ࡱ> =?<y bjbjEE *'' tt8 !t+++++Z!\!\!\!\!\!\!$O#%!!++!j++Z!Z! |&!+Ћlpp!F!!0!!&&$&!&&! !!!&t }:  LMC Position Paper on Remuneration and Reimbursement for GPs working outside the Practice for PCTs Introduction. GPs are increasingly expected to undertake duties outside the practice on behalf of a PCT or other NHS bodies. These range from providing regular clinical specialist services to sitting on occasional performance review panels. However, workload pressure in practices is such that doctors cannot readily be spared for external tasks, and the inadequate availability of locums means that an absent GP cannot always be replaced. Principles to be considered in calculating reimbursement There are three broad areas that should be considered when deciding the cost of taking a GP out of his or her practice. Direct costs incurred The actual cost of employing a locum for the total necessary period of absence travel or mileage costs should be reimbursed. The inexorable rise in locum charges means that it is no longer possible to set locum rates in advance for the year. Payment for expertise Unless a GP is being asked to attend a meeting purely as a working GP, he or she is bringing some special skills to bear over and above those normally used by a family doctor. This needs to be recognised, and an appropriate payment made. The amount of the payment will depend on the particular skills being deployed. Reimbursement to practice Even an experienced locum never fully replaces an absent partner. Work is deferred, patients recalled, and procedures not undertaken when a locum surgery is compared to one run by a principal. Furthermore, telephone calls and paperwork will be left for the absent doctor. A payment element should go to the practice to cover this. Matters to be disregarded A number of suggestions have been put forward as to why one or all of the elements above should not be considered in individual cases. The LMC strongly feels that the following should be disregarded. The activity concerned is of educational value to the doctor. This may be so, but it will therefore be of consequent value to the service. GPs should not be paying personally for the training needs of the NHS It is the interests of general practice to have a GP present This is a decision that only the LMC can make, so requests for GPs to attend meetings of this kind should be addressed only to the LMC. The GP can attend the meeting at a time when he or she is not working in the practice Nonetheless, this is part of the doctors work for the broader NHS so he or she should be able to take time in lieu from their clinical practice GPs are offering to do the work as a hobby or favour This is a wholly inappropriate way to be providing NHS clinical services or management support. 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