A pre-start checklist for newly-qualified GPs

As many GPs prepare to begin practising for the first time, Dr Cheska Ball shares a helpful checklist for what newly-qualified GPs should look out for before they begin working

Completing GP training is a major milestone and marks the transition from resident doctor to independent practitioner. However, the period between finishing training and starting a first substantive GP role can involve several administrative, professional and practical tasks. These can range from regulatory requirements to employment arrangements.

With so many different systems, organisations and requirements involved, it can be easy for newly-qualified GPs to overlook important steps. Having key elements in place before starting a new role can help ensure a smoother transition into practice and allow doctors to focus on clinical work and settling into their new team.

This checklist has been developed as a practical guide to support newly-qualified GPs in preparing for their first role after achieving their Certificate of Completion of Training (CCT). It brings together common requirements and useful considerations across regulatory, employment, professional and practical areas to help ensure everything is in place before the first day in post.

1. Regulatory and professional requirements

Before starting work as an independent GP, there are several regulatory steps that must be completed to ensure you are legally able to practise.

Make sure that you:

• Have applied for your CCT via GMC and had it issued to you
• Have applied to be included on the GMC GP Register
• Are included on the National Primary Medical Performers List (relevant UK nation) and ensure that your PCSE details are accurate and up to date
• Have received your certificate from the Royal College of General Practitioners
• Have your enhanced DBS in place (the update service is often recommended)
• Have completed your immunisations and have occupational health clearance

If you are an international medical graduate (IMG) you may need to apply for a visa grace period pre-CCT. If you have needed a visa grace period or are looking for employment, you may need to review yours and your family’s visas too.

2. Indemnity insurance and unionism

It is important to ensure you have appropriate professional protection and personal insurance arrangements in place before beginning work. This includes confirming clinical indemnity coverage and considering membership of professional organisations that can provide support, advice and representation.

Make sure that you:

• Are covered by the Clinical Negligence Scheme for General Practice (CNSGP) for NHS work
• Have checked whether your indemnity includes run-off cover; this is required to remain protected against claims reported after your policy or membership period has ended
• Have business car insurance arranged if undertaking home visits

You should also consider:

• Membership to a medical defence organisation, such as the Medical Defence Union or the Medical Protection Society, for NHS, non-NHS work, locum work, complaints, GMC, inquests etc. This is strongly advised even if you are covered by CNSGP. Organisations such as the
• Membership to a trade union such as the BMA

3. Employment and contracts

Clarifying the terms of your employment before starting a new role can help prevent misunderstandings and ensure expectations are clear for both you and the practice.

Ensure that you have:

• A written contract confirmed with sessions, workload and admin time clarified (see advice for Salaried GPs here)
• Agreed supervision or mentoring arrangements (this is recommended for newly-qualified GPs)
• Confirmed your pension arrangements – and make sure you are enrolled via your employer
• Provided your bank details to your employer for payments and have checked your tax codes with HMRC (the mobile app is very helpful)

If you are interested in locuming, you may wish to set up a profile via the platform in your region e.g. for Dorset it is a platform called Lantum.

4. Appraisal and revalidation

All practising doctors in the UK are required to participate in appraisal and revalidation to maintain their licence to practise. Early registration with the appropriate systems and responsible body will ensure you remain compliant and prepared for your first appraisal cycle.

Make sure you:

• Are registered with a designated body (this will be the region you work in)
• Have identified your Responsible Officer and have your appraisal month confirmed
• Have registered with an approved appraisal platform e.g. 14fish which is free via RCGP membership

5. Practice induction and local processes

Every GP practice has its own systems, workflows and local pathways. Completing a thorough induction and becoming familiar with these processes before or shortly after starting will help you work safely and efficiently within the team. When you are inducted you should identify your point of contact for clinical questions, safeguarding, prescribing, complaints, HR, payroll, IT and administrative queries so that you feel comfortable for when you start working.

Preparation for working at your practice could include:

• Arranging access for:
  • Clinical system e.g. EMIS/SystmOne
  • Investigation requesting and referral platforms e.g. ICE for investigations and ‘C the Signs’ for cancer pathway referrals
  • NHS email
• Understanding the area’s processes for:
  • Online consultation tools e.g. e-consults
  • Results handling
  • Prescribing
  • Referrals
  • Tasks
  • Coding and letters (workflow)
  • QOF targets
  • Safeguarding pathways
  • Information governance and data protection requirements (usually there are documents to sign before starting)

Make sure that you are also clear on the local services that are available to patients (e.g. frailty or mental health) as well as the local guidelines on shared care agreements and practice procedures.

6. Equipment

Ensuring you have access to the equipment you need will support safe clinical practice from your first day. Depending on your role, this may include:

• Access to essential clinical equipment e.g. BP machine
• An adequately prepared doctor’s bag (particularly for locum or home-visit work)
• A laptop and/or appropriate technology for remote working

7. Career development and support

The transition from training into independent practice is also an important time to establish ongoing professional development and support networks which can help support your long-term career.

It could be helpful to:

• Create or update your GP CV post-CCT
• Save evidence and reflections to support future appraisal and applications
• Continue membership to the Royal College of General Practitioners in order to:
  • Join the RCGP First5 group for your area;
  • Link with local RCGP Faculty and Training Hub
• Be aware of confidential mental health employee support services in your locality

Starting your first GP role can feel both exciting and daunting in equal measure. While there is a lot to think about before your first day, taking the time to prepare now will help you begin your career with confidence. Remember that no one expects you to know everything from day one, and support is always available when you need it. Congratulations on reaching this important milestone, and the very best of luck to everyone about to complete their GP training and begin the next chapter of their careers.

Dr Cheska Ball is a salaried GP, BMA GP Committee elected representative, RCGP council elected member and former chair of the BMA’s GP registrars committee