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Finance diary, July: How to cope with summer holiday leave

Practice rotas often come under pressure in the summer when partners take holidays, writes Bob Senior. Could working patterns be better controlled?

The summer holidays may be approaching but GPs are still working harder than ever, with increasing demands from both patients and the new contract taking their toll.

Constant sniping in the press doesn’t help. Recent comments suggesting that doctors shut the surgery and go home at 5pm are clearly ridiculous. The only GPs I know who go home at 5pm are the ones who were supposed to be working a half-day and should have gone home at lunchtime.

Plan cover ahead

A common comment I hear from GPs is that workload is not too bad when all the doctors are in the surgery, but it all becomes too much when there are doctors absent.

If more than one doctor is absent at the same time, it becomes an absolute nightmare.

The long summer holiday season can be particularly problematic if practices fail to plan adequately. Many practices, when asked how well the GPs plan their holidays, will often say that they try to avoid duplications wherever possible. Often, though, they don’t seem to manage it.

Booking locums to cover avoidable absences is one answer. But does this offer the best value?

Practices that arrange for their own GPs to cover for their absent colleagues will get better value for money. They also tell me that they see a reduction in the number of patients who come back because they saw the locum and now want a consultation with one of the regular practice GPs.

It may not always be feasible for the practice’s own GPs to cover all the holidays themselves, but it is definitely worth attempting to plan as far ahead as possible.

A worrying trend

On a separate note, I have also picked up on an emerging trend of GPs attempting to carry out a full-time role in eight sessions, rather than the traditional nine.

Those eight sessions are usually worked over four days rather than five since in practical terms there is little chance of a GP working only half a day.

Those who try are likely to end up working two-thirds of a day but being paid for only half.

GPs who attempt to fit their work into eight sessions over four days have either realised that the ninth session is usually a very long one, or believe that having an extra day off will enable them to cope.

However, trying to fit a full-time role into four days invariably means that GPs work long, hard periods – 12-hour days are not uncommon. The result is that the fifth day invariably goes by in an exhausted blur as the GP struggles to recover.

Perhaps now is the time for these GPs to stand back and ask themselves whether it is practical to fit a full-time job into eight sessions.

Would it not be better instead to return to the traditional nine sessions but keep a firmer grip on how many hours are worked each day?

If they are successful, they will still work the same total number of hours but by getting home at a reasonable hour each evening and leaving promptly on the half-day they might survive.

Now that is something to think about during your time off this summer.

Bob Senior is chair of the Association of Independent Specialist Medical Accountants and head of medical services at RSM Tenon

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