STARTING WORK AS A GP
Updated March 2012
CONTENTS
Page 2
The Essentials
Performers List
CCT
GMC Registration
Defence union
Introduction to tax
Page 3 - 6
Locuming info
Finding work
Rates
Money matters
Tax for the self employed
Motoring
National Insurance
Being employed and self employed
NHS Superannuation (Pension)
Page 7 - 8
Preparing for partnership
Are you ready?
Curriculum Vitae
Before applying
Interviews
Success
Page 8
Working as a salaried GP
Page 9
Support and information for newly qualified GPs
Page 10
Continued professional Development
Appraisal and revalidation
CPD options
Page 11
Career options
see also:
www.rcgp.org.uk/new_professionals/gp_careers.aspx
Page 1 of 11
ESSENTIALS
1. Apply for CCT & GMC GP Register.
On your eportfolio ‘Accept’ your final ARCP report as soon as it is available.
Then click on 'Apply for a CCT' button once.
This will send your application for a CCT to the RCGP Certification Unit.
Make sure you also complete the GMC online CCT application form. The details of this
will have been sent to you by the RCGP Certification Unit in your final 6 months of
training.
The Certification Unit will take 15 working days to process your CCT application and
forward a recommendation to GMC.
The GMC will take up to 10 working days to issue your CCT
http://www.rcgp.org.uk/gp_training/certification.aspx
http://www.gmc-uk.org/doctors/applications.asp)
This will cost around £800 . You are not eligible to work or earn without this.
2. Apply to join the Performers List.
You must be registered with your local Health Board before being allowed to work as a
GP. Apply to the area where you are based/will do most of your work. You will need to
apply to different lists if you want to work in England, N. Ireland or Wales
Health Boards in the West of Scotland are:
Greater Glasgow and Clyde (kate.mcgloan@ggc.scot.nhs.uk)
Ayrshire and Arran (Jacqui.mccall2@aapct.scot.nhs.uk)
Lanarkshire (Gillian.forsyth@lanarkshire.scot.nhs.uk)
Forth Valley (Jacqueline.lennox@nhs.net)
Dumfries and Galloway (shiona.burns@nhs.net)
For background information (written for an English audience) see
www.nasgp.org.uk/lists/performers_lists_faq_doh.pdf
3. Appropriate membership level of Defence union around £2-3,000. Cost depends on
average number of clinical sessions worked per week.
4. If you are working as a locum; register as Self-employed for tax and national
insurance - go to http://www.hmrc.gov.uk/selfemployed/index.shtml or phone 0845 915
4515
Page 2 of 11
LOCUM WORK
http://www.rcgp.org.uk/pdf/MI_ADVICE_PACK_FOR_LOCUMS.pdf
GP Locums – Getting it Right – Things you need to know
http://careers.bmj.com/careers/advice/view-article.html?id=829
Getting Work
 www.locum123.com You can enter the areas and types of work you are looking for.
You will then receive a text or email letting you know if someone is looking for a
locum. You can also buy a copy of the ‘Locum Doctor Survival Guide’ here.

Glasgow Locum Group

Word of mouth, reputation, contact local practices. Let your friends/colleagues know if
you are looking for work and if you’d like them to give your contact details to practices
that are looking for cover. Think about sending you CV to practice managers in the
areas you wish to work.

Agencies – Back of BMJ, GP ‘Comics’ or google search

Out of Hours GP services for all local Health Boards
http://www.glasgowlocumgroup.org
Greater Glasgow and Clyde
Ayrshire and Arran
Lanarkshire
Forth Valley
Dumfries and Galloway

(jim.marshall@ggc.scot.nhs.uk)
(nicola.montgomery@aapct.scot.nhs.uk)
(marion.macdonald@lanarkshire.scot.nhs.uk)
(linda.davidson2@nhs.net)
Think laterally. If you’d like to do some non-GP work, make enquiries in the relevant
specialty. Often hospitial specialties e.g A&E are keen to employ GPs.
Rates
LOCUMS ARE NOT ALLOWED TO AGREE WITH EACH OTHER TO FIX RATES as
this can be seen by the Office of Fair Trading as operating a cartel, which can land you
with a hefty fine.
However, by asking around locums and practices, you should get an idea of the current
local variations for different types of work. It’s a free market so at the end of the day it’s
a negotiation between you and the practice based on how much you are willing to work
for, and how much they are willing to pay. Supply and demand forces will influence this
as well as individual circumstances
For further guidance and locum FAQs see
http://www.bma.org.uk/employmentandcontracts/employmentcontracts/sessional_gps/in
dex.jsp
Page 3 of 11
Money matters
If you work as a locum you will be self-employed and responsible for an annual tax
return. You will need a system to keep track of where & when you have worked,
invoices, and checking that you have been paid. Learning how to use an Excel
spreadsheet is quite handy for this.
You will probably need to put aside a significant sum of money each month to cover your
tax (20-40%), superannuation (pension) (5 – 7.5%) and national insurance (9%) –
about 35% of your income up until about £37,000 annual earnings and about 50% of
your income after that.
Tax for the Self -Employed
This is by no means definitive - see www.hmrc.gov.uk for a host of information including
self assessment tax returns, allowable expenses, self-employed advice and motoring
advice (purple box.. ‘individuals and employed’… ‘self employed’). Most Locums use an
accountant!
As of 2012 the first £8,105 of your earnings are tax free. After that earnings up to
£34,370 are taxed at 20%. Earnings above £34,371 are taxed at 40% (and if you are
planning to work 365 days a year or have other money making schemes up your
sleeve……earnings above £150,000 are taxed at 50%). These figures may change
depending on government policy.
You need to file your tax return by 31 January for the previous financial year. Eg 31 Jan
2013 for the tax year April 6 2011 to April 5 2012.
Some points:

By law you must maintain "adequate records" and keep them for 6 years

Your work related expenses all become tax deductible. This can include subsistence
and accommodation whilst working away from your base.

GMC, Defence, BMA, RCGP, Motoring, Medical Equipment and Supplies,
Computers, Office expenses, are all deductible, as are ‘Premises’ costs (e.g. a
proportion of your rent/mortgage/utility bills – but that may affect the capital gains
status of your house, if you own it)
Most of these expenses are directly offset against your profit for the year, but certain
assets like a new car or computer are subject to ‘writing down’ as a ‘capital allowance’ as
they depreciate in value. ie – you can claim tax relief on a proportion of the value of the
item per year. If you use these items for personal use, you will need to make
proportional adjustments too.
Currently, writing down is set at 20% per year for cars (but 100% if low CO2 emissions),
40% for computer in the first year and then 25% of its remaining value per year after that.
This is probably where an accountant is needed!
Page 4 of 11
Motoring
As a locum, your home address will usually be regarded as your business address. This
means that you may claim work-related mileage from home to any practice in which you
work, as well as mileage related to the locum work itself.
Remember that Car Tax, Insurance, MOT, Servicing, Repair costs, etc. are all
deductible.
Keep a log – “I keep a note of my mileage at the start of the tax year and record only
locum mileage. I can then calculate the proportion of work/personal. So if 82% of my
mileage is due to work, I simply claim 82% of all my motoring expenses for that year”.
You do need to keep all your receipts. By now you will see that a computer is a very
good idea! Entering each receipt into a spreadsheet or financial program (eg. Quicken)
as you go saves literally days when doing your tax return.
If you don’t want to record all your motoring expenses, the Inland Revenue will accept a
flat rate depending on your mileage and size of car – e.g. 40p per mile.
National Insurance (NI)
As a Locum, you are liable for both Class 2 and Class 4 NI contributions.
Class 2 is a fixed amount of currently about £10 per month, usually paid by direct debit.
Class 4 is 9% of your profit (after expenses) between £7,225 and £42 475, and 2% of
any earnings after that. This will be calculated as part of your tax return.
Being Employed AND Self-Employed
Some of you may find yourself in the situation of being employed part-time (eg salaried
or fellowship) and also work self-employed (eg as a locum).
Your tax return at the end of the year will take into account all your employed earnings
and tax paid. (Using your P60 issued by your employer with your April payslip.)
However the tax return doesn’t allow for the national insurance you have paid in your
employed post (Class 1). So you will find yourself paying NI as part of your employment,
and also on all your self-employed earnings.
If your total earnings are over £42,475 per year then you will likely have overpaid NI (at
7% - ie £700 overpaid if you earn £53, 000). Contact the NI office in Newcastle on 0845
302 1479 to claim this back or ask for an exemption certificate depending on your
circumstances.
Page 5 of 11
NHS Superannuation (Pension)
If you wish to contribute to the scheme (recommended), you will have indicated this
when applying for your performers list. This link will take you to the page with the GP
locum superannuation forms A & B and support notes
(You have to scroll down quite a bit to ‘GP Locum forms’)
http://www.sppa.gov.uk/nhs/forms.htm
There are three different ways of paying your pension contributions!
1. Day-Time Locum Work
Ask each practice you work for to complete ‘Locum Form A’.
At the end of the month collect all your form As together and calculate your
superannuation contribution onto Form B.
Depending on your annual income this will be 5-7.5% - see below
2. Employed work
Your pension contributions are deducted from your pay at source
(Pay as You Earn – PAYE).
This happens for some OOH work where the Health Board is deducting tax, NI
and pension contributions automatically. Check your payslip to make sure the
correct deductions are being made (see additional notes below).
3. OOH Work Paid ‘Gross’
You have to pay 5-7.5% AND your employers contribution of 13.5% !
(You may be able to invoice the practice/health board to claim back the 13.5%)
Complete a Form A. Submit a different Form B from your day-time Form B and
mark the form ‘OOH’. There are complicated sums on the form to take account
of the employers contribution.
Before the 7th of the month, send all your Form As and one/two Form Bs for the month,
together with a different cheque for each Form B to Practitioner Services of the Health
Board whose performers list you are on.
The next link will take you to the SPPA circular explaining the new tiering levels. The
Health Boards may automatically deduct pension contributions at 7.5% for OOH work but
this is incorrect if your income is less than £69,931. Fill in the Appendix at the end of the
circular and if in doubt, contact SPPA for advice.
http://www.sppa.gov.uk/nhs/documents/NHSCircular20106revisedtieredconsfinal_000.pdf
Page 6 of 11
PREPARING FOR PARTNERSHIP
‘Becoming a partner’ by Dr David Wrigley
http://careers.bmj.com/careers/advice/view-article.html?id=1293
Are you ready for partnership?
Some GPs enter partnership immediately after completing training, some prefer to get
experience as a locum or salaried GP first, and some GPs choose not to enter
partnership. There is no right answer to this question and its worth thinking through what
your priorities are.
Curriculum Vitae
Possible CV headings








Education
Post graduate qualifications and exams
Previous employment
Special interests and skills
Audit and publications
Courses
Other interests
Referees
Tip: personalise your cover letter to the practice you’re applying to – practices don’t
want a generic letter, they want to know why you want a job in their particular practice.
Don’t forget to spell check – lots of spelling errors doesn’t look professional
Before applying
Find out about the practice from others – shouldn’t be hard, the world of General
Practice is small. Think about the practice demographics – do you want to work in a
large or small practice, urban or rural?
Interviews
You are interviewing them as much as they are interviewing you so don’t be afraid to ask
about:1.
2.
3.
4.
5.
6.
7.
Money?
Years to full parity?
Do I need to buy in? Does this include premises?
What is the practice vision for the next 5 years?
Do you all get on? How do you resolve conflict?
What is work-life balance like?
Is there a partnership agreement?
Practice interviewing with a friend/colleague before the big day.
Do a practice visit before the interview – shows an element of interest and allows you to
get a feel for the place.
Page 7 of 11
Be yourself at the interview – say what you really think, not what you think the
interviewers want to hear.
Ask what the practice are looking for – any specific skills/interests or are they more
interested in finding someone that will fit in ie. will you get on, can you work together,
what will you bring?
Think about what your preferred team role is e.g. use of Belbin
Psychologically prepare yourself for a big interview panel – at a minimum its likely to be
all the partners plus practice manager.
Success?
If you are interviewed and offered the partnership, ask for copies of the last 3 years
accounts so that you can have them checked by an independent accountant – you want
to know what you are buying into.
Get a partnership agreement – and get it checked by the BMA 0300 123 1233
www.bma.org.uk/sc/employmentandcontracts/independent_contractors
Partnership agreements on the left hand side
WORKING AS A SALARIED GP
For the bma salaried gps handbook and model contract (lower down the page) go to:
www.bma.org.uk/sc/employmentandcontracts/employmentcontracts/sessional_gps
THE GP RETAINER SCHEME
This scheme supports GPs wishing to work part-time who are unable to commit to
substantive General Practice usually due to child care commitments. Retainers can work
a maximum of 14 hours per week in GP (4 x 3.5 hrs) and cannot undertake locum work
although can work up to 2 non GMS sessions per week with the approval of the Retainer
scheme adviser. Potential applicants need to demonstrate a need for additional
educational support to be eligible for the scheme. The practice is reimbursed part of your
pay. You receive protected educational time and support.
The retainer model contract is also on the web page above.
‘Working as a GP retainer’ by Dr Claire Wedderburn
http://careers.bmj.com/careers/advice/view-article.html?id=2998
http://www.nes.scot.nhs.uk/education-and-training/by-discipline/medicine/generalpractice/gp-retainer-scheme.aspx
West of Scotland Associate Advisor Dr. Alison Garvie
Page 8 of 11
alison.garvie@nes.scot.nhs.uk
SUPPORT & INFORMATION for NEWLY QUALIFIED GPs

www.nasgp.org.uk National Association of Sessional GPs

www.doctors.net.uk

West of Scotland faculty of RCGP. The faculty provides representation on local
and national committees as well as organising local educational and social
events.
The RCGP has also launched an initiative called “First5” which aims to support
new GPs from the completion of training to the first point of revalidation at 5 years.

http://careers.bmj.com is a very useful source of information including vacancies,
careers articles and course reviews. You can set a weekly alert to send you an
email about jobs in areas you are interested in.

There is an excellent careers guidance package at
http://gpct.scottishappraisal.scot.nhs.uk/index.html

BNF Your local performers list administrator can send you up to date
papercopies of the BNF. At www.bnf.org you can sign up electronic updates

The MHRA can send you national drug safety email alerts at
http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/index.htm

Many GPs will experience stress or distress at some point in their professional
lives. Mental health and addiction problems are common. Try to look after
yourself, maintain your support networks, keep a work-life balance. If necessary
ask for help sooner rather than later.
Health professionals can self refer to occupational health services. The GPST
‘Important Information pack’ includes a lot of support resources including:
BMA Counselling Service and Doctors for Doctors. 08459 200 169
www.bma.org.uk/doctors_health/index.jsp
Doctors’ Support Line 0844 395 3010 www.dsn.org.uk info@dsn.org.uk

If you are unsure about your chosen career, guidance is available see
http://www.nes.scot.nhs.uk/education-and-training/by-discipline/medicine/careersand-recruitment/careers-guidance.aspx
Page 9 of 11
CONTINUING PROFESSIONAL DEVELOPMENT
Appraisal and revalidation
The RCGP intends to introduce a learning credits system as part of revalidation so be
prepared to record up to 50 hours of continued professional development per year. See
www.rcgp.org.uk/default.aspx?page=7407 for more details.
You will still have access to your GPST eportfolio and in the short term it may be worth
continuing to use this to record your CPD.
The administrator for your performers list can tell you how to ensure you get your annual
appraisal. For more details of appraisal, including the appraisal toolkit, visit
www.scottishappraisal.scot.nhs.uk
This includes a link on the left for sessional gps. This is a helpful page for those GPs
who don’t have a base practice to do significant event analyses, audit etc.
CPD options
You have fantastic access to education as a GPST and after qualification, you can feel
suddenly isolated and out of the loop, especially as a locum. Some of your options
include:
West of Scotland Deaney have excellent CPD activities see
http://www.gpcpd.nes.scot.nhs.uk/west-overview.aspx The local Associate
Adviser for CPD for sessional GPs is Janice Oliver janice.oliver@nes.scot.nhs.uk

Courses/conferences – check out the BMJ and RCGP.

If you’re locuming, ask a practice manager if they would be able to forward you
emails about local educational events.

PBSGL. For more information see www.gpcpd.nes.scot.nhs.uk/pbsgl

OOH education – if you are doing OOH, check if there is any educational events
organised locally.

Practice based – if you work at a practice regularly, ask whether you can join their
in-house education or PLT.

E-learning. Check out the packages on RCGP, BMJ Learning and doctors.net
websites

BASICS – Basics Courses are extremely valuable courses, particularly for rural
General Practitioners and come highly recommended. For details of courses go
to: www.basics.scotland.org.uk

Diplomas/MSc – there are an increasing number of options for postgraduate
qualifications and there is a huge variation in the amount of work you need to put
in and how courses are delivered. See BMJ careers and BJGP

University of Glasgow Dept. of General Practice also organise CPD activity.
Page 10 of 11
CAREER OPTIONS AFTER GPST – April 2012
Career Option
Medical
Education
Fellowship
Remote &
Rural
Fellowship
Academic/
Research
Fellowship
Formal Contact & Application
Info
Gen Info
1 year post in either West, SE, East
or North, of Scotland.
5 Sessions a week to develop
educational skills, experience and
Certificate in Medical Education
1 year post eg Argyle & Bute,
Arran, , Orkney, Highland,
Wigtonshire.
13 Weeks protected educational
time. Base practice and mentor,
plus time in other remote and rural
practices
1 year post based at University
Department of General Practice –
Aberdeen/Inverness, Dundee,
Glasgow, Edinburgh, St Andrews.
david.bruce@nes.scot.nhs.uk
Feb/March
peter.wilkes@virgin.net
Feb/March
a.hinds@dundee.ac.uk
April/May
To develop academic interest eg
research/education
Health
Inequalities
Fellowship
Paediatric
Scholarship
1 year, full or half-time.
West/East/SE Scotland.
Working in area of deprivation plus
protected learning time
36 days over one academic year.
£10 000
To support GPs to develop a
leadership role in child health
services in the future
Murray.lough@nes.scot.nhs.uk
Feb/March
ronald.macvicar@nes.scot.nhs
a.potter@nhs.net
May/June
Adapted from a document produced by David Pinney, Katy Wolstencroft, Vicki Guthrie, Rod Sampson.
Page 11 of 11