Partnerships - the 1st few years how to plan & do it

1. Partnerships - the 1st few years how to plan & do it

2. My journey to GP Land! • Qualified Dec 2000 • PRHO, A&E, mandatory 6/12 travel • SHO medical rotation • Saw the light and moved to VTS (!) • 18/12 Airedale VTS • 6/12 GP Kilmeny with Jim • 6/12 O&G AGH • 6/12 GP Fisher with Alan • Completed VTS Feb 2007

3. Since VTS • Feb – June 2007 – Locum work • July 2007 – joined Haworth, 6/12 mutual trial period 4.5 sessions a week (job share) • Jan 2008 – formally became partner at Haworth 4.5 sessions per week • Initially continued locum work alongside • Now 5.5 sessions per week

4. My roles within our partnership • First and foremost primary care! • Medical student lead • Prescribing lead • Osteoporosis lead • Caldicott Guardian • Family planning/coils/implants • Away Day • Website development • Palliative care

5. Next steps? • Level 2 DM clinic? • GP training? • Keep things changing within your roles • Keep things interesting!

6. Your plans? • What are you doing currently? • Your ideal first post after VTS? • What things are you hoping to get from this session? Any thoughts on areas you would like to cover.

7. Why consider a partnership? • Full involvement in practice decisions • Opportunity to shape way practice develops • Opportunity to shape own career more easily • Opportunity for higher income • Opportunity to own share of business +/- premises

8. Opportunity to develop new skills eg • Recruitment, interviewing • Dealing with staff disputes • Handling patient complaints • Understanding (?!) accounts • Negotiation/decision-making within a team

9. Why consider an alternative? • Worried about having to make financial commitment to a practice • Prefer ease/security of being employed rather than self-employed • Regulated sick/mat/study leave and pay • Fixed hols • No financial risk – salary set • Less paperwork re tax/NI/pension etc • Not ready to commit to staying in one place

10. Not able to find the right practice/role for you at the moment • Not wanting extra time commitment that may be needed • Not wanting extra responsibilities

11. What to consider when looking for a partnership • Size • how many partners/salaried GPs • patients per full time dr • Location • Rural • Inner city • Population demographics • Basic info re usual working day • Level and types of care provided • Skill mix – what’s missing and what can you offer?

12. The “woolly” stuff… • Ethos of the practice – where do their priorities lie? • Patients • Time • Money • What sort of people are they? Do they get on? Will you fit in? • What values do they have? • How often do they all meet up during working week?

13. The business side • How progressive/well-organised/in-tune with challenges of continuing changes to GP work are they? • Approach to division of workload • Who owns the premises? • Financial buy-in • Practice accounts – will they be available for you to see? • Partnership agreement • Do they have one? • Is it up-to-date?

14. Most importantly … • What are they looking for? • What are you looking for?

15. Where to look • Local grapevine • VTS board • Local GPs/trainers • LMC • BMJ • GP/Pulse/Doctor • Local sessional doctor groups

16. Applying • Update your CV early • Develop a template covering letter which you can individualise • Consider visiting practice/speaking to PM or a partner • Ask around for info/gossip about the practice • Trainers/other local GPs • Previous GP Regs/locums/salaried GPs

17. Interviews • Questions they may ask you: • Reasons for applying – be clear about what you’re looking for • Your main achievements to date • The strengths you would bring to the post • Any special clinical interests • What sort of person are you? How would a friend describe your personality? • Hobbies/outside interests

18. What differences do you see between being a partner and being salaried? • Where would you like to see the practice/yourself in 5yr time? • What pros and cons do you see in the government’s plans re GP consortia? • What do you see as the most important features of a successful and stable partnership? • What have you read recently that has changed your practice?

19. “What would you do” questions: • Describe a situation where you had to work effectively in a group or team to achieve a shared goal • Tell us about an achievement that you are especially proud of because it was difficult or demanding to do • Describe a complex problem you have faced and how you resolved it • In your opinion what is the biggest threat to and the greatest opportunity for general practice over the next 10 years

20. Questions you could ask them! • How would you describe your practice population? • How do you stay in touch with each other during the working week? • What plans do you have for how the practice will develop over the next 5-10yr? • Why do you enjoy working here and what things about it do you find stressful? • How would you describe the priorities of this practice? • Over what sort of issues do you tend to disagree and how do you resolve any differences of opinion? • What do you enjoy doing outside work? • TRY TO AVOID THE OBVIOUS AND LEARN SOMETHING YOU ACTUALLY WANT TO KNOW!

21. Before accepting • Gut feeling after interview • Ask to see partnership agreement • Ask to see accounts • Check whether you need to buy in, if so when and how much • Check situation re mutual assessment period • Check plans to draw up new agreement

22. Accounts • Ask to see ideally last 3yr accounts • Consider independent assessment • How are profits divided? • Parity issues • What income is pooled? • Provisions for tax, practice accountant • Who does the accounts?

23. Partnership agreement • Must have one – or you’re relying on Partnership Act of 1890! • Must be up-to-date or risk “Partnership at Will” • Get advice from BMA if any doubts • Check sick/mat/pat/study leave entitlements and pay arrangements • Check re how assets/income divided • Check agreement re decision-making • What happens if things break down? • How will you be treated during a mutual assessment period?

24. What to expect from the 1st year • Try to get a feel for what will be expected from you before you start • Finding your feet • Learning people’s names! • Adjusting to new IT systems/colleagues/referral routes etc • Starting to get an idea of areas you would like to lead on/develop • Allow yourself time to settle in and accept things will take you longer to start with

25. How to get the most out of it and stay sane! • Away Day/practice meeting good opportunity to review how things are going • Plan ahead re areas you would like to become more involved in / skills you would like to develop • Change tack regularly to keep things interesting • Talk to your partners

26. GOOD LUCK!