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
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
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.
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.
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.
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.