The
hidden costs of appointing salaried GPs - Focus on Salaried
GPs (amended April 2008) issued by the GPC
This updated guidance on the terms and conditions of salaried GPs
gives further clarification of the importance of “continuous
NHS service” when calculating entitlement to sickness, maternity
and redundancy payments. This is one of the hidden costs in the employment
of salaried GPs and although the regulations only relate to those
in GMS practices, the guidance emphasises to salaried GPs in PMS and
APMS practices that they should negotiate terms which are equal to
or better than their GMS counterparts.
We are
not convinced that even after more than four years, all GMS practices
understand that it is compulsory to offer the Model Terms or better
to their salaried GPs and, those practices that don’t do so
(and are shopped by a disgruntled salaried GP), can have their GMS
contract withdrawn by their PCO.
The continuous
NHS service provisions mean that a salaried GP may have an entitlement
to “contractual maternity pay” from the practice from
day 1 of employment in the practice (even if they don’t qualify
for SMP). This can put practices in the position of appointing a salaried
GP say in April who starts work in May only to announce on arrival
at work that she is pregnant and will be leaving in August for her
12 months maternity leave. In the worst scenario, if she has come
from another NHS post and qualifies for continuous service under the
terms set out in the Model Contract, she will be entitled to contractual
maternity pay of 8 weeks full pay less SMP or Maternity Allowance,
14 weeks half pay plus SMP or MA plus 17 weeks of SMP or MA. She may
decide at the end of her maternity leave that she will not return
but moves onto another practice (it has happened!). The practice has
paid out thousands of pounds in contractual pay which is not reimbursable
with no comeback.
“Contractual
redundancy pay” based on total continuous NHS service as set
out in the old Whitley Council rules, even though Whitley Council
as such no longer exists, can cost practices tens of thousands of
pounds if redundancy is the only option, with no recompense as you
can only reclaim Statutory Redundancy Pay, and a salaried GP will
not be entitled to this if he / she has less than two years service
in the practice (previous NHS service is not taken into account when
calculating Statutory Redundancy Pay). A salaried GP aged 41 or over
with many years of previous continuous NHS service may have an entitlement
to up to 66 weeks full pay as a contractual redundancy payment!
The rules
for salaried GPs are complex and the BMA / GPC have only in the last
year (August 2007, October 2007 and now April 2008) decided to notify
practices of legal opinions which they have sought to interpret the
rules. They accept that changes to the Model Contract are necessary
and that this is being explored to make it more understandable. We
doubt whether the fundamental principles of the contract as highlighted
above will change though.
BMA Focus
on salaried GPs (updated April 2008) - 
Information
on redundancy payments -
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