Out of hours work can be a rewarding part of a portfolio career. There are, however, a number of pitfalls you need to look out for if you're considering this line of work.
Below are some top tips on how to avoid them and some key questions to ask.
Prime your paperwork
Check what documentation the OOH provider requires before you start work as different providers may have different requirements.
For example, are you required to provide:
- recent DBS (disclosure and barring service) check
- proof of GMC registration
- MDO (medical defence organisation) certification
- CPR certificate
- child protection training
Check the T&Cs
Will you be employed or self-employed? Is there a contract? Do you get an NHS or other pension? Is there annual/sick/maternity/study leave? Can you cancel shifts and, if so, how much notice is required?
Use our contract-checking service
Assess your indemnity
Check with your MDO what level of indemnity cover you will require; this is likely to be much higher than for in-hours work. Even if the OOH provider has indemnity cover for you, your MDO will still need to be informed (e.g. the Welsh risk pool doesn't cover criminal or disciplinary procedures).
Make sure you inform your MDO of the number of sessions you do per week or month and don't undercount or you may find they won't cover you in the event of a claim. The MDO will also want to know if you are responsible for nurses, GP trainees or paramedical workers.
Computer says 'yes'
Ensure you are familiar with the IT system before starting a busy shift. Do you have an individual login ID? How do you prescribe?
Essentials at your fingertips
Ensure you have access to essential information, such as:
- emergency social workers
- psychiatric crisis response team
- various levels of ambulance response and how to contact them
- the location of the treatment centres and their opening hours
- which hospitals cover your area and their phone numbers
- how to contact the shift manager
- what EoL (end of life) services are available
Also, how do you refer to the community nurses? Where is the emergency resuscitation equipment? Are emergency admission alternative pathways available? What drugs are stocked? Is there a formulary you must stick to? Is there a list of local pharmacy opening hours?
Check what's included
All OOH providers differ in what they provide eg repeat prescriptions, faxing prescriptions, drug formularies, basic kit, payment for running over time. Do you have a driver or are you expected to drive? Will you be expected to do a ward round at a community hospital and clerk in patients?
Does the OOH provider have a policy for dealing with potentially violent patients? Is a chaperone available when needed?
How are they handled? How do you make a complaint or raise a significant event?
Does the OOH provider offer funded training in:
- telephone triage
- child protection
- protecting vulnerable adults
- assessing mental capacity
- EoL care
- use of the resuscitation equipment provided
Where are the toilets? Are there tea and coffee-making facilities? Are you allowed a meal break? Under the EWTD (European Working Time Directive) you have the right to an uninterrupted 20-minute break during your working day (this could be a tea or lunch break) if you work more than six hours.
Read guidance on the European Working Time Directive
If you are working in isolation, how do you contact colleagues in other bases for advice or to discuss difficult cases? Does the OOH provider give good support in the event of complaints? Are there any support or co-mentoring networks? Are there links with local sessional GP groups? Can information about your work be used for appraisal?
Read guidance on mentoring and support schemes