Terms and Conditions

As a medical professional I aim to deliver a professional service to the practices with whom I work. I understand the day-to-day pressures and difficulties encountered in general practice, my intention is to provide you with dependable locum cover that eases some of this pressure and can be relied upon to do the work you ask of me.

I treat the practices I work for with honesty, courtesy and respect and I hope to receive similar treatment in exchange.

To deliver a safe and reasonable service to you and your patients is only possible if the work you ask me to undertake is reasonable and can be achieved within the constraints of time, distance and my knowledge of your patients and the area.

Considering this, it seems sensible to seek to define some agreement of the work I expect to do.

Concise Terms

  • I am an adaptable and capable doctor. If you tell me what you want done, I can probably do it.
  • A “Session” is normally for 4 hours.
  • A Session incorporates up to 3 1/2 hours of “consulting”.
  • A “Full Day” is normally 9 hours with 1 hour for breaks and meals.
  • Longer sessions, on-call, out of hours cover and other variations can all be catered for if you ask.
  • A Session includes up to two Home Visits as part of the consulting time.
  • Appointments should be at 10 minute intervals.
  • Please structure workload within a session such that it can be reasonably achieved within the time allocated.
  • Where a surgery is longer than 2 hours I would request that admin blocks are included to prevent late running. (details agreed at time of booking).
  • I will provide the usual equipment for my work, but expect consulting rooms to have a reasonable standard of equipment.
  • Non-NHS Work, if you require it, is paid to me at a rate of 90%.
  • I do not normally provide substitute or detoxification medication in drug dependency.
  • Late cancellation terms apply.
  • Payment within 14 days please. Late payments over 14 days incur a surcharge of 10%.

Terms and Conditions in Detail

Booking Arrangements and Confirmation of Booking

Employing Practices should confirm bookings by e-mail. Please see the Bookings section for a suggested procedure to follow. The exchange of e-mails will constitute our contract, and the Terms and Conditions detailed here will apply unless otherwise specifically agreed.

Start time

The starting time of the booking is the time from which I am first expected to be available to the Practice. If I’m required to provide emergency cover before the start time of the first booked appointment this should be clearly stated, and will be subject to an additional payment.

Finish Time

The time of completion of the booking should also be specified, and should detail any continuing emergency cover required by the practice, if applicable.

Sessions

The normal duration of a session is 4 hours. This incorporates up to 3 ½ hours of “consulting” which includes booked appointments, extras, phone calls and visits. I will require up to 30 minutes over the course of each session for administration (referrals, chasing results, phone calls etc). If you need me to manage correspondence, results, or repeat prescriptions then please reduce the amount of face to face consulting time accordingly.

Booking Intervals

Ten minute appointments are now the norm in General Practice, and I will need this even if some 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 (see BMJ: Improving quality in locum general practice). Adequate time provision should be made for any telephone consultations. It is often useful to have a 10 min slot free after every 6 patients to prevent late running.

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

Visits

A session can include up to 2 home visits (in addition to a surgery) if time is made available for this. Please bear in mind that home visits to unknown patients in unfamiliar environments carry an increased medico-legal risk and will take longer to do when carried out by a doctor who does not know the patient. As a guide, I would normally expect 30 minutes for each home visit, although this clearly varies with local conditions.

Repeat Prescriptions

The MDDUS advise locum doctors doing repeat prescriptions to review the case notes for every patient regardless of the system used to manage repeats. I try to adopt a pragmatic approach to this advice and normally, if you require it, I will be happy to review and sign a share of repeat prescriptions or special requests. If your practice has a repeat prescription policy it would be beneficial if you can make this available to me before asking me to sign repeat prescriptions. Nevertheless, as medico-legally repeat prescriptions carry an increased risk for non-principal GPs they may take me longer to process and produce more queries than when done by your usual doctors.

I am of course not able to sign prescriptions without being confident they are safe and correct, and I am not able to sign acute prescriptions issued by another clinician or nurse.

Chaperones

The practice will provide a suitably trained member of staff to act as chaperone should one be requested. The chaperone will be in such a position as to be able to confirm there has been no abuse in the case of intimate examination.

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). 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.

On Call and Other Services

I am normally happy to do “on-call” work, but I need to be told beforehand that this is required. As my standard fees do not include being the “on-call” doctor this additional responsibility will incur additional charges.

Other work, such as providing care to nursing homes or GP hospitals, managing specific clinics, out of hours cover and so forth can all be catered for but I must know in advance what you require.

Single Handed Cover and 24 hour Care

Where I am covering a single-handed practice I expect to do the normal work of the usual doctor as far as possible. Cover will be for the full day / on call period as specified in the booking form and all normal clinical and administrative tasks (excluding private work) will be inclusive in my price.

Private Work

The service I provide to practices is for NHS contracted work only. By default, I do not expect to undertake any private work for your practice unless you request otherwise. Remember this includes requests from patients for private medical certificates.

Any Private Fees earned by me as a Locum will need to be paid additionally and separately. Private fees should be paid at a rate of 85% to me, and 15% to the Practice, of the Fee received by the Practice from the Patient or the relevant third party.

Drug Dependency

I am happy to see patients with opiate and other drug dependencies for general health care.

I do not normally initiate prescriptions for opiates or benzodiazepines to drug addicts for the purpose of detoxification or maintenance. In particular, I do not provide prescriptions for methadone.

Information for Locums

It will help me if you can provide an up to date information pack. An excellent model Practice Induction Pack has been designed by the National Association of Sessional GPs. 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 information on your local practices should be provided when I first attend the practice. I am familiar with use of EMIS LV, EIMS PCS, VISION, and GPASS, in paperless and paperlight environments and am quickly adaptable to computers. I will endeavor to ensure that all information collected during consultations is appropriately ‘Read coded’ to facilitate data collection for audit and new contract purposes. It would be useful if a member of staff could to prepare a consulting room and turn on the desktop computer, ensuring I am able to start consulting without delay.

Drugs and Equipment

I will provide my own basic clinical equipment. I expect your consulting rooms to be appropriately equipped. I do not carry more specialised equipment such as a defibrillator or nebuliser and if these items are normally carried by the doctors doing visits I would ask that the practice provides them.

I may provide patients with information leaflets from recognised sources such as Patient.co.uk, Prodigy.nhs.uk and I may refer them to other suitable internet resources.

I normally carry a selection of emergency drugs, medications and simple equipment. If I use any of my own supply of drugs on your patients I would appreciate it if you were able to replace these for me via stock order.

Travel / Mileage

I will agree any mileage charge with you at the time of booking, but rates apply for significant distances from my base in EH32

Cancellation Terms

Bookings should not be cancelled by either party except by mutual agreement. Practices will find it difficult to obtain substitute cover, and patients will be inconvenienced by enforced surgery cancellations. By the same token, the Locum will have difficulty in replacing sessions cancelled at short notice. I will only cancel a pre-booked session within 28 days of the session in the event of significant illness or accident in myself or a close family member or other unforeseen significant disasters! In the unlikely event of this occurring I would of course not expect any payment.

If you need to cancel a session with me within 14 days of the session itself I will require a cancellation payment of 25% of the agreed total fee.

Payment

I will provide you with an invoice and I would normally expect payment to be within 14 days of my invoice. I shall invoice practices either at the end of the month or after completing my bookings with the practice, a receipt can provided on request.

Payment by personal cheque or BACS is preferred. I can also accept Credit Card payments indirectly via PayPal (though there may be a transaction charge for this).

I shall require you to complete GP locum Form A (NHS Pension form) and return it to me with your payment.

Payments received more than 14 days after the invoice date will be subject to a 10% surcharge of the total amount due.