Dr Liz Hodds 18th December 2019
Clinical Lead and OOH GP, Warwickshire, Coventry and Rugby.
A bit of history…
I qualified as a GP in 1998 and worked until recently in a GP practice in Rugby. Initially I was expected to do OOH along with the day time GP work, via a local cooperative. The government then ‘dangled a carrot’ and gave GP’s the option to give up OOH as part of the new contract. Needless to say the majority of GPs voted in the new contract.
Despite having the option of never doing an OOH shift again I chose to stay working in OOH on top of my surgery work.
After a few years I took it upon myself to arrange the GP registrars shifts in the OOH service, I was obviously too successful as when a different provider for the OOH took over the running they offered me the clinical lead role. After twisting my arm and a bit of sweet talking, I agreed. That was 13 years ago!
I admit I worked a lot of hours but enjoyed it and until recently managed ok.
Due to health reasons I had to cut back my hours worked. The decision was then which job role I would give up as I did enjoy all three (GP surgery, OOH and the clinical lead roles). I left surgery work in February 2019 and I have not looked back.
Why did I chose to give up the surgery?
I have never been a morning person and the days in the surgery were getting longer and more stressful, much more than when I started out as a newbie. The paperwork /administration work piled up, demands from patients increased and having no spare appointments meant patients would come in with multiple complaints let alone the QOF agenda we were expected to do.
Working in the OOH has lots advantages for myself:-
- I can work in the evenings and not get up so early!
- The appointments are 15 minutes and not 10.
- The patients come in with only one issue in the majority of cases.
- Once the notes have been typed up there is no more administration/paperwork to do.
- Once the shift is over its home time, no extra patients or home visits.
I have continued to do the clinical lead role as well as seeing patients face to face, but I have now got time off in the week. It is definitely better to go shopping, out and about etc. in the week as weekends tend to be busier.
Now I am less stressed, rested, and much happier than I have been in a long time.
Why do others take up OOH?
A lot of clinicians are realising that a portfolio career is less stressful than full time General Practice. OOH is just one aspect of what work is out there for GPs.
Several of my colleagues work part time in the surgery and part time in the OOH.
There are some clinicians who work solely in the OOH as it suits their lifestyle. A female colleague worked nights while her children were sleeping and slept when they were at school.
The pay can be better than some of the day time general practice salaried posts and even some partnership incomes.
Shifts are generally 4-5 hours long and fly by, compared with seeing GP surgery patients for 2-3 hours. I generally don’t feel tired after a shift even though I am continually seeing patients.
Children … In the GP surgery GPs rarely get to see children as ANPs etc have taken up the minor illness roles. Christmas is my favourite time to work as I get to ask the kids what they have asked Santa for, look up where Santa is on Christmas eve and dress up.
You can work for the OOH as a self-employed GP through a Limited Company or as a salaried GP in which you get pro rata study leave, annual leave and a reimbursement of your indemnity subscription.
Evenings, weekends and bank holidays are working days. But as I mentioned earlier, days off at other times are less busy and thus much more enjoyable.
The OOH isn’t always NHS pensionable, however they do offer a private pension as an option.
Continuity: it is possible in various ways to find out what happened to patients you see in OOH, but you don’t often see a patient as you would in general practice and the familiarity is not there. Don’t get me wrong there are regulars in the OOH too.
The IT system is behind, with lack of access to carious other platforms, however this is being worked on.
I enjoy OOH work, it suits my lifestyle and I get paid to do it.