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Commissioning dilemma - providing a GPSI service

You have a special interest in dermatology and your partners are keen for you to provide a service for the commissioning group, seeing it as a way of maintaining income. This will seriously impact on your time available for your routine patient care – and your colleagues are not keen on taking on any extra manpower. Dr Michael Dixon advises GPs on how to resolve this.

You have a special interest in dermatology and your partners are keen for you to provide a service for the commissioning group, seeing it as a way of maintaining income. This will seriously impact on your time available for your routine patient care – and your colleagues are not keen on taking on any extra manpower. Dr Michael Dixon advises GPs on how to resolve this.

Your colleagues cannot have it both ways. The obvious solution is for you to have your hours working in dermatology backfilled by partners or others. If they are not prepared to take on any extra manpower then this must be done "in house". It is unreasonable for them to expect you to fill those missing hours yourself. It must be a shared arrangement between all partners (including yourself) so that workload is fare between all. If you or they are not prepared to put in some extra shared hours to backfill and they are not prepared to take on extra manpower then your taking on the dermatology job is not feasible. You might argue, however, that provided the dermatology job paid for any missing hours in practice (and this is something that you will need to ensure) then they are not losing any money and therefore need to be more reasonable.

Commissioning Dilemma

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