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At the heart of general practice since 1960

Why the retainer scheme could be your best option

It is possible to

have a home life and keep your career on track ­

Dr Sarah Humphery explains how

joined the GP retainer scheme because I have a two-year-old daughter and wanted to spend time with her but not become deskilled. I've been a GP retainee for the past 18 months and it has been perfect for this stage in my career.

The GP retainer scheme was introduced in 1969, allowing doctors taking a career break to stay in general practice on a part-time sessional basis working up to two sessions a week in an approved practice. The scheme remained largely untouched until 1998 when changes were introduced allowing doctors to work up to four sessions per week. The changes led to a doubling in the number of GPs working as retainers by 2001.

The scheme is for doctors who wish eventually to return to general practice as a principal or non-principal and keep up to date, retain skills and develop their careers in a protected and educationally stimulating environment. Men and women can be retainers and there is no age limit as long as the doctor intends to return to general practice.

Retainer criteria

Applicants:

lshould have well-founded personal, domestic or other reasons for wishing to join

lmust have a vocational training certificate or be able to demonstrate equivalent experience

lmust be registered with the GMC and be a member of a defence organisation

lshould intend to work a minimum of one session per week, no more than four sessions on an average week, and no more than 52 sessions in any one quarter; a session is defined as between three and three-and-a-half hours, including administrative time; a retainee may agree to do home visits and on-call responsibility provided it is completed within the agreed sessional time

lcan undertake outside (non-GMS) work if beneficial to their future work as a GP ­ normally no more than two sessions

lmust agree to undertake 28 hours of paid medical educational sessions annually; three hours should occur within practice with the educational facilitator.

Revalidation will include a 'folder' of evidence of continuing professional development. This includes a framework for developing your personal learning plan. The GP retainer scheme is not intended for those considering a career as an academic, portfolio doctor or in another sector of practice.

Sorting out pay and conditions

Doctors who join are expected to work in practices where they receive regular support by a named GP who is their educational facilitator. The role of the GP retainee is supernumerary. So the practice gets £50 reimbursement for each clinical or study session. The retainee gets an annual allowance of £310 towards a medical defence body subscription.

A BMA model contract for retainees sets out the recommended holiday (usually the same as the partners' six weeks), maternity and sick leave. Pay rates are a matter of negotiation between the GP retainee and their facilitator. More details are available from the GPC on 020 7383 6617.

On joining the practice you get an induction period to meet the primary health care team, familiarise yourself with the practice routine, protocols and prescribing aims.

A prospective retainee will need to apply to their local postgraduate deanery. They will be sent application forms and may have to discuss with the sector tutor their reasons for entering the scheme.

I qualified as a GP in 1997, locumed for 18 months then was a GP assistant for two years. Now I am a GP retainer in north London.

It was helpful having the BMA model contract to work with when negotiating my terms of employment. Pay was tricky to agree and it was helpful to take the suggested rates to the 'negotiations'. It is wise to talk to other local retainees to see what they are getting.

I feel more supported and less isolated than when I was a GP assistant. I meet my GP facilitator regularly to discuss cases and problems, and each month go to a non-principal group for educational activities and peer support. I feel a valued part of the team and have made several suggestions about changing some aspects of the practice, which staff and partners welcomed.

Four sessions a week is enough to keep my clinical skills up to date. I think a minimum of two sessions a week is needed ­ otherwise you can lose confidence and become more hesitant when seeing patients.

The scheme allows you to do two sessions a week of non-GMS so I have taught undergraduates, which is both rewarding and stimulating.

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