Application Form for the Retainer Scheme

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Application form for the Retainer Scheme

FORM RS1

The GP Retainer Scheme

The GP Retainer Scheme was introduced in 1969 and remained largely unchanged until 1998, when new proposals were introduced allowing doctors on the retainer scheme to be employed in an approved practice for up to 4 sessions per week. The underlying principle of the scheme is outlined in the NHSE HSC 1999/004 (available to download from the DoH website at which states that the purpose of the scheme is to ensure that doctors who wish eventually to return to General Practice into a more substantive post are able to keep up-to-date, retain their skills and further develop their careers.

The scheme is therefore a combination of service commitment and continuing professional development, by offering the opportunity to do a small amount of paid professional work and to be involved in educational sessions. The scheme aims to facilitate the practice of medicine and career development within a protected and educationally stimulating environment.

GP Retainer Scheme Doctor - suitability criteria in brief

1. The doctor must have a CCT or vocational training certificate or be able to demonstrate equivalent experience.

2. There is no gender discrimination as to who is suitable to become a retainer scheme doctor.

3. The doctor should have well founded personal, domestic or other reasons for undertaking only limited paid employment; the Deanery will take individual circumstances into account.

4. The scheme is intended for those who wish eventually to return to a more substantive post in General Practice.

1. The doctor must hold full registration with the GMC.

1. The doctor must be on a Medical Performers List.

7. The doctor must be a member of a defence organisation.

8. The doctor should work a minimum of 1 session per week, not more than 4 sessions on average per week in general practice, and no more than 52 sessions in any one quarter.

9. The doctor may undertake a limited amount of non-GMS/PMS work, such as family planning or clinical assistant sessions, OOH work subject to Deanery approval - normally no more than an extra two sessions per week. Work in the practice over 5/sessions per week is not allowed in any capacity. The scheme is not intended for those intending a career as an academic or portfolio doctor or in another sector of practice.

1. The doctor will be entitled to the pro rata FTE of one protected session per week for Continuing Professional Development (“CPD”). A doctor working only one session per week will have eight sessions of CPD as a minimum.

1. There should be a weekly meeting with the educational supervisor to discuss any issues with the suggestion that this should be for a minimum of 20 minutes per week.

1. It is the Deanery’s policy to accept onto the scheme only GPs who are offered the BMA’s GP Retainer Model Contract (2007) unchanged (or any BMA contract, relating to sessional GPs, that supersedes this). This is to ensure that the scheme is equitable for all GPs in the Deanery and is in accordance with the minimum terms and conditions of employment offered to a salaried GP as introduced under the new GMS contract of April 2004.

Form RS1

Application

for the Retainer Scheme

Part A

Personal Details
Surname / First name
Previous Surname(s)
If applicable / Initials
Home address / Nationality
Home phone
Mobile phone
Sex
E-mail address / DOB
University / Year of qualification
Qualifications / GMC Number
Country of
Qualification / Fully registered / Yes/No
Right of residence
In EEA / Yes/No / Year of full UK
registration
On LAT Performers List / Yes/No / Name of LAT (if applicable)
Have you been a member of the retainer scheme before? / Yes/No / Name of Deanery and start and finish date (if applicable)

Part B

Please attach a brief CV

Part C

Do you have a long term illness or disability which would affect your ability to carry out your duties?
YesNo
If “Yes”, please give further details:
Please give brief details of your reasons for wanting to join the retainer scheme and what is your long tern career plan? If appropriate, please give dates of birth of your child/children
How many sessions do you want to do a week?
Non-GMS work: Retainees can undertake a limited amount of non-GMS work, subject to the approval and support of the Director of Postgraduate General Practice Education.
Do you undertake, or intend to undertake, any non-GMS work and, if so, in what occupation and for how many sessions per week? How does this work enhance your continuous professional development and fit in with your PDP? (please detail)

Part D

Criminal Convictions and Fitness to Practise

Declaration

Registration with the General Medical Council imposes on doctors the duty to provide a good standard of medical care for, and behave appropriately, towards patients. NHS Employers also have a duty to ensure that patients receive a good standard of medical care and ensure as far as possible the safety of patients. Therefore, there is a need to establish if you have been found guilty of a criminal offence, been bound over or cautioned or are currently the subject of proceedings which might lead to a conviction, an order binding you over or a caution in the UK or in any other country. There is also a need to establish if you have been the subject of any fitness to practise proceedings in the past, or if any fitness to practise proceedings are being contemplated, by a licensing or regulatory body in the UK or another country.

Employment as a GP is subject to an exemption order from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. You are NOT therefore entitled to withhold information about convictions which for other purposes are “spent” and must declare all convictions including ones

which are pending.

Deanery applied to: / THE NORTH WESTERN DEANERY
LAST NAME: / FIRST NAME:
CRIMINAL CONVICTIONS:
A conviction is a criminal offence where a charge has been made and resulted in a verdict of guilt. This includes breach of the peace, being bound over, being cautioned, final warnings and reprimands.
Have you been convicted of a criminal offence, been bound over or cautioned or are you currently the subject of any police investigations, which might lead to a conviction, an order binding you over or a caution in the UK or in any other country?
If YES, please attach details including approximate date, the offence, and the authority and country which dealt with or will deal with the offence. / YES / NO
FITNESS TO PRACTISE:
This includes disqualification from the practice of a profession or required to practice it subject to specified limitations and includes being dismissed from any employment, office or other position by reason of misconduct.
Have you been or are you currently subject to any fitness to practise proceedings by an appropriate licensing or regulatory body in the UK or any other country?
If YES, please attach details of the nature of proceedings undertaken, or contemplated, including approximate date of the proceedings, country where proceedings were undertaken and the name and address of the licensing or regulatory body concerned. / YES / NO
DECLARATION:
I hereby declare that the information given here is true. I further declare that should my situation change with regard to either criminal convictions or fitness to practise that I will provide full details within 5 working days to the Postgraduate Deanery. I understand that failure to disclose any relevant information for whatever reason may disqualify me from appointment or result in disciplinary action which may include summary dismissal and referral to the General Medical Council.
SIGNATURE:
DATE:

Educational Contract

DECLARATION

If accepted as a member of the scheme, I undertake to:-

1. Comply with the terms & conditions of the scheme.
2. Maintain membership of a medical defence organisation and registration with the GMC.
3. Complete a minimum of 28 hours educational time per year, to include a minimum of three hours supervision by the practice educational supervisor.
4. To undertake an annual appraisal.
5. To undertake no more than 52 sessions (including educational sessions) per quarter and work a minimum of one session per week.

Signed / Date

Practice Details

Applicants Full Name
Name of LAT
Name of practice
Address
Educational Supervisor
Phone number
E-mail / @
Start Date in Practice
(must be on a LAT Performer’s List, before start date)
End date in practice
Number of sessions per week
Please attach a timetable

Declaration

1. I confirm that this practice/LAT is willing to employ this doctor under the terms of the Retainer Scheme
2. I have checked this doctor’s references (The educational supervisor should confirm 2 most recent references) or I confirm that the LAT will check this doctor’s eligibility for the performers list in line with local performance procedures.

Signed / Date
Name
On behalf of (Practice)/PCT
GP Tutors Declaration
Having spoken to Dr ……………………………………………….. and discussed his/her Personal Education Development Plan, and having reviewed the intended date for return to general practice which is:
I can recommend him/her for initial/continued membership of the GP Retainer Scheme.
GP Tutor Signature
GP Tutor’s name
Date
Review date

To be completed by the deanery

Postgraduate Dean's Office declaration
To be completed by the Director of Postgraduate General Practice Education or deputy
Application accepted: YES NO
If not accepted, reasons for this:

• Based on the information provided in this document, the North Western Deanery has registered this appointment and has entered the details on the departmental database.

• A copy of this document will be forwarded to the relevant practice educator.
• Details contained on this form will be given to the relevant LAT/Agency

Signature / Date
Name (in block capitals)