I'm trying to get some clarity in forthcoming discussions with my PCT regarding my role as clinical lead of a Tier 3 service.

My present contract is as a GPSI, but looking at the NTA document below I'm actually working (& qualified) as a 'Substance misuse specialist - Primary Care'

http://www.nta.nhs.uk/programme/national/docs/Doctors_r...responsibilities.pdf

The RCGP doesnt seem to use these distinctions, and I wonder if anyone has experience of negotiating a transition from GPSI to 'SMS-PC'?
Regards

Actually Graham, the document you describe is not an NTA one its a joint document produced by the RCGP and RCPsych (its on their web-sites too) in order to define the doctor role in this field. So the substance misuse specialist-primary care role is one that the college has signed up to.

Unfortunatley they only drew up draft competnancies/qualifications for this role and left it off the 'skills escalator'.

many GPs (or doctors from a GP background) are now working in specialist jobs, for PCTs or non-stat agencies. Al;so increasingly they are working in mentalhealth trusts taking on the role thgat would formally have been fulfillied by a consultant Psych. If you want some examples don't hesitate to contact us.

Dear Graham,
I'd echo all that Jim says. I was involved in some of the drafts at the time and I think it's fair to say that there's a grey area between substance misuse specialist primary care and GPsi. For me the former is something about those GPs who have made a transition into working full-time with drug users and therefore all of their CPD etc tends to be drug misuse related. The analogy does have limitations of course as there's some very experienced GPs who are practicing mainstream GPs yet know as much as anyone about managing drug dependence. But yes I think if you're the clinical lead for a service and it's pretty much your full-time business then I'm sure Jim can point you in the direction of some of the contracts around.

Thanks for your prompt & useful responses.
Jim, yes I would be interested in some examples/draft contracts if possible.
Nat/Jim,are we talking about article 14 PMETB GMC specialist registration as equating to SMS-PC 'grade'? I suspect not.
What you're calling 'grey' I'm calling 'fudge'.
It's a serious point about our local PCT fudging the issue of service provision by inferring that all services provided by GPs are 'off the peg' GPWSI services, therefore 'bog-standard'.
Incidentally, any PCT or other organisation exercising FT vs PT as a criteria for grading a post would find itself in an Industrial Tribunal on the losing side.Straightforward indirect sex discrimination!
http://www.eoc.org.uk/Default.aspx?page=15282
kind regards
Graham

It may be not so much FTvvPT, as that GPwSIs have to have a certain proportion of thir week as generic GPs I think..I forget what proportion exactly.. but if they stop doing any generic GP work at all, then they stop being a GPwSI and would then become a "substance misuse specialist primary care". I don't think it is a matter of higher or lower status as GPs of course already have as high a status as it is possible to attain in the medical world, don't they?!

Graham

I'm afraid no-one has given me a copy of their exact contract. I have a job description or two and some job adverts (theres some on our main site). What I was offering was to put you in touch with others operating as specialists (primary care) who are in a similar position to yourself who may be able to advise you.

Briefly, I know several of the people working in mental health trusts are on consultant equivalent contracts. In PCTs its different and each PCT seems to do it differently either by picking what they think is an appropriate pay band or through individual negotiation.

If you want to contact me you can on 0151 632 0409 or smmgp@freeuk.com

Hi again Graham
there are two issues here.
1. your contract with the PCT - its a local negotiation thing, as the BMA have advised me many times. In my case I have ended up on a consultant style contract, and used a useful paper produced by another colleague last year which surveyed others on their salaries in order to negotiate a substantial pay rise.
2. The Roles and Responsibilities paper defines an 'Addiction specialist - primary care' as having a higher professional qualification in addictions, such as a masters-level diploma. My local RCGP deanery has not been happy to let me define myself as such without this, and I have therefore gone back to adding a mimnimal GP commitment to my week and calling myself a GPwSI, even though, like you and so many others, I act in a specialist role. I intend to take the diploma when circumstances allow, and will them be 'safe' to drop the GP work if I chose.

Hope this helps. Happy to send paper, and my contract if you would like to see them.

Hi Susi
I've actually found the LMC much more robust & prompt with their advice than the BMA. I would be interested in the paper & contract, I'll email you offsite.
I am the once proud owner of a low mileage MRCPsych, which I occasionally like to trundle out when the 'experience and qualifications' discussions start!
i've only recently joined this site and must say what an extremely helpful resource it is
Thanks again

Its good for your soul being doing some "ordinary " GP stuff too. And all that asthma/COPD/diabetes/Hypertension stuff seems more and more prevalent in our aging drug using population unfortunately. This is one of the many reasons why GPs are so wonderfully effective and useful in this line of work. (and practice nurses)

I was looking for a quote to justify blowing ones own trumpet, but just came across this one which says you shouldn't (along with other good advice)
http://www.hindu.com/edu/2005/07/19/stories/2005071900570200.htm