Registering as self-employed

The largest group of sessional GPs are freelance GP locums, and is also the most flexible and often the most in demand. Strangely, perhaps because of this, we are, by some, awarded the lowest professional status and are sometimes thought by patients, practice staff and some doctors to be some sort of failure.
Of course this is far from the truth - many freelance locum GPs are recently qualified members of the RCGP, whose only failing is to have suffered from diploma-titis and to have been workaholics since leaving medical school. And a sign of the times - a growing number of locums are mid-career ex-partners.
Freelance GPing provides a good opportunity to work in lots of practices, in lots of areas. You see a wide range of patients, buildings and ways of running a practice. It’s an education in itself and very useful if freelancing whilst looking for a partnership. It enables one to get to know the locality and to gain vital experience.
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And of course it's a great career choice in itself, providing a good balance of career and lifestyle.
GPs generally work freelance in 3 different ways:
Freelance GPs are small businesses in themselves. It can be daunting at first but, after a while you get used to it and, it’s often fun. Dealing with the money is the trickiest part, and the key is to keep a record of everything.
The GP Performers List is the list that your name will have to have been on from 31st March 2002 in order to practice as a GP in the UK. From 2013, in England, Wales and NI, there is just one national performers list. If you're already on a list, your existing registration will have been transferred to the national list. In Scotland, you currently have to apply to each Health Board you work in - ouch!
As a GP working, or planning to work, in the UK, you need to go through a three-stage process.
Health warning: in our members’ experience, the application process can be Kafka-esque. In England, it’s a 27 page online document and stumbling blocks for locums, or those newly-returned to the UK with no current employer include;
We strongly suggest you read these great top tips from some recent (2015) applicants;
After nine painful weeks of going through the process of joining the Performer's list, NASGP member Mark de Kretser gives a helpful rundown of how to get through the application process. Mark provides some hints and tips, many of which we hope will avoid you having to discover the same many weeks into your application.
You can keep up to date with news, and helpful blogs in our GP performers list section
This FAQ is from the perspective of being a GP locum in the same practice for a 'long time', rather than about choosing working as a GP locum as part of your career portfolio.
It explains it from four different perspectives - NHS pension scheme, HMRC tax perspective, employment law and 'mission creep', and there's even an audio podcast too.
Traditional holiday times are the busiest times for freelance locum GPs to work. The quietest times tend to around Easter, November and January. These are also the cheapest times to take holiday, so take advantage! Christmas and Easter are traditional holidays that many doctors will have given up over the years. Consider using your locum flexibility to take them as holiday yourself and relax. There are perks to being freelance!
If you're using LocumDeck's Instant Book feature, we suggest you block off holidays in your calendar so that you or the practices can't accidentally book you for an afternoon on call while you're drinking a cocktail in Sevilla.
A big misconception about working in different GP surgeries is that they're all the same. They're not. In fact, each practice has around 500 different 'information variables' unique to itself. The only safe, effective and efficient way to present this information is through what the CQC call a 'practice induction pack'. And to help GPs access this all in a standardised way, NASGP has produced the Standardised Practice Information Portal (Spip - part of NASGP's Practeus GP web platform).
You can login to Spip via Practeus right now and invite all your practices to add you to theirs if they have one set up. If they haven't, asking them for all the contact details for the list below should be a good prompt for them to invest in Spip right now (and better still, its completely free to practices)!
See our full article on how to set your rates.
Decide when you are available and more importantly when you are not. If you don’t want to work, it probably isn’t diplomatic to tell practice managers you are planning to spend the day in the garden or on the beach when they have 30 demanding patients who need seeing. Just say you are not available that day - never feel guilty about booking time off to recoup and recharge!
Respond to offers of work quickly. If you are slow, you will lose the offer and if you never phone back, practices will stop phoning you. Or use LocumDeck's Instant Book, which allows practice to book you, well, instantly!
Know how much you want to earn for x amount of work at y practice. Have an ideal rate and a bottom line. Be prepared to decline work when practices won’t pay your bottom rate (again, this is all built into LocumDeck). Don’t forget the travelling time and costs if you’re going some distance from home. And always use your own Terms and Conditions.
Or if not using NASGP's LocumDeck, other packages like MyLocumManager and Locum Organiser also exist. Or if you're already using other services and want to use LocumDeck, get in touch to see how we can transfer your information over.
Know exactly what you are being asked to do (LocumDeck enables you to precisely state all of this, customised to each practice). Confirm your understanding in writing and ask the practice manager to do the same (...all handled automatically in LocumDeck). Things to consider are:
Be aware that this can have consequences in three different areas - employment law, your tax status, and your NHS pension arrangements.
This FAQ is from the perspective of being a GP locum in the same practice for a 'long time', rather than about choosing working as a GP locum as part of your career portfolio.
It explains it from four different perspectives - NHS pension scheme, HMRC tax perspective, employment law and 'mission creep', and there's even an audio podcast too.
Many of us choose locuming to maintain some control of our work boundaries so watch out also for the potential for 'mission creep' if based in one practice.
Pay cheques into your account quickly. This avoids cash flow problems and will earn you small amounts of interest. But beware. If there is a transaction charge on each cheque it makes sense to wait and collect a few up. Setting up Bankers Automated Clearing System (BACS) arrangements with practices that you work for more than a few times is worthwhile, provided they use electronic banking, as many now do.
If payment fails to appear, call the practice manager and write formally requesting payment again. Keep a copy. If payment has not arrived, say 2 months after the work, you can turn to the small claims court for assistance.
It may be worth contacting an officer of the LMC who may be sympathetic and try to mediate.