Hardly optional though if we have a large chunk of cash deducted for
not doing it. We have already paid to get rid of OOH and then get
this. Someone will next confirm that we need to maintain the same
working conditions as 'in hours' - i.e. deal with phone, emergencies,
visits. drop-ins at the surgery ete, and all of the unexpected stuff
that makes the average day a nightmare.

If it is optional with no financial penalty then none of us would
touch it. I was doing PAID OOH until 12 months ago to supplement my
income, but decided with the tax hit that it was not economically
worth it.

Paul Bromley.

On 12/02/2008, Gavin Jamie <[log in to unmask]> wrote:
> Paul Caldwell wrote:
> > a gp acquaintance in another pct has been informally told in his x4
> > hander practice (x6 hours extre)that the PCT's interpretation of the
> > guidance (such as it is) is that there can be no change at all in
> > daytime working (eg no later start for the doc doing the late surgery,
> > even if he does his normal x2 daily surgeries after lunch), they will
> > count the traditional half-day during week as absence having to be made
> > up by extended hours and that if a patient survey shows that the
> > extended hours need to include weekends so be it. ie no flexibility
> > allowed, do as u r told and sod the consequences on your health+family.
> > x2 of the partners (not my acquaintance)are a couple and r currently
> > investigating leaving the country. apparently if this couple continued,
> > a weekend together uninterrupted by surgeries would, with covering
> > annual leave, fall to a rarity and at least 2 weekday evenings one
> > parent would be working.
> > Fay, is the PCTs stance correct? if so, has anyone at the DOH thought or
> > even care of the knock-on consequences of extended hours on medical
> > staff and staffing, practice organisation and delivery of services to
> > the vast majority of our pts? presumably the DOH  hopes that if GPs
> > leave, they can get more from the New Colonies (poland, roumainia etc!)
> > employed by PCTs or Virgin.
> >  i am old enough to remember as a JHD what it was like to work in a fug
> > of permanent tiredness.
> > interestingly, extended hours could favour small list practices over
> > time, just as Darzi wants us, especially in inner cities with high
> > numbers of small practices, into large conglomerates and NGMS favours
> > larger practices.
>
> The PCT is basically doing what it is told, although it does seem to be
> particularly inflexible on the in hours stuff.
>
> The thing to remember is that this is _optional_, it is highly
> disruptive as you state and it is badly paid. There is individual
> assessment of practices on www.gpcontract.co.uk with estimates of hourly
> cash rates.
>
> It may be that PCT fail to hit their target of 50% of practices doing
> the DES and better LESs start to appear.
>
> On the subject of list sizes it seems more likely that practices will
> attempt to keep lists below the steps (2999, 5999, 8999 etc) to avoid
> doing an extra 90 minutes.
>
> Financially not worth doing the DES - so don't bother.
>
> --
> Gavin
>


--
Best Wishes

Paul Bromley

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