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Practice owners

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Practice owners may work under a number of arrangements: single handed, with employed or self-employed associates, in a partnership or in an expense-sharing arrangement.

Scotland and Northern Ireland

A single-handed practitioner will probably need to employ a locum during their absence, who will usually work under their contract number as a deputy, thus avoiding the need to transfer patients. Depending on the reliability of staff and the quality and experience of the locum, it may be possible safely to leave the management of the practice in the hands of the locum. The section on locums discusses paying a locum and the arrangements that may be made.

Briefly, it is easier to pay a locum a flat daily/sessional rate commensurate with responsibility, which avoids the need to calculate continuing care and capitation payments. If you know how long you will be absent on parental leave and prefer to use a day book, you might estimate the continuing care and capitation payments for that period, add the daybook treatment fees and take a percentage of the gross after deducting laboratory costs. Bear in mind the need to try to maintain practice income at normal levels. If the GDS in Scotland or Northern Ireland were to be changed to follow the England and Wales system, there would be a reference period during which GDS earnings and activity levels would be used as the basis of new NHS contracts. If the reference period includes a period of parental leave, experience from England and Wales is that atypical earnings during the reference period are not automatically taken into account. This would make it particularly important to engage a locum. Contact the BDA Scottish or Northern Ireland offices to check the latest situation. 

The locum would normally be an employee when providing long-term parental leave cover, not being responsible for treatment under the GDS, and tax and national insurance should be deducted from pay. To protect both parties, it is advisable to enter into a comprehensive written agreement with the locum and there are suitable models in the BDA Practice Compendium. Employed locums must have such a contract of employment within two months of starting work.

A practice owner with partners, expense sharers, associates or assistants will often be able to arrange for these dentists to cover for their absence. In these circumstances it will not be necessary for patients to be transferred, since the other dentist may undertake treatment as a deputy. If the number of patients on the owner’s list is too great to make this feasible, a locum will have to be engaged to act as a deputy. Discuss with your colleagues in good time how to keep disruption to a minimum and what arrangements are to be made for patient care.

Practice management may be a problem for absent practice owners. The degree of control which you maintain in running the practice while you are on leave will depend on a number of factors:

  • how long you will be away

  • whether your staff are reliable and experienced

  • whether you have partners/sharers/associates/assistants

  • whether you can give staff incentives/bonuses

  • whether you will be employing a locum.

You should be kept regularly informed of what is going on at the practice, certainly about any problems. You might like to give one member of staff responsibility for keeping a diary of events in the practice so that you can be fully briefed while you are away or on your return, or to send you an email every week. Make sure that all your post is forwarded, particularly official correspondence.