THE • BUSINESS • SIDE • OF • GENERAL • PRACTICE The GP's Guide to Professional and Private Work Outside the NHS Edited by FRANK McKENNA Head of Private Practice and Professional Pees British Medical Association and DAVID PICKERSGILL Chairman, Private Practice and Professional Pees Committee British Medical Association Foreword by MAC ARMSTRONG Secretary British Medical Association CRC Press Taylor & Francis Group Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business First published 1995 by Radcliffe Publishing Published 2016 by CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 1995 Frank McKenna and David Pickergill CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works ISBN-13: 978-1-85775-074-4 (pbk) This book contains information obtained from authentic and highly regarded sources While all reasonable efforts have been made to publish reliable data and information, neither the author [s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and not necessarily reflect the views/opinions of the publishers The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional's own judgement, their knowledge of the patients medical history, relevant manufacturer's instructions and the appropriate best practice guidelines Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified The reader is strongly urged to consult the relevant national drug formulary and the drug companies' and device or material manufacturers' printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint Except as permitted under U.S Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data is available Typeset by Marksbury Typesetting Ltd, Midsomer Norton, Avon *iO Contents List of contributors v The Business Side of General Practice: Editorial Board vii Foreword ix Preface x Everyday work for GPs outside the NHS contract David Pickersgill Work for central and local government Frank McKenna Private GP services Geoffrey Samson 15 Opportunities in insurance work Chris Evans and Spencer Leigh 23 Working as a locum or deputy in general practice Adrian Midgley 33 Police surgeon (forensic medical examiner) work Hugh de la Haye Davies 41 The role of the part-time prison medical officer Eric Godfrey 51 Working for schools and colleges Roger Harrington 57 Pharmaceutical trials Frank Wells 65 CONTENTS 10 Part-time occupational health work Joe Kearns 73 11 Sports medicine Stuart Came 83 12 Surgical work in general practice Brian Elvy 89 13 Doctors, solicitors and the courts: a guide to accepting and receiving instructions Angela Anstey 99 14 Medico-legal fees: dealing with solicitors and courts Prank McKenna 111 15 Opportunities in medical journalism Tim Albert 123 16 Opportunities in medical education Eddie Josse 135 Index 143 The GP's Guide to Professional and Private Work Outside the NHS List of contributors TIM ALBERT, Medical Journalist, Castlebank House, Oak Road, Leatherhead, Surrey KT22 7PG ANGELA ANSTEY, Solicitor, BMA Legal Department, BMA House, Tavistock Square, London WC1H 9JP STUART CARNE, Vice President QPR Football Club, Past President RCGP, St Mary Abbots Court, Warwick Gardens, London W14 8RA HUGH PL LA HAVE DAVIES, President, Association of Police Surgeons, Creaton House, Creaton, Northampton, NN6 8ND BRIAN ELVY, General Practitioner, Oak Street Medical Practice, Norwich NR3 3DL CHRIS EVANS, Consultant Chest Physician and Chief Medical Advisor, Royal Life Company (Liverpool); The Cardiothoracic Centre, Liverpool, NHS Trust, Thomas Drive, Liverpool L14 3PE ERIC: GODFREY, General Practitioner and former part-time prison doctor, Deplesdon Road, Cheadle, Stockport, Cheshire SK8 1DZ ROGER HARRINGTON, General Practitioner and Secretary, Medical Officers for Schools Association, North End Surgery, High Street, Buckingham MK18 1NU EDDIE JOSSE, General Practitioner, Brownlow Medical Centre, 140-142 Broivnlow Road, London Nil 2BD JOE KEARNS, Consultant Occupational Physician, Ascott Avenue, London W5 3XL SPENCER LEIGH, Chief Underwriter, Royal Life Company, Liverpool ADRIAN MIDGLEY, General Practitioner, The Homefield Surgery, Homefield Road, Exeter EX1 2QS GEOFFREY SAMSON, Private General Practitioner, 80 Redcliffe Gardens, London SW10 9HE FRANK WELLS, Director of Medicine, Science and Technology, Association of the British Pharmaceutical Industry, 12 Whitehall, London SW1A 2DY LIST OF CONTRIBUTORS Editors FRANK McKENNA, Head of Private Practice and Professional Pees, British Medical Association, Tavistock Square, London WC1H 9JP DR DAVID PICKERSGILL, Chairman, Private Practice and Professional Pees Committee, British Medical Association, Tavistock Square, London WC1H 9JP The Business Side of General Practice Editorial board for the series STUART CARNE, former President, Royal College of General Practitioners JOHN CHISHOLM, Joint Deputy Chairman and Negotiator, General Medical Services Committee, British Medical Association NORMAN ELLIS, Under Secretary, British Medical Association EILEEN FARRANT, former Chairman, Association of Medical Secretaries, Practice Administrators and Receptionists SANDRA GOWER, Fellow Member of the Association of Managers in General Practice WILLIAM KENT, Secretary, General Medical Services Committee, British Medical Association CLIVE PARR, General Manager, Hereford and Worcester Family Health Services Authority DAVID TAYLOR, Head of Health Care Quality, Audit Commission CHARLES ZUCKERMAN, Secretary, Birmingham Local Medical Committee; Member, General Medical Services Committee, British Medical Association Foreword GPs are being presented with ever increasing opportunities to undertake work outside their NHS contract Some are well versed in how to develop the financial benefits these opportunities can bring to their practice But others, not surprisingly, are unsure where to turn for information on how to develop these areas of work This book contains valuable advice and information on the practicalities of professional and private work outside the NHS It draws on the knowledge and experience of both professional advisers and GPs themselves I am confident that both newly appointed and experienced GPs alike will find this book informative, practical and essential reading if they wish to keep informed of professional opportunities outside the NHS Mac Armstrong Secretary British Medical Association September 1995 -*s% i^m 16 Opportunities in medical education Eddie Josse The opportunities available to principals to become involved in medical education have been increasing over the years, not only in the postgraduate field, but also with medical students and other health carers and in nonmedical university departments The commitment by involved and interested GPs has been considerable, eroding into professional service and domestic time The financial return has been variable and rarely, if ever, matches the actual work-load incurred Clearly, it has required the active goodwill of partners and spouses Female GPs are playing an increasingly important part in the whole field of education Many of the opportunities and positions have been recognised by the DoH and have been negotiated through, by or with the support of the General Medical Services Committee (GMSC) of the BMA, leading, in many situations, to the inclusion of explanatory paragraphs in the Statement of Fees and Allowances (SFA) (see below) However, many posts, such as academic appointments to undergraduate departments of general practice at medical schools, would not directly concern or involve the DoH A perceived advantage of encouraging principals to pursue a high profile in medical education is the positive spin-off that it will have in enhancing primary health care delivery, although it could be argued that it is more likely to be those GPs already providing good quality care who would be prepared and able to add medical education to their professional activities The degree to which GPs (and other doctors) have actually trained academically, i.e for diplomas or degrees in medical or general education, has been variable and generally low, although there is now an almost universal expectation and requirement that teaching courses are attended and re-attended by those involved or wishing to be involved in general practice vocational training There is, however, a growing interest amongst GPs in studying for higher examinations, especially masterships in the fields of general practice, community work and education 136 PRIVATE AND PROFESSIONAL WORK OUTSIDE THE NHS Trainers The activity most recognised by GPs in the field of medical education is that of being a trainer in an approved training practice This was developed and brought into operation at the same time as the introduction of the NHS in 1948 It came about as a result of an initiative in early 1948 by the then Ministry of Health to, and in the dying days of, the Insurance Acts Committee, the forerunner of the GMSC, some four years before the founding of the college of General Practitioners (RCGP) Any principal may apply to become a trainer, generally being appointed by a regional general practice sub-committee in England or parallel bodies in the other parts of the UK Scotland limits the number of trainers who may be appointed at any one time Each region (or subregion) develops its own criteria and precise administrative arrangements in relation to trainer appointments and re-appointments, although regard is paid to guidelines and a number of expected standards from such bodies as the Joint Committee on Postgraduate Training for General Practice (JCPTGP) Visits to the practice always occur and recur, and regions are constantly nudging up standards It is expected that GPs on LMCs and local RCGP faculties should be involved in the process of determining standards and appointing and re-appointing their peers The commitment by a trainer extends beyond the supervision, teaching and assessment of the trainee The trainer is expected to attend basic and advanced trainers' courses, trainers' workshops and conferences, take a part in the appointment and re-appointment of fellow trainers, play a role, when requested, in half-day release schemes, and ensure that he or she keeps abreast of training and service developments Doctors who are not appointed or re-appointed may appeal against this decision (although not in Scotland) to the GP Trainee Scheme Appeal Committee at the JCPTGP offices (SFA ref: Paragraph 38.1-38.43) Course organisers A natural extension of the trainer system was to appoint a trainer with special responsibility to supervise and organise a course local to a number of trainees (registrars), whether in the general practice or hospital phase of training Thus, the course organiser was born, appointed, as now, through the regional GP advisory machinery accountable to the Regional Adviser in MEDICAL EDUCATION 137 General Practice (RAGP) Up until 31 March 1992, the remuneration of a course organiser was equivalent to the trainer's grant and was paid via the contracting FHSA out of the'general medical services pool set aside for all GP remuneration Since April 1992, the pay and rations of course organisers became the responsibility of RAGPs acting on behalf of postgraduate medical deans The global spending on course organiser remuneration, including such costs as superannuation and national insurance, has therefore became part of the postgraduate dean's educational budget, having been deducted in a once-for-all action from the general medical services pool At the same time, the level of remuneration was greatly enhanced by additional funding (1995/96 = £7922.72, based on two sessions per week), thus exceeding the trainer's grant (1995/96 = £4740.00) The position of course organiser per se does not exist in Scotland; parallel duties are undertaken by Associate Advisers It had been recognised that the responsibilities now covered by course organisers had mushroomed to include not only the local scheme educational half-day or full-day courses, but also, for example, setting up and administering three-year vocational training schemes, attending to the needs of trainees on self-constructed schemes, counselling duties, assessment procedures and attending appointment committees, relevant courses and conferences Most course organisers join their national body, the Association of Course Organisers, which has provided a powerful forum in which to facilitate their development and training There is no means of appeal against not being appointed or re-appointed a course organiser GP tutors A more recent and welcome development has been the appointment of a cadre of GPs with responsibilities in the area of continuing medical education/continuing professional development in a locality The appointments were properly recognised by, and funded through, the DoH from April 1993, partly in response to the 1990 contract, although a number of appointments had been made much earlier The tutors are appointed on a regional (or subregional) basis and are accountable to the RAGPs The role of a GP tutor is essentially to try to create an environment in which local principals (and assistants) are encouraged to pursue continuing education and further development This requires initiative, drive, some understanding of educational processes, innovative ideas, organisational talent and an ability to relate to colleagues and facilitate their own progress 138 PRIVATE AND PROFESSIONAL WORK OUTSIDE THE NHS A National Association of GP Tutors has been formed, and attention has been given to the training needs of new and established tutors The remuneration is the same as that for course organisers, and, as for them, there is no appeal against a failure to be appointed or re-appointed Regional/associate advisers RAGPs were originally appointed to develop vocational training for general practice in their regions of responsibility The GMSC had supported their creation in a policy document of 1968, and an impetus was given to their appointments following the Todd Royal Commission Report on Medical Education of 1968 By the early 1970s, all regions had appointed RAGPs although the original job description of 1972 has expanded to include the financial management of the Section 63 and PGEA accreditation allocations At this time, continuing medical education for principals was funded through the Section 63 arrangements (of the 1968 Health Services &c Public Health Act), administered by postgraduate medical deans, to whom the RAGPs were and are accountable It was quickly recognised that, with the expansion of vocational training for general practice in the NHS and its becoming mandatory through legislation by the late 1970s, RAGPs required assistance By 1973, trainer appointments and re-appointments were being administered through regional educational committees serviced by RAGPs Throughout the 70s and thereafter, Associate Advisers were appointed, accountable to the RAGP The work of an Associate Adviser was and is either on a geographical patch basis or task-specific, for example being responsible for a region's course organisers, GP tutors or assessment procedures for trainees or combinations of these Most Advisers hold university appointments, although a few are employed by RHAs With the disappearance of RHAs and their replacement by the NHSE, new contractual arrangements will be put in place by 1996 to take account of the expanded role of RAGPs in holding budgets for vocational training and continuing medical education RAGPs have been administering these budgets provided through the DoH for some years It is, therefore, likely that RAGPs will hold part-time contracts as civil servants for a proportion of their advisory work They will be looked upon as purchasers of medical education, although many will also have a provider function, largely through the organisation of specific educational programmes MEDICAL EDUCATION 139 Regional, Deputy and Associate Advisers are all paid the same remuneration from the commencement of their appointments, namely at the top of the NHS Consultant rate without a merit award It is counted as officer service and is, of course, superannuable PAYE deductions are made unless the Adviser is on an NT (no tax) coding, in which case tax is paid in accordance with the Adviser's self-employed status as a GP in contract with an FHSA (or Health Board) and there is a liability for national insurance contributions The original intention was that all RAGPs should be part time (working a variable number of sessions per week) and otherwise be principals A number have become full-time employees and have left active practice, certainly in their capacity as principals It is clear that the work of RAGPs has expanded very considerably and will continue to so, with the possibility that most will become full time in the not too distant future Their additional work includes advising on applications under the prolonged study leave and doctors' retainer scheme arrangements, assisting the CMC in the retraining of doctors with disciplinary or health problems, career counselling, assessing hospital posts for vocational training for general practice, advising the postgraduate dean and other bodies on educational matters concerning general practice, having a role in the development of re-accreditation and developing a relationship with academic departments of general practice at medical schools Associate Advisers are part time and likely to remain so Since they will not be budget holders, there will be no need for them to become civil servants, even on a part-time basis RAGPs meet regularly on a national basis, at times accompanied by their Associate Advisers These meetings and conferences are becoming of growing importance, and, although they are independent of the RCGP, GMSC and JCPTGP, there are links between the advisers and these bodies; for example, RAGPs hold three seats on the JCPTGP There is no specific programme of training to become a Regional or Associate Adviser, although most will have had previous educational experience as a trainer, course organiser, GP tutor or member of an undergraduate department of general practice The main thrust of their work is educational and administrative, although an increasing amount of research is being pursued or commissioned through their departments Academic departments of general practice Although many, if not most, of the appointments to these departments are 140 PRIVATE AND PROFESSIONAL WORK OUTSIDE THE NHS full time, there are opportunities for principals to be appointed as senior lecturers, lecturers or tutors The placement of medical students into practices is growing as part of the recognised pattern of enhancing the teaching of medical students in and about the community This has in part been recognised as an NHS responsibility, whereby payments may now be made for student attachments in a practice (SFA 40.1-40.5) Other activities Opportunities exist in other educational fields, such as lecturing not only to doctors, but also to other health care professionals and administrators, for example practice nurses and administrative staff, to members of the public in the St John Ambulance Brigade or British Red Cross Society, and on academic and other courses, for example an MSc or continuing medical education A number of principals have become very entrepreunerial in arranging intensive courses often linked with leisure activities abroad It is arguable whether or not the financial return has assumed a higher profile than the desire to provide good educational programmes However, reports from doctors attending such courses have, in the main, been very favourable The PGEA arrangements recognize the educational value of a practitioner's lecturing at an approved educational event by enhancing the credits that can be given to a doctor (SFA ref: Paragraph 37.9) Conclusion There is little doubt that there are considerable opportunities enabling principals to become involved in one or more aspects of education (Table 16.1) Remuneration is available, but if doctors look to education as an easy option with rewarding pickings, they would be well advised to look elsewhere MEDICAL EDUCATION 141 Table 16.1: Educational opportunities Post/ experience SFA reference Trainer Para 38 Employing/ appointing authority Usual accountability Regional GPS/C or equivalent RAGP Course organiser RHA via GPS/C RAGP GP tutor RHA via GPS/C RAGP Regional/associate adviser University/RHA PGD RAGP Senior lecturer, lecturer, tutor Medical student teacher University Head of department Variable N/A Lecturer, PGEA, other Para 40.1 - 40.5 Para 37.9 GPS/C = General Practice Sub-committee RAGP = Regional Adviser in General Practice PGD = Postgraduate (medical) dean Index ability, in private general practice 18 absence control, occupational health work 79-81 academic departments of general practice 139-40 Access to Medical Records Act occupational health work 80 Access to Medical Reports Act insurance work 24 occupational health work 81 active voice, journalism 130 acupuncture 22 adjudication, Prison Medical Officers 51, 53 adoption reports 13 advertising, private GP services 15-17 affability, in private general practice 17 agencies, deputies 35-6 ambulance associations answering machines 39 appliance charges, exemption from appointment systems, surgical work 92 Associate Advisers 137, 138-9 Association of British Insurers (ABI) 8, 23 Association of British Pharmaceutical Industries (ABPI) 67, 68, 70 Association of Chief Police Officers 47 Association of Course Organisers 137 Association of National Health Service Occupational Physicians 81 Association of Police Surgeons (APS) 42, 47, 48-9 Assurance Medical Society 30 Attendance Allowance 4, 10 audit, surgical work 95 availability, in private general practice 17-18 availability fee see retainers Benefits Agency Medical Services (BAMS) 9-10 blind people 13 block contracts 92 blood samples, under Road Traffic Act 44 boarding schools 58, 61, 63 brief, defining 125-6 British Code of Advertising Practice 16 British Medical Association (BMA) court appearances 114, 122 education work 135 fees, guidance on 7, Benefits Agency Medical services 10 Collaborative Arrangements 13 Driver and Vehicle Licensing Authority 11 insurance work 23 local authority work 14 medicolegal fees 114, 115 Ministry of Defence 12 pharmaceutical trials 70 police surgeon work 45 school doctors 63 sports medicine 88 Prison Medical Officers 56 Private Practice and Professional Fees Committee 6-7, locums 33 treatment charges business plan, locums 33-4 cancelled hearings 118-19 'Category 1' work 'Category 2' work 144 PRIVATE AND PROFESSIONAL WORK OUTSIDE THE NHS Category A fees Category B fees Category C fees Category D fees 8, 19-20 central government work Civil Service Occupational Health Service 11 Department of Social Security/ Benefits Agency Medical Services 9-10 Driver and Vehicle Licensing Authority 10-11 Ministry of Defence 11-12 chairman, locum support group 37 charge, entitlement to 2-4 chief medical officer, insurance companies 24, 27, 28-9 childminders, regulation of 12, 13 Children Act 13, 58 civil cases 114-15, 116 civil employment, reinstatement in Civil Service Occupational Health Service (OHS) 11 cliches 129 clinical medical officers (CMOs), schools 58 clinical trials see pharmaceutical trials clothing, surgical work 94 Collaborative Arrangements 12-13 community charge, exemption from computers, locums and deputies 40 confidentiality health surveillance records 78 insurance companies 24 consent, pharmaceutical trials 69-70 contempt of court 103, 104, 120 contracts central and local government work private general practice 15 surgical work 90, 91-6 Control of Substances Hazardous to Health (COSHH) Regulations 75, 76 Coroner's Act 115 coroner's courts 115 cost and volume contracts 92 cost per case contfacts 92 county courts, fees 115 course organisers 136-7 courts 2, 99, 103, 111 address, modes of 107—8 cancelled hearings 118-19 evidence 104-6 fees 116 medicolegal report 102 police surgeons 42, 47 preparation 106-8 subpoenas and witness orders 103, 119-20 witness types 100-1, 112-13 covering letter to editor 131 crematoria, medical referees to 14 criminal cases 113-14, 116 criminal proceedings Crown Indemnity 121 Crown Prosecution Services (CPS) 113-14 Data Protection Act death certificates 2, 21 insurance claims 28 defence societies 96 degrees, for private general practice 18 Department of Social Security (DSS) 9-10 depression, in prisoners 51, 52 deputies 34—5 rates 33 representation 39 training 39 Deputy Advisers 139 Diploma in Medical Jurisprudence (DMJ) 45, 46, 48 Diploma in Occupation Medicine 82 Diploma in Prison Medicine 54, 55 diplomas, in private general practice 18 INDEX disability benefit recipients Disability Living Allowance 4, 10 Doctors' and Dentists' Review Body (DDRB) drive, fitness to 1, 2, 10 Driver and Vehicle Licensing Authority (DVLA) 10-11 drug addicts, in police custody 44 drug charges, exemption from Drury, Sir Michael 69 duration certificates 28 early death claims 28 education opportunities 135, 140-1 academic departments of general practice 139-40 course organisers 136-7 GP tutors 137-8 regional/associate advisers 138-9 trainers 136 equipment, surgical work 93^4 ethics committees, pharmaceutical trials 68, 69 European Medicines Evaluation Agency 65 evidence, giving 104—6 expenses court appearances 103, 119, 120 locums 34 sports medicine 88 experience, surgical work 96 experts' meetings 108 expert witnesses 101, 113 Faculty of Occupational Medicine 81, 82 Family Health Services Authority (FHSA) allowances complaints to fax machines, locums and deputies 40 feedback surgical work 95 writing 130 145 fees Benefits Agency Medical Services 10 Collaborative Arrangements 13 Driver and Vehicle Licensing Authority 11 education work 137, 138, 139, 140 insurance work 23, 28, 30 journalism 123 levels 6-8 local authority work 14 locums 33, 34 medicolegal 101, 113-16 Ministry of Defence 12 pharmaceutical trials 70-1 police surgeon work 41, 45, 46 Prison Medical Officers 53 school doctors 62-3 sports medicine 83, 88 fitness certificates 1-2, 3, follow-up, surgical work 94-5 forensic medical examiners see police surgeon work fostering reports 13 General Medical Council (CMC) advertising rules and guidance 15, 16 Professional Conduct Committee general practitioner tutors 137-8 Good Clinical Research Practice (GRP) 66, 67-9, 70 government work see central government work; local government work Governors, prison 53, 54—5 hazards, occupational 75, 76 Health and Safety at Work Act 74 health screening 77-8 HIV testing 29 homeopathy 21-2 Honorary Medical Officers 83 Hospital Medical and Dental Staff hospitals 146 PRIVATE AND PROFESSIONAL WORK OUTSIDE THE NHS medical reports 120-1 private work in 5—6 hypnosis 22 immunisation, sports medicine 85 Incapacity Benefit (IB) 4, 9, 10 Income Support scheme independent medical examinations (IMEs) 24, 26, 27 independent medical organizations, advertising 16-17 independent schools 58, 59-60, 62-3 infectious disease notification informed consent, pharmaceutical trials 69-70 insurance companies competition 30 disclosure to patients 28—9 early death claims 28 independent medical examinations 23-4 life assurance 26—8 nature of 23 panels of examiners 29—30 policy types 25 primary health care insurance 15 private medical attendant reports 23 relationship with doctor 24-5 sickness claims 28 interviews, medical journalism 126 Invalidity Benefit (IVB) Joint Committee on Postgraduate Training for General Practice (JCPTGP) 136 journalism 123 brief 125-6 collecting information 126 creativity 127 feedback 130 markets 124—5 presentation 130-2 structure, planning 126-7 style 127-30 training 132—3 jury service, fitness for 4, 113 Law Society 120 Legal Aid Board 113, 114, 116 legal indemnity, surgical work 96-7 life assurance 25, 26-8 reports Local Government Management Board 14 local government work 9, 13-14 Collaborative Arrangements 12-13 local research ethics committees (LRECs) 69 locums agencies 35-6 and cancelled hearings 119 deputising 34—5 groups 36-8 opportunities and income 33 preparation 33-^4 representation 39 technology 39-40 training 39 Locums and Deputies Working Party 39 Lord Chancellor's Department (LCD) 114 Managing Medical Officer 54 markets, journalism 124—5 medical defence organisations Medical Officers of Schools Association (MOSA) 63, 64 Medical Protection Society 97 medicine charges, exemption from Medicines Control Agency 65 medicolegal reports 102-3, 111 mental disorder certificates Mental Health Act 12, 13 Prison Medical Officers 53, 54 Ministry of Defence (MoD) 11-12 mobile phones 39 motor insurance 30 INDEX National Association of GP Tutors 138 National Health Service General Medical Services Regulations charges free services medicolegal fees 113 Prison Medical Officers 55 terms of service for GPs 2-3 National Training Centre for Scientific Support 47 non-attributable interviews 126 Occupational Health Committee 81 Occupational Health Nursing Certificate 78 Occupational Health Service (OHS), Civil Service 11 occupational health work 73—4 health screening 77-8 legal context 74-6 opportunities 78-9 organizations 81-2 qualifications and training 82 responsibility to employer and employee 79-81 'off the record' interviews 126 'one-third' rule 5-6 'on the record' interviews 126 opening lines of articles 127 open prisons 52 ordinary witnesses 101 orthopaedic consultants 84 osteopathy 22 sports medicine 87 panels of examiners, insurance companies 29-30 partially-sighted people 13 Patient's Charter 95-6 pension schemes 55 performance targets, surgical work 92 permanent health insurance (PHI) 25 147 pharmaceutical trials 65 consent 69-70 ethics committees 69 expenditure 65 fields of 66 Good Clinical Research Practice 67-9 investment, factors influencing 66 monitoring 70 remuneration 70-1 threats to 65-6 physiotherapists, sports medicine 86-7 police surgeon work 41-3 Association of Police surgeons (APS) 48-9 contrasts 45-6 nature of 43-5 training 47-8, 49 useful addresses 50 pompous phrases 128-9 pompous words 128 postgraduate support 21 post mortems pregnancy certificates premises, surgical work 93 presentation in journalism 130-2 Prison Medical Officers (PMOs) 51-6 Prison Service 51, 54 Diploma in Prison Medicine 55 Health Care Directorate 51 private medical attendant reports (PMARs) 23, 26-7 Private Practice and Professional Fees Committee (PPPFC) 6-7, locums 33 private prescriptions, sports medicine 87 private services 15 advertising 15—17 setting up 17-21 types of 1-2 useful addresses 21-2 Professional Conduct Committee, CMC 148 PRIVATE AND PROFESSIONAL WORK OUTSIDE THE NHS professional witnesses 101, 112 promotion, private GP services 17 providence associations primary health care insurance 15 psychiatry 52 psychotherapy 22 qualifications, for private general practice 18 quality standards, surgical work 92-3 redundant words 129 Regional Adviser in General Practice (RAGP) 136-7, 138-9 Regional Medical Service, replies to remand centres 52 remuneration see fees research clinical see pharmaceutical trials journalistic 126 resuscitation equipment, surgical work 94 retainers police surgeon work 42, 45 private general practice 18 sports medicine 88 Retainer Scheme, locum support group officers 38 risks, occupational 75-6 RM2 form road traffic accidents Road Traffic Act 44 Royal Army Medical Corps 12 Royal Society of Medicine, Section of Occupational Medicine 81 Safety Assessment of Marketed Medicine (SAMM) 67, 71 sanatoria, boarding schools 61 schools children's absence, certificates to cover working for 57, 58-61 commitment 61-2 historical perspectives 57-8 Medical Officers of Schools Association 64 remuneration 62—3 training 63-4 secretary, locum support group 37 sentence structure, journalism 129-30 short-term certification shotgun licences sickness benefits insurance companies 28 recipients sick rooms, schools 60-1 skills, for private general practice 18 Social Fund social security claims Society of Occupational Medicine 81, 82 solicitors 99-100, 103 contact by 112-13 experts' meetings 108 fees 114, 115-18, 119, 120 medicolegal reports 102, 111 personal preparation 107, 108 subpoenas 104, 119 sports fitness to undertake injuries at school 61, 62 medicine 83-5 fees 88 NHS/private 87 relationship with other GPs 86 relationship with other professionals 86-7 training 86 Statement of Fees and Allowances (SFA) education work 135 Statutory Sick Pay stillbirth certificates 2, 4, 21 structure, medical journalism 126—7 style, journalistic 127-30 subpoenas 103-4, 119-20 suicide awareness, prison staff 51 149 INDEX support group, locums 36-8 surgical work 8-90 contracting process 91-6 future 97 legal indemnity 96-7 training and experience 96 surveillance procedures, occupational health work 77-8 surgical work 96 travel prophylactics, sports medicine 85 treasurer, locum support group 37 Treasury general schedule treatment, charging for 6-8 tribunals 105 tutors, GP 137-8 taxation of witness fees 116-17 telephones, locums and deputies 39 trainers 136 training course organisers 137 journalism 132-3 locums and deputies 39 occupational health work 82 police surgeons 47-8, 49 Prison Medial Officers 55 school doctors 63^ sports medicine 86 vocabulary, medical journalism 128-9 voters, absent waiting lists, surgical work 92 warned lists 104 witnesses, types of 100-1, 112-13 witness orders 103^4 work absence, certificates to cover Young Offenders Institutions 51, 52 .. .THE • BUSINESS • SIDE • OF • GENERAL • PRACTICE The GP's Guide to Professional and Private Work Outside the NHS Edited by FRANK McKENNA Head of Private Practice and Professional. .. practicalities of professional and private work outside the NHS It draws on the knowledge and experience of both professional advisers and GPs themselves I am confident that both newly appointed and experienced... choose to have both an NHS GP and a private GP from another practice NHS GPs must only prescribe on NHS prescriptions (FP10) to their NHS patients; they cannot prescribe on NHS prescriptions for their