We speak to Dr Kevin Fernando about his deliberate and successful transition from a GP partnership to a thriving, multi-faceted portfolio career.
Dr Fernando explains how a desire for better work-life balance initially led him to general practice, and how his passion for medical education became the key to unlocking a global role with Medscape.
He shares practical advice on how to start teaching, the importance of surrounding yourself with mentors, and how part-time sessional work provides the necessary foundation for flexibility.
We also discuss his new private practice (focused on CVRM), the luxury of time it affords for holistic care, and his thoughts on the evolving role of AI as an invaluable tool for clinicians.
Frequently-asked questions about portfolio GP work
Which training costs can GP locums claim for?
The rules for salaried GPs and self-employed GP locums are different.
If you are a salaried GP you can only claim for courses that are ‘wholly, exclusively and necessarily’ in the course of your work. The ‘necessarily’ is the tricky bit – because that would mean absolutely anyone doing that job would have to do that course. The effect of this is that generally salaried doctors cannot claim training costs, so ideally get them built into the remuneration package so that the practice pay for them. Providing it is work related, it will not be a taxable benefit.
There was talk of training being treated differently just before the 2018 Budget, but nothing came of it. Be aware that the rules may change in the future.
GP locums
If you are a self-employed doctor, you can claim for courses that are ‘wholly and exclusively’ for the purposes of your work. This gives much more scope.
Generally any courses that are keeping you up to date or improving your existing skills will be deductible. Anything unrelated to your work won’t of course – so a GP couldn’t claim for a course on plumbing or bricklaying!
A new qualification – or something that enables you to do something that you cannot currently do – will be treated as ‘capital’ and will not be deductible. There is a grey line between what is a new skill and what is an extension of an existing skill – and that needs professional advice when it arises.
What does ‘wholly and exclusively’ mean? Generally there won’t be personal benefit in a course, but beware ‘holiday’ courses where HMRC could argue that the holiday element is more than an incidental part of the cost. Once there is ‘duality of purpose’ (such as a holiday with some training), HMRC are within their rights to refuse the whole of the claim.
What is the cost of the course? That will be the course cost itself, any related reading material etc, travel to get there, subsistence and reasonable accommodation (if it is not reasonable to return home).
What if you are both salaried and self-employed?
It will normally be acceptable to claim course costs against the self-employed income. If HMRC want to be awkward, they could argue duality of purpose – because you can’t learn something and only use it for your self-employed work. We had this point made in an investigation some years ago, but HMRC did back down and agree the cost in full against the self-employed work (but on a reasonable basis, rather than under the letter of the law). If you are trying to claim for a £5k course against £5k of locum work when you are employed full time, expect it to be questioned!
How do I use LocumDeck to find NHS GP jobs?
There are a few of ways you can use LocumDeck to find GP locum jobs in the UK.
You can look for GP locum and salaried GP jobs, both in GP practices near you and by exploring GP jobs at new practices.
Find NHS salaried GP jobs
LocumDeck has a GP jobs board that’s private to GPs and GP practices. Login to see the GP vacancies near you and across the UK.
LocumDeck has a smart way of booking designed by GP locums which means you don’t have to find work – the work finds you. It’s called Instant Book.
With Instant Book, you don’t have to wait for job alerts from practices. Instead, you set up your terms and profile, tell your chosen practices how you want to work and add your availability to LocumDeck’s calendar. Your practices can review your terms and credentials then book you instantly.
Practices like the efficiency of not having to post alerts and wait for responses, and you get the work you want on your terms, with minimal hassle and fewer booking errors.
Our LocumDeck Setup Guides have a step-by-step introduction, ‘Get booked by practices‘, which can get you started.
GPs can also look out for ‘Availability requests’ from local practices.
If a practice on LocumDeck needs cover but no locums have made themselves available for pre-set instant booking on the dates they need, the practice can send out an Availability request, to all GP locums on LocumDeck within a 45-minute radius.
GP locums can quickly respond by clicking on the request on the calendar, and selecting a session to offer for booking. The practice gets notified when a GP locum responds. The practice can review the GP’s LocumDeck profile and terms, and book you right away.
This will be stated in the written contract. The private fee can either be entirely subsumed within the normal, regular work of the salaried GP, or there could be a provision for private work to be undertaken over and above the their usual work, stating how much of the fee they receive (bearing in mind the practice’s overheads.
Locum GPs
For locum GPs, there is no issue as to whether or not a freelance GP can perform private work in a GP practice.
The practice and locum will need to agree beforehand whether their normal clinical caseload will contain private as well as NHS patients, with adequate time given for the private work in line with what other GPs in the practice would expect.
The practice and locum will also need to agree between them whether private work is charged at the same rate as NHS work.
Model locum Terms and Conditions template
If you’re doing any sort of locum work as part of your portfolio career, you’ll definitely need your own personalised Terms and Conditions to help protect both you and the practice you’re working for.
NASGP’s model T&Cs has been specifically developed for NASGP members by a specialist employment law firm. It allows GP locums to not only fully adopt all its recommendations, but also to add any necessary clauses and tailor it to suit each locum’s personal needs.
Your own cancellation sliding scale from 0 to 100% of your booked fee for 0 to 28 days in advance.
Your 14.38% employer’s pension contributions
Legal employment status
Tax status, IR35 etc
Duties (on-call, triage etc)
Private fees (HGV medical etc)
Cremation fees
Payment terms (14 days? 28 days?)
Plus much more.
As an NASGP member, go to your T&Cs generator, choose your settings and then save. You’ll then be given a unique link, “View my TCs” which will automatically be added to your automated invoices, confirmation emails and session request emails, or you can paste the link into your own GP locum website.
As an added bonus, GP locums can update their T&Cs as often as they like on LocumDeck. Each change is saved in an archive, accessible by practices, for extra confidence.
In our experience, if private patients are seen within the usual agreed hours then the locum would not expect to be paid any extra. But if seen outside the usual agreed hours, the locum would expect to be paid the full private fee, with any practice overheads being offset by the additional service being offered by the locum. It makes the paperwork easier too.
How do medical defence organisations represent sessional GPs?
We’ve asked the 3 leading UK medical defence organisations to let members know what they do for sessional GPs.
Medical Protection Society
MPS is the leading provider of comprehensive professional indemnity and expert advice to doctors, dentists and health professionals around the world. We are a mutual, not-for-profit organisation offering more than 280,000 members help with legal and ethical problems that arise from their professional practice. This includes clinical negligence claims, complaints, medical council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal-accident inquiries.
Using our wealth of knowledge and experience we have developed a range of education and risk management resources that will assist you in reducing your exposure to complaints and claims. The portfolio available includes publications, conferences, lectures, workshops, E-learning and clinical risk assessments. 97% of members who used MPS say they would recommend us to their colleagues.
The MDU is the UK’s leading medical defence organisation, a not-for-profit organisation wholly dedicated to our members’ interests. Our team is led and staffed by doctors with real-life experience of the pressures and challenges faced in practice.
We offer members expert guidance, personal support and uncompromising defence in addressing medico-legal issues, complaints and claims. Our customised services range from legal assistance, indemnity, training and risk management advice.
As an MDU member you can also benefit from the following:
24-hour medico-legal advice and guidance free via our 24-hour helpline (0800 716 646, 24 hours a day, 7 days a week).
Medico-legal journal and publications. Our highly regarded journal and other publications are free to members and feature real case histories and articles on subjects such as complaints and confidentiality.
Learning and development support, take advantage of our local medico-legal seminars, specialist training courses and online CPD.
Member prices for CPD workshops, which are interactive and tailored to small groups.
MDU online CPD, an online, free easy-to-use resource, which provides an introduction to medical ethics and law and helps you understand the principles and apply them to a variety of day-to-day practice scenarios.
Free MDU podcasts are available on key medico-legal topics.
Visit themdu.com to find out more, or speak to our membership department on 0800 716 376 (8am to 6pm Monday to Friday, excluding bank holidays).
MDDUS
MDDUS is a mutual organisation that has been providing indemnity, advice and guidance on medico-legal matters to members who encounter professional difficulties for over 100 years.
Membership of MDDUS provides access to:
Professionally trained medico-legal advisers who are qualified in medicine and are available to speak to you 24 hours a day, 365 days a year
Medical indemnity against claims of negligence
Legal representation from solicitors who are recognised as the UK’s leading experts in the medico-legal field
Representation and legal support at General Medical Council (GMC) proceedings
Help in dealing with complaints
Assistance with disciplinary matters
Legal representation and support at coroner’s inquests
Worldwide indemnity for Good Samaritan acts
A quality, personalised service at a reasonable cost
The MDDUS Risk Management Team have produced a new range of CPD verified online learning and risk management tools. The majority of these resources are exclusively available to members and include video modules, risk checklists, blogs and expert interviews.
For an online quick quote or information about the range of additional benefits of membership visit www.mddus.com
Call our membership team on 0845 270 2038 or email membership@mddus.com
Follow us on Twitter @MDDUS_News
How many GP locums work in the UK?
How many GP locums work in the UK? No one seems to know how many GP locums there are in the UK. All data pertaining to the number of GPs in the UK states “excluding locums”.
As we wrote in a recent news story, salaried GP numbers in England now surpass GP locum numbers. In 2015, the salaried GP workforce was just 70% of the size of the GP locum workforce; in 2024, it was 104%.
Using the GMC’s methodology of estimating the number of GP locums (by subtracting the number of salaried GPs and partners from the GMC’s register of practising GPs), the number of GP locums fell from 21,091 in 2023 to 17,836 in 2024 – an estimated fall of 3,255 in a single year.
These new figures have emerged at a time when GPs face a double workforce crisis: GP partners struggle to fund the GP vacancies they need, and sessional GPs struggle to find both salaried and locum roles.
At the time, 28% of all GPs worked outside a managed organisation.
This raised many questions, including:
How does the profession represent these GPs?
Will this have an effect on the resources allocated for revalidation?
Assuming the Department of Health does not know about these GPs, then how can it make plans for future manpower resources and training?
If 28% of all GPs practise outwith traditional salaried posts or partnerships, what is the profession and Department of Health doing to engage these 17,000 GPs into the clinical governance systems of the
NHS?
The Government and profession needs to ensure that its resources are allocated equitably, and reassurance given to patients that the quality and professional welfare of its GP locums is not being ignored.
