ࡱ> EGD5@ bjbj22  XX*******>8 >/2        %%%%K&*:/0R3L:/*     :/**  O/    F* * %  %  $**%  y]Pa%% e/0/y%e3"e30%>>****e3*%(        :/:/>>D $ >>  LMC Position Paper on GPs with Special Interests Summary GPs with Special Interests can contribute significantly to managing demand at the interface between primary and secondary care. The remuneration package offered must recognise their special skills and ensure that these can be retained and developed. Contracting Models The preferred model will depend on the location at which the service is provided, the nature of the service ( diagnosis, investigation, treatment), the frequency with which it is provided, and the nature of the special skills provided. The LMC favours either an IOS arrangement, or a contract for a salaried service. We recognise that there are increasing moves towards the latter. Remuneration GPSIs are experienced GPs who have developed skills over and above those of their peers and partners. Their remuneration package needs to recognise: The value to the NHS of the service that is being provided. The expenses involved in providing this service. The market value of their time as GPs, and the cost of locum replacement. Their skill development that accrues over time. Salary LMCs generally are negotiating from a base annualised salary of 7500 per session. This should include 6 weeks annual leave (excluding Bank Holidays) and at least 4 sessions for audit, professional development, and liaison with the PCT. There should be an incremental scale that recognises experience in providing the service. Hospital Practitioner and Clinical Assistant pay scales are not applicable in this context. Superannuation All income arising from GPSI appointments should be fully superannuable (Note: We anticipate that this will be the case under the new GMS contract) Conditions of Employment GPSIs should normally be offered equivalent employment conditions to those of other PCT professional staff relating to sickness and maternity leave, professional development, and clinical governance work. The LMC recognises that where an item of service contract is agreed this may need to be modified. Either way, the GPSI should be prepared to participate in clinical audit and appraisal as appropriate. Costs Over and above the GPSI salary there may be personal or practice costs that should be met. GPSIs will often operate from practice premises. This offers significant advantages to patients, especially in availability and accessibility. However, all the costs to the practice of providing the service must be included in cost calculations, along with a reasonable profit element. Elements include: Rental of non-cost rented space Occupancy costs (heat, light, cleaning, decoration) Staff costs ( nursing , reception, secretarial) Administrative support (telephone, stationery, management) Access costs (car parking, waiting area) Use of equipment (including clinical consumables, repair and inspection, cleaning, depreciation) These costs should be calculated on an individual practice basis as each service will be different. To take as an example, one practice in TDPCT has worked out that the cost of providing a vasectomy is 36-37 per completed case for 2002/03.This does not include the costs of counselling and correspondence related to patients who choose not to proceed to an operation. Profit It is legitimate that there should be a profit element for the practice in providing a GPSI service. We consider that 10 per session is reasonable. Training We would normally expect PCTs to fund any training that GPSIs require. 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