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2 - Work for local authorities

Work under the 'collaborative arrangements'
The ‘collaborative arrangements’ between health authorities and local authorities were established under legislation in 1974 (current legislation is contained in sections 26–28 of the NHS Act 1977 and section 15(1)(c) of the NHS (Scotland) Act 1978). They allowed certain local authority services in the fields of education, social services and public health to be provided by the corresponding health authority without charge. They include a number of services provided in the community health service (particularly sessional work in family planning, go to Fees guidance schedule 4) which were transferred to the NHS in 1974. Mechanisms and responsibility for the reimbursement of fees and allowances are agreed locally between the parties concerned but should allow the doctor to charge the local health authority who will in turn charge the primary care organisation.

Apart from the services specifically listed in this schedule, it is the view of the Departments of Health ‘that the services provided under the “collaborative arrangements” should be decided at a local level dependent upon the individual needs of an area.’ Hence, for example, it would be a matter for local decision whether attendance at multi-agency risk panels or reports for local authority housing associations were covered by the ‘collaborative arrangements’.

It has been agreed with the BMA that basic health information provided by GPs for community care purposes would not attract a fee (guidance on this was issued by the then GMSC to local medical committees (LMCs) in 1992). Any community care work undertaken by GPs that goes beyond the provision of basic health data does, however, attract a fee as outlined in section A of this schedule.

Under these arrangements, a ‘full session’ is normally one and a half to two and a half hours, including, where necessary, travelling time. A ‘short session’ is normally up to one hour.

Consultants working under the 2003 contract (for England and Northern Ireland)
Schedule 9, 10 and 11 of the Terms and conditions for consultants 2003 outline the principles governing receipt of additional fees for NHS consultants on the new contract. As a general principle, work undertaken during NHS programmed activities will not attract additional fees or if a fee is paid it must be remitted to the employing organisation; but the consultant is entitled to the fees for work done in his or her own time, or during annual leave, unpaid leave or where the work is deemed but agreement reached to cause ‘minimal disruption’ to NHS activities.

Consultants working under the pre-2003 contract
Work under the ‘collaborative arrangements’ will continue to be considered as category 2 work for consultants. Some trusts may also have agreed separate contracts with individual consultants, which allow for work under the ‘collaborative arrangements’ to be performed as part of contract duties.

Consultants working under the 2003 contract in Wales
Fee paying work including category 2 should not attract double payment. However, it may be carried out with the professional fee retained by the consultant in the following circumstances, which will be agreed in the job plan review:

• when carried out in the consultants’ uncontracted time or in annual or unpaid leave
• where it is agreed the work involves minimal disruption to contracted NHS time
• where such work constitutes a significant element of time, consultants will identify this in the job planning process, and identify 37.5 hours of time provided to the NHS apart from

• day nurseries for children aged five and under
• nursery schools for children aged two to five years
• residential special schools and boarding homes for handicapped children
• local authority boarding schools
• community homes
• mother and baby homes
• residential accommodation provided under part III of the National Assistance Act 1948, part 4 and section 59 of the Social Work (Scotland) Act 1968, or articles 7 or 15 of the Health and Personal Social Services (Northern Ireland) Order 1972
• reception centres for accommodating persons without a settled way of living
• teacher training and other residential colleges.

1. Unless otherwise indicated a 'full session' normally means a session of one and a half to two and a half hours including allowance for travelling time and 'short session' means a session not normally exceeding one hour.
2. Attendance at case conferences arranged by social services departments, but not called by the doctor, should be treated as one session unless attendance would be part of the doctor's normal duties (eg as part of a multidisciplinary team) and a fee paid in accordance with the length of the conference.
3. The fee for the dental anaesthetic session only applies to practitioners with a recognised qualification in anaesthetics.

1. The fees for re-examination should be paid if the previous BD8/A655 is available at the time of the re-examination.
2. Where form BD8/A655 is completed in the course of or following a domiciliary consultation for hospital purposes without a further visit being necessary, the combined fees in Fees guidance schedule
3. go there should be paid by the employing authority at the rate shown in appendix 1 (para 145) to the hospital medical and dental staff terms and conditions of service.

1. The fees for re-examination should be paid if the previous BP1 is available at the time of the re-examination.
2. Where form BP1 is completed in the course of or following a domiciliary consultation for hospital purposes without a further visit being necessary, the combined fee should be paid by the doctor’s employing authority at the rate shown in appendix 1 (para 145) to the terms and conditions of service of hospital medical and dental staff and doctors in public health medicine and the community health service, and in appendix 5(b) of the terms and conditions of service of the new consultant contract in Scotland.