Asymptomatic COVID-19 testing
NHSE has confirmed that it is making asymptomatic COVID-19 testing available for GP practice staff. This testing is not a mandatory requirement for locum GPs to work within practices.
In accordance with NHS Employers' advice, if you have had a PCR-confirmed positive test, you should not self-test until 90 days have passed as the results are likely to continue to be positive for several weeks subsequently.
If you test positive, you will need to remove yourself from face to face work for 10 days in order to comply with requirements to self-isolate, though you can work remotely from home.
There are therefore a number of considerations that locum GPs should discuss with contracting organisations. These should include:
- avoiding testing less than 48 hours before a face to face shift booked for a practice where you do not have remote working arrangements set up
- assuring yourself that your practice is willing to provide the same opportunities for remote working to you as they are providing to their other clinicians, so that booked sessions can be honoured by the practice for all locums who find themselves needing to self isolate as a result of agreeing to undergo voluntary asymptomatic screening
- if it is not possible to work remotely, practice locum agreements should make provision for payment in lieu of activity to locums from the Covid support fund of £150million across England.
This is will encourage appropriate uptake of asymptomatic testing which has public health as well as occupational health benefits without resulting in financial hardship for locums.
Currently there is no national system in place within the NHS to compensate locum GPs when self-isolation requirements necessitate the cancellation of booked sessions, and the subsequent loss of income for two weeks.
Self-Employment Income Support Scheme
The recent budget announcement included an extension of the Self-Employment Income Support Scheme (SEISS) to provide self-employed individuals with a taxable grant of 80% of 3 months’ average trading profits (up to a total of £7,500) to cover lost earnings due to covid-19 through February, March and April of this year. If you’ve been operating as a locum during this time and have seen your income impacted by the pandemic you may be eligible for this grant.
Criteria for eligibility
- have traded in both tax years 2019-2020 (and submitted your tax return by 2 March 2021) and 2020 to 2021
- have an income below £50,000 for the year (or average for 3 years to then); and
- are currently trading but are impacted by reduced demand due to coronavirus or have been trading but are temporarily unable to do so due to coronavirus
HMRC will consider your eligibility based on 2019 to 2020 Self Assessment tax return and will contact individuals in mid-April. If you’re not eligible based on your 2019 to 2020 Self Assessment tax return, they will then consider the tax years 2016 to 2017, 2017 to 2018, 2018 to 2019 and 2019 to 2020.
Further details and guidance on the scheme is available from the government website.
The government also announced that there will be a fifth and final grant covering May to September, determined by how much your turnover has been reduced in the year April 2020 to April 2021.
This will be worth:
- 80% of 3 months’ average trading profits, capped at £7,500, for those with a turnover reduction of 30% or more
- 30% of 3 months’ average trading profits, capped at £2,850, for those with a turnover reduction of less than 30%
You will be able to claim from late July if you are eligible for this fifth grant.
What the BMA is doing to ensure death in service and other protections for locum GPs
Death in service protection is a top priority for the BMA.
Greater clarity and support to extend death in service cover is needed from the Government for all healthcare workers.
We continue to tirelessly lobby for safeguards and we have written to the chancellor calling for additional provision to ensure that the dependants of NHS staff receive their full death in service entitlement, irrespective of whether they are an active member of the NHS pension scheme.
The BMA is developing a model contract for the engagement of locum GPs in order to maintain death in service throughout the full duration of an engagement, as well as access to occupational entitlements to annual leave and sick pay.
Additionally, the BMA GP committee England is in discussions with NHS England regarding their plans for a national service for cascading additional shifts in primary care which will be supported by a national fixed-term contract offered through a single lead employer.
Welsh Government have published a temporary salaried GP contract. GPs should contact their local health board if they are interested in this temporary employment.
The BMA in Scotland has repeatedly pressed the Scottish Government to commit to providing death in service and other protections for locum GPs. On 29 April, they announced that death in service benefits would be provided for those not otherwise eligible, with a lump sum worth twice the member’s annual earnings and continued survivor benefits.
Eligibility for this scheme includes GP locums.
In addition to this, the BMA has agreed a contract with the Scottish Government that would allow locum GPs who wish to be engaged by a health board to receive death in service, annual leave and sick leave benefits for the duration of their engagement.
You should aim to work remotely where you are resourced to do so with appropriate, secure hardware and software.
Even where social distancing rules are relaxed, remote working further reduces the risk of transmission of COVID-19. It reduces the amount of time spent in practices and allows patients who need a face-to-face consultation to do so with less risk of transmission.
In practices where resources to work remotely are limited, risk assessments should be carried out to determine how these are allocated. However, wherever possible remote working should be facilitated as a way to reduce risk to both staff and patients.
We are in ongoing discussions over making resources available for locums to work remotely where this is not already possible.
Registering for CCAS
NHS England has released two contracts for GPs to engage in the CCAS (COVID clinical assessment service), one for retired GPs returning to service and one for existing employed GPs to provide services within or on top of their existing employment.
It is also possible for a locum GP to engage through one of these contracts.
While the BMA recognises the importance of this service, it has expressed concerns to NHS England regarding the inadequacy of the terms and conditions being offered in these contracts.
You can find further information on the CCAS website.
In Wales, you should contact your local health board to discuss options for working as part of the COVID response.