BMA guidance

Workload and overtime guidance for salaried GPs

This guidance offers practical advice and resources for salaried GPs to use when approaching their employer to discuss their workload.

Location: England
Audience: GPs
Updated: Wednesday 11 October 2023
Topics: Job planning, Working hours
GP practice article illustration

Overtime means any time worked beyond the contracted hours fixed by your employment contract.

Salaried GPs across the UK are faced with unmanageable workloads resulting in working overtime amounting on average to an additional 25% of their contracted hours. Overtime is a key factor in driving salaried GPs to resign from their posts, move to locum work or leave general practice as a whole. Addressing this issue is therefore a matter of wellbeing, fairness and retention.

This guidance looks at ways you can:

  1. Address overtime to mitigate its effects on safe care, wellbeing and retention (i.e. using job plans, by monitoring your hours and potentially refusing overtime)
  2. Ensure your overtime is fairly rewarded either through pay or time off in lieu (using our rate card or letter to employers)

This guidance highlights the need to respect the agreed contract, to reward all worked time in order to retain GPs in the workforce

All working time should be rewarded and your agreed contract should be respected by employers. Employers are responsible for service delivery. This means they need to either offer an overtime rate which is agreeable to the salaried GP to work the additional hours, organise locum cover or complete the work themselves. If an unforeseen problem with cover arises, employers cannot force salaried GPs to work beyond their contract.

Overtime can occur usually in 3 contexts:

  • Planned and agreed in advance as discrete extra-contractual sessions (for example, an extra clinic). These are usually referred to as “locum” sessions. A fee and rate are usually agreed in advance as well as the expected workload.
  • Extension of an existing session due to excessive workload which cannot be completed in the scheduled time and for which no payment has been discussed as no explicit request has been made of the doctor to work overtime. In this case, it has been assumed they will complete all necessary work regardless of the time needed to complete it.
  • Extension of an existing session due to excessive workload where the doctor has been asked explicitly to work additional hours or do extra work for additional pay because of an unexpected increase in demand, absence of a colleague, lack of holiday cover or other event for example IT down time.

What your contract says

The salaried GP model contract includes mechanisms for recognition of overtime which salaried GPs can utilise to manage their workload. All salaried GPs should be employed on terms no less favourable than those contained in the model contract.

Even if you are not on the model contract you should insist the hours contained within your contract are respected and ask for fair remuneration or time off in lieu for additional time you work over and above the contract.

If you are unsure if you are employed on the model contract, you can contact the BMA’s contract checking service for free as part of your membership. We suggest that all GPs taking on employed roles have their contracts checked prior to agreeing to start work.

We encourage all salaried doctors to discuss remuneration for all periods of time whether planned or unplanned where they find themselves working beyond their contracted hours.

You may feel compelled to work extra hours out of professionalism without having the opportunity to seek agreement about payment in advance. This professionalism and goodwill should not prevent you from seeking fair remuneration retrospectively.

The model contract

The model contract allows for overtime to be paid for on a pro rata basis for the additional sessions. The rate provided in the model contract is the minimum that should be paid and it is of course open to practices and salaried GPs to agree a different rate. We would encourage salaried employees to agree an hourly rate above the pro-rata rate reflecting the fact that overtime does not accrue employment benefits like annual leave, CPD or pension contributions.

Clause 6 of the salaried GP model contract states:

"A Practice may agree with a practitioner that he or she should undertake work which is not specified in his or her Job Plan by way of additional nominal sessions or fractions thereof. The extra session(s) shall be remunerated on a pro rata basis to a full-time practitioners’ salary. Any such agreement shall be reviewed when required but at least annually and will be terminable at three months’ notice on either side."

This clause 6 refers to “work which is not specified in [the] Job Plan”. The work referred to here could be additional duties which are not already covered in the job plan or it could be additional time required to perform the duties already in the job plan (overtime).

Agreeing overtime rates

If your contract does not contain an agreed rate for overtime which is acceptable to you, you can either refuse to work overtime or discuss and agree a rate of pay which is acceptable to you for overtime work requested by your employer. We’ve drafted a letter to help in this scenario.

The salaried GP rate card sets out the minimum rates the BMA recommends for additional sessions agreed to perform overtime.

TOIL (time off in lieu)

You can also request to accrue TOIL for any overtime hours worked by using this letter. Time off in lieu should also be claimed at an enhanced rate for the same reasons that overtime pay is enhanced. The recommended TOIL rate is 1.5 hours in lieu for every hour of overtime worked during core hours and 2 hours in lieu of every hour worked outside of core hours. This could be added to your annual leave entitlement or taken within a certain timeframe agreed between you and your employer.