Dr Mahibur Rahman
Many doctors spend a large part of their careers working in a salaried capacity. For some doctors, it is the first step on the path to a partnership, for others, working as a salaried GP bring the benefits of working in general practice without the extra responsibility, time and uncertainty of partnership. Here is a comprehensive guide to some of the advantages and disadvantages of working as a salaried GP:
As a salaried GP, you will have a stable work environment, being able to develop a working relationship with members of the team. You will be able to plan your finances as you will have a fixed monthly income. You should have a structured working week, making it easier to plan social engagements, childcare etc. Having a regular workplace also makes it easier to access CPD, to take part in audit and significant event analysis – all of which are important as part the appraisal and revalidation process.
As an employee, you have significant rights. First, you have entitlement to sick pay, a minimum amount of paid annual leave, paternity / maternity pay and leave and unpaid time off for compassionate leave. After working for 2 years in the same employment, you also gain full employment rights including the right to redundancy pay. Usually your past NHS service would be recognised towards this as long as you have not had a break in service. Employment rights are one of the biggest advantages of being an employee.
As a salaried GP you should have a job plan outlining your duties, and your work time commitment should be fixed. If the practice suddenly needs extra cover, while your employer can request that you do an extra shift, you do not have to accept, and they cannot demand that you provide the extra cover. Your main commitment will be to clinical work, and many doctors prefer this – managing other employees, dealing with the upkeep of the building, keeping an eye on the accounts will not be your responsibility.
Salaried GP pay is very variable throughout the UK, and even between practices within the same region. The review body recommended range for salaried GP pay for full time doctors (working 9 sessions) is currently £56,525 and £85,298 (2018 figures). These figures apply to doctors working for GMS practices, PMS practices in England on the 2015 contract or for PCOs directly. Other PMS and APMS practices are free to offer any salary they wish. Average pay for salaried GPs in the UK working in either GMS or PMS practices in the 2014-2015 tax year (last available actual figures) was £55,800. This figure includes those GPs working less than full time (i.e. less than 9 sessions), which make up a large proportion of salaried GPs.
In some cases, if there is a shortage of applicants, or if you are taking a salaried role with additional responsibilities, pay can be much higher, or include a “Golden Hello” – an incentive to take a post in a specific area. In the current climate of GP shortages though, you may be able to negotiate a good overall package, especially if you have additional skills that can bring the practice extra income (such as fitting coils and implants, offering joint injections etc.). In many cases, actual take home pay for a full time salaried GP may be similar to a full time partner in a practice with below average profits once you take into account deductions for NHS pensions and indemnity.
Lack of Control
As a salaried GP, you will have less control on the direction of the practice or the services offered. You may also have less flexibility in terms of how much leave you have or when you take it, compared to working as a locum or a partner. Over time, some doctors find that the workload expected of them can creep up, with additional time and responsibilities expected that are not always reflected in additional income.
Like any job, there are both advantages and disadvantages to working as a salaried GP. Hopefully this article is a good starting point to thinking about how whether working as a salaried GP is for you.
Dr Mahibur Rahman is the medical director of Emedica and author of GP Jobs – a Guide to Career Options in General Practice. He teaches on the Emedica Life after CCT: GP Survival Skills course which includes sessions on salaried GP contracts, partnerships and succeeding as a GP locum. It also includes practical advice and demonstrations on how to negotiate contracts. You can see more details at www.emedica.co.uk/cct