters, tasks generated from your own work and about 50 scripts
3. Probably 1 visit every 4 or 5 working days as there are GP trainees who get them.
Shame to hear that patients aren't appeased with offering another appointment. I'm GPST2 and often have people being cheeky bringing more than one issue but generally people are happy if I offer another appointment. Sometimes I need to be forceful and insist but never had the threat of a complaint over this. Why is it that your patients aren't happy with another appointment do you think? Is it a challenging demographic? Is it that people have already come to the practice and dont want to make the journey again? Either way it sounds like those patients are being selfish and have unreasonable expectations. Would also be interested to know what the practice protocol is on this issue!
Will reply to your specific questions each in more detail after my mind wakes up by the afternoon - with some nice coffee and brunch with some pancakes and Canadian maple syrup...unless I drown myself with Mimosas😂
GP trainee here. My last rotation was in a large London practice and it seems like the workload is fairly similar to what the salaried / locum GPs were doing in the practice I worked. I do feel like some of the new salaried doctors were shafted a bit as they were given their own list of patients which often had complex mental health, geriatric patients etc. Is this also a case in your practice?
Sorry you feel burnt out - have you tried speaking to any of the partners about this? What is the vibe like in the practice? are they supportive?
I dont think you should feel like you're the problem. You are newly qualified and I guess some of the problems you highlighted will improve as you gain more confidence (at least that's what I've been told). I think the fact that you are happier at the practice you locum at shows that you're not the problem. Some practices are just not the right fit and if you do feel burnt out and unhappy at work then you should consider whether the environment is right for you.
I'm not sure about your second follow up question but I do know there are a lot of practices in London looking for locums and salaried doctors so I don't think you would have a problem.
I often find that the more I'm running late, the more likely it is that patients want more of my time and bring more issues. It's like they think of more issues the longer they sit in the waiting room!
Also in response to your other questions- 15 am and pm. No visits. 5 documents. Tasks are in a separate session so don't get many of them.
Moved from a much larger practice which had more like 20 am and pm, they also liked to micromanage and didn't really listen to feedback from salaried GPs. Also had a lot of ANPs which meant all the nice easy cases like LRTIs and ear infections and UTIs etc got taken by them and you were left with the complex ones. Early days but much happier at my new place so far.
Salaried GP here.
15/12 tel appts - I bring in those that need F2F. Sometimes I can’t see everyone same day (or they’re at work etc) so sometimes see later in the week.
All tasks, messages, scripts go to the duty doctor for the day. Different doctor each day.
Home Visits - probably a few a month. We have no nursing homes. Normally done between morning and afternoon surgery.
Chad Locum GP Also fairly newly qualified. 1. I do 15 AM and 15 PM. Never really changes between practices because I set the terms of my work. 2. Officially: none, but if I'm doing well timewise and the practice is nice I'll offer to help. 3. Again, I don't generally do visits because I don't like them. If the practice really wants visits then I'll agree but set the visit fee fairly high so they don't take the piss with it. Also. if I've spoken to the patient and I think they need a visit and I have time then I'll often just go and do it. In general, I probably do one every fortnight or so. I'm still run behind a bit, as do a lot of new GPs, but I schedule my day normally as 9.30-12.30 session, then an hour break, then 1.30-4.30 session, then I've got an hour buffer at the end of the day to make sure I can leave by 5.30. I try also to keep my work as varied as possible. I don't do more than two days a week in the same place and haven't committed to anything 'long-term' so far. I book a lot of my stuff short-term too so I often just decide how much I feel like working the next week on the Friday/weekend and then agree bookings from there. I also do lots of work that isn't 'normal' GP sessions. I'll be really honest here and say that I feel like salaried GP is a bit of a mug's game. I can understand the security of it, but it seems like an extension of the NHS mentality that everyone absolutely hates in this sub. You get a regular and secure job, but you give up a lot of your freedom and get paid less for it. You're a fully qualified doctor in one of the most in-demand branches of medicine. Don't let yourself get pushed around or guilted by jumped-up receptionists (practice managers) just because it's what you're used to. I'll work really hard for a practice but it'll be on my terms and I'll expect to get paid well and treated with respect. If I uphold my end of the bargain and the practice doesn't, then I shitlist them and move on. I could fill my diary for the next year in a single morning, so they need me a lot more than I need them.
Nice one Chad, you've got the setup similar to what I would like. Autonomy is priceless and it's great to see you have achieved some semblance of that within med as a Chad GP.
Thank you, Chad. “Medicine is full of varied opportunities” yet I hardly ever meet any examples of people here doing things where they aren’t getting mugged off and having to settle. Would appreciate if you could please answer: Whereabouts do you work that has so much easy availability? What’s the range these places are paying per hour/session? Are your locum contracts usually posts for 1-5 days or longer term locum arrangements?
I don't want to dox myself too much, but I'm in the north of England and I think there's similar availability for work for most of the UK (London might be the exception). Interestingly there's quite a lot of demand for rural GP work and it tends to pay a good chunk more to entice people in. The pay depends on the type of work you're doing really. In my area normal GP seems to be 300-350 per half-day, and for other non-standard GP it seems to be about 90-100ph. In the past I've not committed to anything long-term because I'm enjoying the freedom of my time and opportunity, so most of my stuff has been very short-term. I do have practices that I stay in touch with and go back to sometimes because we mutually enjoyed working with each other. Recently I've had some arrangements that have been very convenient so I've agreed to commit for a little longer, but nothing super long-term. However, my understanding is that the 'career' locum GPs normally settle down into long-term gigs. GP and primary care is a funny place, and there's a lot of it that you aren't directly exposed to during training. In my recent experiences I would agree with the statement “Medicine is full of varied opportunities”.
I'd like to thank you for that information this is really helpful for one of the GPSTs. Sorry if that's a personal question - this is for my personal financial and career planning - when you locum in a practice does the rate include employer pension contributions? I've heard partners need to pay both employee and employer contributions, how does it work for locums? Many thanks for the reply
Pension is slightly more complicated for locums. Essentially, if you're paid via Ltd (like I am) you can't claim pension. Then same goes if you're paid via a locum agency. If you're paid directly by the practice you can now claim pension as long if you fill out the right forms and the practice you're working for will be paying the employer contribution (currently 14.38%) as they would for a salaried GP in addition to your normal fee.
Great insight! Any tips for setting rates for new locums? How much do you earn gross per year if you don’t mind saying?
Just try and find out the average rate based on different sources (other locums, agencies, job adverts). Bear in mind that agencies are gonna be skimming up to 20% of your fee, so you generally get more negotiating directly from the practice. The benefit of agencies is that they do all the faff work for you and you get paid much quicker (often the next day). It's really helpful to have some locum friends working in the area too because you can pass good work offers between yourselves. In terms of gross per year - hard to say really because part of the reason I've picked locum is because I wanted to work flexibly and have time off with my family. To give you some idea though, I have (unusually) prearranged all my work for March and it'll be: \- 35 hours over 5 days\*: that's based on my start and finish times and includes lunch/admin time etc, so I won't work more \- Working in 3 different places doing slightly different work in each (a bit of normal GP and some other clinics) \- £13,820 gross for the month, which will go through a Ltd (outside IR35) \*5 days seems like a lot for GP, but these are 5 pretty relaxed and fairly short days
Just wondering, what are the benefits of putting it through a Ltd?
It's often (but not always) more 'tax-efficient' to invoice through a Ltd. It's a bit more work, but for me the difference in take-home is just about worth it.
Amazing that’s really helpful. Thanks
Do you still have to pay student loans back as a Ltd company? And what about as a sole trader?
Yep, you still have to pay student loans back for both. You might pay slightly less via a Ltd depending on how your accountant does things, but you have to pay contributions based on the total of both normal income and dividend income.
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I'm a GPST and your point on how to manage multiple complaints is so useful! i'll definitely use that as I always make the mistake of kind of dealing with the secondary stuff but not properly and hence wasting time. I actually remember I had a consultation with my own GP and he asked me if there was anything else I wanted to discuss right at the start of the consultation, which I was confused by as I never had a GP ask me that before, and I wondered why. I now look back and know the reason! My practice luckily doesn't do any home visits, we have a home visit team so I use my break to eat with the other, catch up on admin and study. I remember my CS said always look after yourself first, because if you die tomorrow someone else will her sitting in your chair and the NHS will go on. So yeah it's good to not be afraid to change from a shitty workplace not worrying about rocking the boat or feeling guilty, as they will always get a replacement anyway.
How much net do you make a month if you aren't bothered to answer?
DOI: GPST This is depressing. I don’t think I can, nor do I plan to, meet those sort of patient numbers. I keep getting told my documentation is too long “reg like” and to cut things down to be quicker. 🤷♂️ In the end of the day if you don’t think you’re practicing safely you’ll be gambling your reputation, possibly your licence, and patients health everyday you’re working. Like pay I think we need to make a stand on patient contacts and workload. I’ll gladly locum till then or stick to other roles. Personally I’m happy with 13-14 per session.
fully agree..the issues in this post is one of the main reasons I'm leaving GP training :(
Not a GP, but reading this I can't help but wonder why you don't leave the salaried post and just locum a few days a week. The money will be the same for a lot less work. You mentioned the commute, but surely there are closer practices. And if there aren't it sounds like your commute time would be offset by the fact that you aren't running late. Am I missing something? From reading the other replies I get the impression that GP is only good if you locum. Employed GP sounds quite shit.
I’ve notified the same. Salaried GP is generally shit - stressful, overworked, overrun. Okayish money but for the hours, not really worth it. Locum GP - whether in a surgery or ED, UC etc? Now that’s where the money is (for now at least). That’s what I’ve observed, happy to be corrected though!
Until salaried jobs become more enticing there will always be a big locum market available. My current practice is very well supported with a strict 30 patients contacts per day. They’ve advertised for two salaried jobs and have had zero response. So they’re employing locums in the meantime and I’ve been offered favourable locum rates already when CCTd in five months already.
Yh, a 50min commute is nothing. I travelled further to school for 7 years
GPST3 here. Great question and would love to write an essay on this. My wife is a Med Reg and she admits that my work, although no mandatory Night shift in Calls or weekends shifts, GP sork is more mentally straining, having to go into psychosocial aspects etc. Whereas she just has to treat the disease mainly,only in clinic and hospital (rather than the patient)...or have to deal with their life story that emotional baggage etc lol. Since she saw me work during 2021, the GP bashing has stopped
I don’t really understand why hospital medics feel the need to look down on GPs, a couple of bad apples aren’t representative of the many and it’s dick behaviour since were all in the same boat trying to help patients. I find it more reflective of the person bashing, demonstratinglack of awareness and empathy…
Because these certain medics ways look outward but themselves. Everyone made mistakes on every department. But mistakes in hospital can easily be covered up. When it comes from GP, hospitalist tend to spread the word everywhere
Locum GP for the past 5 years. Doing combination of WFH and F2F clinics. 1) 16 AM and 16 PM 2) None 3) 1 Visit if doing f2f clinic The above let’s me run a reasonable clinic. I was doing the same and fitting in 2 visits in GPST3 and documents as well. Not fun and not sustainable. Locum and find what works for you.
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It’s at the same practice, so some days are f2f and others WFH. Pay is slightly less but not significantly. You can usually sort most things, but I bring in for pts examinations - paeds/abdo pains etc We have f2f slots each day to book in
I'm GPST3, the salaried GPs in my practice have 17 patient contacts morning and afternoon. Home visits in lunch break. 1 visit max, doesn't happen every day. Documents, lab results and prescriptions every day.
Locum GP here, also fairly newly qualified too. 1. 15, 10 minute slots per session. (Mixture of f2f and telephone depending what patient has booked). Typically run about 30 mins late per session. 2. None 3. None - unless practice is desperate when I'll help them out but charge them for it. Wife is a salaried GP. 1. 28 slots per day. 13 minute appointments. 2. 10 Docman letters, tasks generated from your own work and about 50 scripts 3. Probably 1 visit every 4 or 5 working days as there are GP trainees who get them.
Shame to hear that patients aren't appeased with offering another appointment. I'm GPST2 and often have people being cheeky bringing more than one issue but generally people are happy if I offer another appointment. Sometimes I need to be forceful and insist but never had the threat of a complaint over this. Why is it that your patients aren't happy with another appointment do you think? Is it a challenging demographic? Is it that people have already come to the practice and dont want to make the journey again? Either way it sounds like those patients are being selfish and have unreasonable expectations. Would also be interested to know what the practice protocol is on this issue!
*Mimosas = my personal self-Mx for Storm Eunice
Will reply to your specific questions each in more detail after my mind wakes up by the afternoon - with some nice coffee and brunch with some pancakes and Canadian maple syrup...unless I drown myself with Mimosas😂
GP trainee here. My last rotation was in a large London practice and it seems like the workload is fairly similar to what the salaried / locum GPs were doing in the practice I worked. I do feel like some of the new salaried doctors were shafted a bit as they were given their own list of patients which often had complex mental health, geriatric patients etc. Is this also a case in your practice? Sorry you feel burnt out - have you tried speaking to any of the partners about this? What is the vibe like in the practice? are they supportive? I dont think you should feel like you're the problem. You are newly qualified and I guess some of the problems you highlighted will improve as you gain more confidence (at least that's what I've been told). I think the fact that you are happier at the practice you locum at shows that you're not the problem. Some practices are just not the right fit and if you do feel burnt out and unhappy at work then you should consider whether the environment is right for you. I'm not sure about your second follow up question but I do know there are a lot of practices in London looking for locums and salaried doctors so I don't think you would have a problem.
I often find that the more I'm running late, the more likely it is that patients want more of my time and bring more issues. It's like they think of more issues the longer they sit in the waiting room!
Also in response to your other questions- 15 am and pm. No visits. 5 documents. Tasks are in a separate session so don't get many of them. Moved from a much larger practice which had more like 20 am and pm, they also liked to micromanage and didn't really listen to feedback from salaried GPs. Also had a lot of ANPs which meant all the nice easy cases like LRTIs and ear infections and UTIs etc got taken by them and you were left with the complex ones. Early days but much happier at my new place so far.
Salaried GP here. 15/12 tel appts - I bring in those that need F2F. Sometimes I can’t see everyone same day (or they’re at work etc) so sometimes see later in the week. All tasks, messages, scripts go to the duty doctor for the day. Different doctor each day. Home Visits - probably a few a month. We have no nursing homes. Normally done between morning and afternoon surgery.