Clinical voice ignored
Dr David Turner has worked as a partner and a salaried GP. He earned more as a partner, but he certainly had to work for it
One of the more positive outcomes from all the recent changes in general practice is an increase in the variety of ways in which it is possible to work as a GP. When I was a partner I took home more money than when I was salaried – but that extra money had to be earned.
Salaried doctors by and large only see patients. As a partner I had the additional responsibility of running the business.
Staff and nurse recruitment and training, health and safety, the accounts, complaints, computer problems, building repairs and blocked drains all ended up being my problem. It is true larger practices have more partners to spread the load, but they also have more work.
Working as a partner in a large practice I found barely a week went by where we weren't recruiting.
The bottom line
What actually is the difference in income between partnership and salaried work?
Many partners are now earning very well as a result of nGMS. A full-time, full parity (receiving full partnership share) partner in a well-run practice could be earning more than £100,000. But this can vary, depending on whether you are in a GMS or PMS practice, how efficient you are, how well you have met QOF targets and whether you offer any enhanced services.
But there is no doubt about it – now is a good time to be a partner.
So what of salaried posts? The BMA gives a guide range from £49,248 to £74,816 for a nine-session week. Of course this depends on experience, local demand for doctors and your negotiation skills.
As with partnerships, each salaried post is unique and can (and should) be negotiated to meet your needs. Ideally this should allow you to work when you want, and spell out as specifically as possible what you will and will not do.
As a salaried doctor you could be employed directly by the practice or by the PCO. Either way you should ensure you have an appropriate contract. The BMA can check yours before you sign it.
Also, as a salaried doctor you will have employment rights: sick leave, holiday, maternity leave and redundancy pay. Annual and study leave should be the same for partners and salaried doctors. However, partners may have to contribute towards locum costs.
Partners are self-employed, and not protected by employment law in the same way as salaried doctors.
Both partners and salaried doctors must undergo annual appraisal. Salaried doctors get protected time to prepare and can keep any payments from the PCO for this.
Many salaried and partnership positions
carry a starting bonus. Inner cities and deprived areas attract the biggest ones. I received £12,000 on taking up my salaried position in inner-city London. This is a hassle to claim and has to be paid back in part if you leave before two years.
I prefer working as a salaried doctor as I know exactly when I will start and finish. I have had time to pursue other interests and have managed to cut out the paperwork I hated as a partner.
Even as a part-time partner you will find your free time is absorbed by practice work. For me salaried work means more control, more free time, less stress – but less money.David Turner is a salaried GP working in London