Period of of weeks: cover: …………………………….…………. (No. ……………) Number of clinical sessions worked……….. Amount paid to individual: £………………………….. Name and surname: …………………………………………………………………… Period of of weeks: cover: …………………………….…………. (No. ……………) Number of clinical sessions worked………… Amount paid to individual: £………………………….. Name and surname: ……………………………………………………………………. Period of of weeks: cover: …………………………….…………. (No. …………….) Number of clinical sessions worked………… Amount paid to individual: £………………………….. Details of internal GPs covering absence If employing an external locum GP to cover the GP then please performer’s absence, complete the information below (add more lines if required). Name and surname: …………………………………………………………………… Period of of weeks: cover: …………………………….…………. (No. ……………) Number of clinical sessions worked………..
Period of cover: …………………………….…………. (No. of weeks: ……………) Number of clinical sessions worked……….. Amount paid to individual: £………………………….. Name and surname: …………………………………………………………………… Period of cover: …………………………….…………. (No. of weeks: ……………) Number of clinical sessions worked………… Amount paid to individual: £………………………….. Name and surname: ……………………………………………………………………. Period of cover: …………………………….…………. (No. of weeks: …………….) Number of clinical sessions worked………… Amount paid to individual: £………………………….. Details of internal GPs covering absence If employing an external locum GP to cover the GP performer’s absence, then please complete the information below (add more lines if required). Name and surname: …………………………………………………………………… Period of cover: …………………………….…………. (No. of weeks: ……………) Number of clinical sessions worked………..
primary-medical-care-policy-guidance-manual-final.docx