The Practice Team
One of the best parts of being a GP is that you work as part of a team. There are a range of roles that exist in practices. You can find out more about the professionals who make up the team below
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In this role you:-
are self employed and are effectively running a small business
receive a share of the profits of the practice – with the potential for higher earnings
pay your own tax and do not receive benefits such as sick-pay, holiday and maternity pay
are still involved with clinical work, but also share responsibility with the other partners for decision-making and the ultimate survival of the practice. This includes the financial aspects of keeping the business afloat and employing staff whilst ensuring the practice provides high quality care
are generally committed to one practice for many years, which offers great continuity for both doctors and patients
can influence the future direction of the practice and the range of services offered, for example deciding on the staff mix within the practice which can include employing nurse practitioners, paramedics or pharmacists to improve the running of the multidisciplinary team (MDT) and subsequent patient care
are responsible for the financial success of their practice, even though some GP practices employ a business manager. Business functions such as financial management, practice strategy and policy, service development and recruitment are all part of the job.
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In this role you:-
are employed by the practice and receive a set salary on a scale according to your experience
receive all the benefits of being employed, such as sick-pay, holiday and maternity pay
are mostly involved with clinical work
have less say in the way a practice is run
can change jobs fairly easily
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In this role you:-
have regular work 4 sessions per week in a practice of your choice for up to 3 years
work one session per month in out of hours (OOH) service (any session in OOH provider of your chocie)
have the benefits of being a salaried doctor mentioned above
have a practice mentor who can support/guide you in terms of your future career
have protected time to attend CPD (6 sessions per year)
You can find out more about the Retainer Scheme here
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In this role you:-
have the freedom/flexibility to choose where and when you work in GP
are self-employed
pay your own tax and do not receive benefits such as sick-pay, holiday and maternity pay
are mostly involved with clinical work
typically work in a number of practices allowing you to see how different teams work. This can be helpful before choosing a salaried or partner role.
have no say in the way a practice is run and very little continuity with patients
can change jobs easily
can pursue more easily other interests inside/outside of healthcare
You can find more information about starting as a sessional here
Practice Manager
A GP Practice Manager is a business manager ensuring that patients are cared for within the Surgery. It is a demanding but extremely rewarding role. The job is varied and covers HR, Finance, Training, IT management, Systems and Protocol development. You need to be motivated, a good communicator, a sympathetic ear and a first class manager to excel in this role. No two days are ever the same and the job satisfaction is a reward in itself
Some of their roles include:-
Overseeing the day to day working of a GP Practice
Strategically planning the future with the Partners in the Practice.
Managing staff, the building, and the finances
Orrganising training and skills updates to ensure staff are well trained and able to cope with the demands of a very busy work environment.
Working alongside the GP Partners to ensure practices are safe, efficient and provide a first class service to all patients.
A Practice Manager Handbook was launched in Autumn 2023
NI GP Practice Manager Handbook 1st Ed
General Practice Pharmacists
General Practice Pharmacists (GPPs) work as an integral part of the multi-disciplinary general practice team.
Every GP practice in NI avails of the services of a GPP through membership of the GP Federation. Although GPPs have a well-defined and wide ranging remit, the GPP role within an individual practice can vary according to practice need and priorities. The role includes some of the following tasks:-
resolving day-to-day medicine issues
consulting with and treating patients directly. This includes providing help to manage long-term conditions, advising those taking multiple medicines (polypharmacy) and delivering clinical advice about treatments.
managing medicines shortages by suggesting suitable alternatives where appropriate
mentoring newer pharmacists, depending on their level of experience.
General Practice Nurse (GPN)
Practice Nurses are highly skilled members of the primary care team. They carry out a range of roles within the practice including:-
chronic disease management eg. DM, COPD, asthma, CVD
cervical screening
childhood/adult vaccination
blood monitoring
The GPN Training Scheme has been designed to reflect the Career Pathway for General Practice Nursing NI (NIPEC 2019)
The Scheme runs over 1 year and includes three primary elements of (a) practice-based learning within a host Practice, (b) the Ulster University Post-graduate/Advanced Certificate General Practice Nursing and (c) knowledge and skills training provided by the Clinical Education Centre.
There are a range of courses available for those considering this career pathway https://www.publichealth.hscni.net/directorate-nursing-and-allied-health-professions/nursing/primary-care-nursing
Multidisciplinary Teams
More recently some practices in Northern Ireland have had access to a broader group of health care professionals. The main role and function of this extended primary care multidisciplinary team (MDT) is to provide a first contact and brief intervention service to patients presenting in General Practice. Each multidisciplinary team is ideally made up of GPs, nursing staff, practice based social workers, senior mental health practitioners, pharmacists and physiotherapists. The roll out of MDTs is ongoing, and not all practices have access yet.
The introduction of MDTs to primary care was relatively recent, and in response to a series of reports. In October 2016, “Health and Wellbeing 2026: Delivering Together” (a 10-year plan for transforming health and social care in Northern Ireland) was launched by the Department of Health (DOH). This plan was the response to a report produced by an Expert Panel led by Professor Bengoa. He was tasked with considering the best configuration of Health and Social Care Services in Northern Ireland. A key element of the plan was the development of multidisciplinary teams (MDTs) of professionals working alongside GPs as first responders in General Practice. Following a period of engagement with the Health and Social Care (HSC) system and service users, the Department of Health (DOH) proposed that the HSCB commission multidisciplinary teams (MDTs) in General Practice in 2018/19. These MDTs aimed to deliver the vision set out in “Delivering Together” with an increased emphasis on a holistic model of health and wellbeing which includes physical, mental and social wellbeing with a greater focus on prevention and early intervention.
The MDT includes:
First Contact Physiotherapists
This group of Health Care professionals can:
Diagnose a range of musculo-skeletal conditions
Offer patients advice and exercises to manage their condition
Order tests including X-rays
Prescribe medication
Refer patients to another service if required including to community based activities .
Practice Based Social Workers
Social workers can provide patients with practical advice, help, and support in order to address their problems. They work closely with other members of the MDT, as well as with groups in their local community that can support patient needs.
Senior Mental Health Practitioners
The Senior Mental Health Practitioner can be from one of four professional backgrounds (Social Work, Nursing, Occupational Therapy or Psychology). The Senior Mental Health Practitioner is an integral part of the MDT working alongside other professionals in a seamless and coordinated way effectively meeting the holistic needs of the GP patient and their families.