Is salaried option the best for you?
The salaried option has become more attractive over the past few years, driven largely by the confusion over the new contract. What are the pros and cons of being salaried, what should you look for in a practice and how will the new contract change things?
The most important thing to remember is there is a GP shortage,
so there is no need to rush to join
the first practice you see with a vacancy you can take your time and be choosy.
Under salaried service workload is well defined. You should not automatically be expected to do work beyond that for which you are contracted. (As a partner you just have to get on and do the work that's why partners get paid more.) Paperwork should just be related to your clinical work, but this will still be considerable. You will be spared the business aspects of running a practice and the costs of buying into practice assets. As an employee you will also have more employment rights and if paid under PAYE will be spared most of the hassles of a tax return.
However, although you have less responsibility, you will not be paid as much. Most contracts are time-limited so you do not have a job for life.
You will also have less say in how the practice is run and how it develops.
Buying into practice property will not be an option. Under the cost/notional rent scheme buying in is usually an excellent investment, so this might be a drawback for some.
What should you look for in a job? Can you get along with the other doctors? Are they nice people? No job will be enjoyable if you can't stand your colleagues.
Money is important. Your salary for nine to 10 sessions should be in the range of £55,000-£60,000 per year. This should cover basic surgeries and around two visits per day, but doesn't usually include defence subscriptions. Anything else, such as Saturday mornings and out-of-hours, should be open to negotiation. Salaries vary and usually represent the level of desperation of the recruiting practice. View salaries outside the normal range with suspicion.
Sick pay entitlement will usually be less than that of a partner or for hospital service so you may need to take out your own cover.
Other things to check include, holiday entitlement (six weeks), study leave (one week) and maternity leave (as for partners).
Your appointment and surgery lengths should be the same or less than that of a partner.
You should have your own consulting room.
Remember you are there to do your share of the work and not be a general dogsbody. It is not acceptable for your surgeries to be full every day while the partners twiddle their thumbs.
The new GMS contract is likely to increase the opportunities for salaried service. PCTs are increasingly becoming responsible for staffing areas where doctors are scarce and they tend to go down the salaried route. Beware of floating PCT posts where you are sent to wherever the need is greatest.
I suspect many GMS practices will move to PMS where it will suit them to employ salaried doctors rather than partners.
A new partner under GMS brings another basic practice allowance while in PMS a new partner would just dilute the pool of money. Extra salaried GPs are often paid out of development funds and so may not affect the partners' drawings. The exception would be a PMS practice that is keen for someone to buy into the practice assets; in this case they would still want a partner.
The BMA has just produced a new 'ideal contract' for salaried GPs, which covers most employment concerns. It has also suggested salary ranges, but market forces will dictate the rate far better than the BMA.