Work rotas

This is a complex topic. The comments below reflect real life scenarios. 

When a GP job is advertised it is often full time for 8 half-day sessions per week. Commonly people reduce their hours after 2 or 3 years to create a better work/life balance. After a doctor or nurse has settled into a practice and is well liked after 2 or 3 years ; the employer will be accommodating to  retain good staff. Many Hospital Consultants do this also. 

A good plan is to reduce to 7 sessions per week after 2 years; and after saving some more money reduce to 6 sessions (3 days per week)  after the third year. I have found this is a good work/life balance. 

If the senior GP works  2 or 3 days per week he/she will need one admin. session per week blocked off to check staff job contracts, accounts, bank statements, ICB (Health Authority) payment statements, legal cases, building maintenance staff management and staff discipline, monitoring the performance of the Practice Manager (PM) , attending Locality & Health Board  meetings etc. 

If he/she does not have this time blocked-off these iportant tasks will not get done; and the Practice will not run smoothly.

He/she will also need one extra session blocked off to do UK CQC work; another session to do UK QOF work; so he/she will need around 3 sessions per week blocked off for all these admin. duties. I have emailed  this point to  the LMCs and BMA over the years.

Many GPs are busy working mothers and may choose to work 2 to 3 days per week from the start. This depends on childcare arrangements in the background - may be grandmother  or her husband  can care for the children for these days; so she can work full long  days to cover the Practice rota. 

If a doctor or nurse has inherited a flat or Investments from parents or relatives then life is far easier as there is no mortgage to pay. He/she can feel secure with long term emotional stability and security. 

Male doctors may be keen to earn more  money  for the family when they are young and energetic; and work less by the age of 40 or 50 years. Illness makes people more tired so they want an easier life. Sadly many doctors have serious illnesses such as Cancer or heart attacks by age 55 years.

Many doctors have significant  illnesses by the age of 55 years so life gets more difficult. Having an extra day off work helps with looking after elderly relatives, shopping, housework, clearing the drains every month, arranging workmen  (plumbers, electricians, roofers  etc. ), managing Investments , looking into new projects , teaching children , doing "private" GP or hospital work etc. So we all need to undertand what is going on in colleagues' lives; and have an interest in them. We all learn from these conversations and discussions. 

Reducing from 4 days per week to 3 days per week    creates  a far less stressful life. This creates 52 days  of extra Annual Leave per year . This is the equal of around 10 weeks extra rest days per year. 

The trick is to save and invest money in the early 20 years of one's career to create financial security and a safety net. 

e.g. For a small GP Surgery with 6,000 patients with three Doctors:

Doctor "A" works 8 session per week (2 half days off per week)

Doctor "B" works 8 sessions per week (2 half days off per week)

Doctor "C" works 6 sessions per week ( 3 full days per week)

Once the doctors are liked and loved within the Practice, they can amend their rotas as needed; employing locums or other doctors as necessary; so long as they calculate enough money to pay for their mortgage, loans & families.

Most GP Partners and Managers are sensible people and will accommodate reduced hours and proportionately reduced pay for staff; especially when staff become ill or need to look after elderly relatives; but some Doctors are inflexible, unreasonable  and arrogant. We need good Senior Doctors and Managers with the       correct attitude an  temperament.

Each Practice needs to ensure sufficient staffing levels to fulfil the NHS Contract it holds; and to fulfil all the    duties needed. 

Speaking to friends and colleagues, hospital Consultants in their forties and fifties often work two NHS days per week ; and one or two days doing  "private" work in "private"  hospitals to earn good money. They can charge around £250 per patient but a GP can charge around £90 per patient.