25/04/2014dr andrew mowat1 practice structure and organisation an introductory overview
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10/04/23 Dr Andrew Mowat 1
Practice Structure and Organisation
An Introductory overview
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General Practice Independent Contractor Employed by LHA Provide “General Medical Services”
OR “Personal Medical Services” Demand-led Service secure long-term contract taxation advantage
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Independent Contract GMS or PMS Core Services Item-of-Service payments Target payments Drug/Dispensing payment Reimbursement
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Partnership Partnership Agreement (contract) Teamworking Trust
mutual support buddying covering duties sharing workload
Rotas
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Partnership
Strengths/Weaknesses
Roles Chemistry Numbers/divisions Bonding/cohesion Flexibility/tolerance
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Holiday Rota
Bank Holiday 10 year planJames Street Family Practice
Winter Half-Term Easter Mayday Spring Summer Half-Term First Choice of August Autumn Half-Term Christmas New Year(off) Good Friday Weekend Monday (off) Summer Holidays (off) Day Boxing Day (weekend) (weekend)
Past1996 LP AM * LP x ST * ST AM ST IC1997 AM * IC LP AM LP/AM ST x IC LP LP LP IC ST AM1998 LP IC LP IC ST AM AM x LP ST AM ST AM LP1999 ST AM ST AM LP IC LP x ST AM JM LP JM/LP AM2000 AM LP JM LP AM ST ST x JM* LP ST AM * JM
Future2001 LP ST AM ST LP JM AM JM HH ST LP JM LP ST AM2002 JM HH LP HH ST AM ST AM JM HH AM ST AM HH JM2003 AM JM ST JM HH LP HH ST AM LP HH LP HH AM ST2004 ST AM HH AM JM ST LP HH LP JM ST JM ST LP HH2005 HH LP JM LP AM HH JM LP ST AM LP HH LP JM AM
* No Co-op shifts
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Structure
R ec ep tion & A d m in is tra tion D is p en sary P rac tice N u rses C lean in g
P rac tice M an ag er
P artn ers
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Roles Practice Manager Practice Nurse Dispenser Receptionist Secretary Data Clerk
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Attached Staff District Nurses Health Visitors Palliative Care
Nurse Midwife Podiatrist
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Other close contacts Podiatrist Mental
Health/Drug Abuse
Gynaecologist Chiropractor Homeopath Audiologist
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GP Registrar Roles & Responsibilities Supernumerary Protected training time Self-directed learning
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Premises
Health Centres Cost-Rent
Scheme PFI/LIFT Equity Partners Use of space Long-term return
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NHS Primary Care Structure Department of Health (DoH) NHS Executive (NHSE) Regional Health Authority (RHA)
(Trent) Local Health Authority (LHA)
(Lincolnshire) Primary Care Group (Trust) (East
Lindsey)
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East Lindsey PCG Determines local health needs Deploys resources to meet needs Holds Prescribing/Staff budgets Clinical Governance
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Taxation Schedule D
self-employed expenses “wholly
and exclusively …” Schedule E
PAYE tax code given expenses “wholly
and necessarily”
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Professional Expenses
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