Dr Martin Dace - independent GP

Terms of business for locum work

Document version 17.06.2010. This document is printer-friendly.

Please note the important clarification below about prescriptions generated by non-GMC-registered staff.

No other changes have been made to these terms since 29.05.2008.

Booking arrangements and confirmation of booking

Employing practices should confirm bookings in writing, stating their expectations clearly. Please see the section how to employ me for a suggested procedure to follow. The signed copy of the locum agreement/booking form at the foot of this document will constitute our contract, and it will refer directly and specifically to these terms of business. Where no agreement has been signed, these terms will nevertheless apply once the booking has been accepted.

Terms of booking

The following terms should be included when confirming bookings:

Normal sessional period

A half-day booking is normally for a continuous period of three hours or three and a half hours. Patients should be booked not more frequently than at 10-minute intervals, and there should be a 10-minute mid-session break. Sufficient time should be allowed for associated administration, such as phonecalls and letters. Thus a three and a half hour session would typically consist of 17 patient consultations plus associated administration time, and a three hour session would typically consist of 14 patient consultations plus associated administration time.

A full day booking is normally for a total of 6 to 7 hours divided into two sessions, as outlined above, including administration time. The midday period between the two sessions should be free of practice commitments, unless separately negotiated.

The Practice will need to provide a dictaphone if required for preparing correspondence, or provide photocopying facilities if letters are to be hand-written.

Booking intervals

Patients should be booked at intervals of not less than 10 minutes, even when permanent medical staff book at shorter intervals. Remember that I will often need more time in each consultation due to lack of prior knowledge of the patients, and extra time to familiarise myself with practice computer systems, procedures and referral systems.

Adequate provision should be made for any telephone consultations.

The last appointment slot of a booked surgery session should begin at least 10 minutes before the end of the surgery session (for example, a session due to finish at 6.00pm should have the last patient booked no later than 5.50pm).

Extras consulting and additional tasks

I do not normally charge for small time overruns, as long as the workload has been reasonable within the guidelines stated above. Any additional work which causes me to leave significantly later than the agreed time will be subject to an additional charge at my usual hourly rate, charged in half-hourly increments. Examples of such work include: a patient booked at the finish time, extra patients after the end of the booked period, and prescriptions or other administrative tasks for which adequate time has not been allowed.

The work to be done in consultation

It is not possible to define this. However, I expect, with experience, to work in the same way as the permanent medical staff of the practice. In addition to normal consultation services this will include appropriate data entry into the practice computer and Read coding of clinical observations (such as diagnosis, blood pressure, smoking status etc. as these arise). I shall enter item of service codes as appropriate whenever possible, and also record these in writing if I am in any doubt about the computer accepting the codes. Naturally, if you have particular requirements you would need to supply a list of preferred codes. I appreciate that the work of consultation is changing, and that practice income will depend on reconfiguring consultation work.

Signing prescriptions generated by non-GMC-registered staff

Please note that my defence union insurance, like that of most locums, does not cover me for taking responsibility for the work of other clinical staff and by extension for signing their prescriptions. In a case where a practice nurse generates a new prescription and she/he is not qualified to sign it him/herself, then adequate time must be allowed for me to satisfy myself that the prescription is appropriate and safe. I may also need to document this in the notes. There may be occasions when I feel unable to sign the prescription without seeing the patient myself, in which case the patient must be added to my list to be seen by me.

The principle behind this is that the clinician who signs the prescription is the one who is accountable for it in the event of any error or complaint.

Visits and on-call

Normally to a maximum of three patients, although this number may be exceeded for multiple visits at one location (e.g. a care Home). I would expect to cover one visit for each 25 to 30 minutes allocated; though this is subject to the driving time involved. Local circumstances may increase the time required. In these circumstances, the normal expectation of 2 visits in an hour should be adjusted accordingly.

I may be available to provide emergency cover outside of the normal sessional period. This is outside the normal terms of a working session, is subject to agreement, and will be subject to additional payment.

Additional payment will also apply if I am required to provide emergency cover over the midday break of a full day booking.

For visiting and on-call rates, see my rates of pay page.

Drugs and Equipment

I will provide and maintain personal medical equipment such as a stethoscope, otoscope and ophthalmoscope, but not drugs or associated equipment (syringes etc.).

Practices should ensure that adequate supplies of in-date emergency medication and equipment for administration are available in the surgery.

When I conduct home visits or provide emergency cover, a suitable portable pack, including prescription forms, emergency drugs, nebuliser, syringes etc. should be available from the time that such cover begins.

Scheduled drugs present a particular problem. It is not permissible for practices to put DDAs in a locum pack. The requirements of the Home Office present an onerous burden for locums who attempt to maintain and record their own DDA pack. In the circumstances and also to reduce the risk of theft and assault I do not carry DDAs.

Information for locums

It will help me if you can provide an up to date information pack. An excellent model has been designed by the National Association of Non-Principals at www.nanp.org.uk. Where the practice has referral and information forms already organised I shall of course be happy to use the existing system.

If your practice uses computer systems extensively, adequate training should be provided when I first attend the practice. I am familiar with most versions of EMIS, and am quickly adaptable to computers. A member of staff will need to prepare a consulting room and turn on the desktop computer, ensuring I am able to log in without delay.

Certified end of placement reports

For any locum employment I may at my discretion ask for a certified end of placement report as required by the GMC for revalidation. Any non-reimbursable costs incurred by the practice in producing this report are to be borne by the practice.

Rates of pay

See my rates of pay page.

Mileage and parking

I do not charge mileage within the south east London area (SE postcodes and Bromley BR1). Outside this area a charge will apply - see my rates of pay (mileage) section.

If parking is not provided then I shall expect the practice to be responsible for the cost of parking.

Congestion charge

I reserve the right to add part or all the cost of the Inner London Congestion Zone charge to the bill to practices where I necessarily incur this expense. My current policy is in my rates of pay (congestion charge) section.

Private/non-NHS work

For brief private work done within the booked time (such as private medical certificates) I shall charge the patient the practice’s customary rate, or if unsure, then what I consider a reasonable fee, and hand the fee to the practice. For all private work the principle is simple: if you are paying for my time, I shall perform any reasonable tasks requested for my agreed rate, whether it be seeing NHS patients or doing private medicals, as long as sufficient time is allowed.

Cancellation

Bookings should not be cancelled by either party except by mutual agreement. Practices would find great difficulty in identifying a substitute, and patients may be inconvenienced by enforced surgery cancellations. By the same token, I would have difficulty in replacing sessions cancelled at short notice.

Cancellation Fee

Bookings cancelled at short notice will be subject to a cancellation fee. Cancellation less than or equal to 21 days before the booked date will require a fee of 80% of the payment agreed, and between 21 and 42 days before the booked date a fee of 40% will apply. (For the purpose of calculating a cancellation fee the payment agreed will usually be taken to mean the payment for booked surgery consultation work and not the payment for extra items (e.g. visits) that may not ‘on the day’ apply.)

Surcharge for late payments

I shall invoice practices either at the end of the month or after completing my bookings with the practice, whichever is the sooner. I should appreciate payment within 5 working days of receipt of the invoice. Payments received more than 4 weeks after the invoice date will be subject to a 10% surcharge of the total amount due. I shall require you to complete GP locum Form A (NHS Pension form) and return it to me with your payment.

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Contract for locum work

Contract between . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (practice)

and

Dr Martin Dace, GP locum (GMC 2369875)

This contract is subject to the terms of business current at the date of this agreement.

The rate of pay shall be . . . . per hour.

Booked dates and times:













signed for the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

name (block capitals) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

signed by Dr Dace . . . . . . . . . . . . . . . . . . . . . . . . . . . . .