These days, starting in a GP partnership can be just as exciting, but possibly more daunting than it used to be, because of growing demands and uncertainties about the future of the NHS, as well as the GP's role.
The three articles in this guide consider a number of areas of importance when beginning as a new GP partner, which should be borne in mind to increase the chance for a successful start.
There will be considerable variations in the relevance of these reminders, depending on your background or previous experience and how the practice is set up to take you on and integrate you.
The information below, and in the other parts of this guide, is best used as a template or checklist to start from and to add to, before you join your new practice and as you go along thereafter.
It may be useful to revisit this outline on a regular basis, for example, at least monthly for the first three to six months of the partnership, to check how you are getting on and help you identify possible areas to work on as you go forwards.
This part of the guide looks at starting at your new practice, getting to know the local area and some general practicalities you should bear in mind. Links to the other parts of the guide can be found at the bottom of the page.
Local setting
The local NHS
Are you already familiar with the practice surroundings, area, region, NHS infrastructure, out-of-hours settings, walk-in centres, specialist community clinics? Make sure that you receive a comprehensive list of all of the relevant essential telephone numbers right form the start, including hospitals (bleep system), the CCG, safeguarding teams etc.
Don't be shy to phone and talk to hospital consultants (and GPs from other practices) when needed to get to know them a bit and to let them get to know you. Are there any regular local teaching events or meetings to meet colleagues from other practices and/or secondary care or community teams?
Read the locum information pack (if available) to learn about referral pathways and other practical information.
Consider other relevant sources of information, support, or challenge locally, such as the CCG, the LMC and how they interract with the practice.
In the practice
Ensure that all technicalities of you joining the practice have been completed – usually by the practice manager – in reasonable time (for example, change of your status on the Performers List, GP Appraisal planning, NHS pension contributions, accounts and finances).
Do you have an agreed induction plan with or without a mentor and a timeline of reviews at the practice? This can be useful if it has not already been agreed.
Familiarise yourself as soon as possible with where the practice's emergency equipment and cupboard keys are kept, as well as any key codes and essential telephone numbers. Remember to protect any private details.
If you have your own room, gradually declutter and shape your new working space to suit your requirements. If you do not have your own room, find some secure space within the practice to store your portable bag of personal equipment etc.
Get to know the current rhythms of information flow in the practice, such as the delivery and pick-up times for samples as well as team meetings, clinic times.
Check on timings and preparedness with regards to the practice's CQC inspection, and find out who is dealing with it at the practice.
The local area
Learn timings and distances to reach the local hospital, care homes and so on, and find out about any traffic bottlenecks in the area. Check which mode of transport will be quickest and easiest to use.
Enquire about any potential problematic spots within the practice area, in terms of personal safety, vandalism of your car, traffic hot spots, good places to get lunch from, etc.
Clinical staff and patients
Clinical staff
Pay attention to and respect individual nuances, in particular, colleagues' work patterns and routines. Use coffee breaks or other opportunities to meet colleagues informally – if these have stopped consider how you might be able to revive them.
If there are any staff roles in the practice that you have not worked with before make sure you understand their responsibilities, for example if the practice has a clinical pharmacist, an advanced nurse practitioner or a paramedic practitioner.
Patients
Allow yourself two to three years to get to know your regular patient population, if there is a chance for this to happen in the setting.
Explore the culture and the sometimes subtle expectations of individual patients and care homes, especially regarding interactions, for example, home visit requests, reassurance follow-up calls, your accessibility, the degree of personalised care, and consultations with a list with several problems. Identify ways in which you can adapt to this.
Other considerations
Plan your finances early (loan, tax code, pension). Expect considerable variations in tax calculation payments in your first one or two years as a partner. Consider taking independent professional financial advice. Be as transparent as necessary about your current financial situation, if it is relevant for timings and amounts of drawings etc. for the initial couple of months.
Don't use the practice computer for personal business and absolutely avoid social media or downloads at work. Adhere to practice IT/data protection protocols (for example, memory sticks) and advice for email.
Read more: Starting as a GP partner
> Ensuring the new partnership is a success
> Working with the practice team and your CPD
- Dr Jacobi is a GP in York.
