Contract General practitioner England

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Focus on locum cover for parental and sickness leave

Practices are eligible to receive reimbursement for locum costs incurred when partners and employed GPs are absent for maternity or sickness leave.

Over recent years both reimbursement schemes have been amended to provide practices with easier access to such funding. This guidance outlines the respective schemes as currently set out in the Statement of Financial Entitlements.

 

Locum reimbursement for parental leave (maternity, paternity & adoption)

Eligibility

When a salaried GP or GP partner is absent from the practice due to a period of parental leave (maternity/paternity/adoption) the practice is eligible to receive funding towards the cost of cover for that GP.

For the purposes of this the GP must be on leave for longer than one week and must be entitled to that leave either under statue, their contract of employment (in the case of salaried GPs), or the partnership agreement or other agreement between the partnership (for GP partners).

Cover for the absent GP can be provided by either an external locum or another GP already employed within the practice.

 

Payments

Under the SFE practices are eligible to receive up to a maximum of £1,143.06 per week for the first two weeks and £1,751.52 per week thereafter. If the full cost of the locum is lower than these maximums then the practice will receive the invoiced amount.

Practices should submit costs incurred to their commissioning body at a frequency agreed with the commissioner or within 14 days of the end of the month for which they are claiming reimbursement.

These payments will not be pro-rated in line with the working pattern of the absence GP.

 

Time scales

There are no timescales set out in the SFE for locum reimbursements for parental leave. We would expect such payments to be in line with the length of maternity leave.

 

Locum reimbursement for sickness leave

Eligibility

When a salaried GP or GP partner is absent from the practice due to a period of sickness leave the practice is eligible to receive funding towards the cost of cover for that GP.

For the purposes of this the GP must be absent for longer than two weeks before reimbursement of costs will be paid. There are no stipulations regarding the type of illness/injury and there are no medical exclusion criteria. The only requirement is that the GP who is absent because of sickness would be expected to provide a fit note.

Cover for the absent GP can be provided by either an external locum or another GP already employed within the practice, provided that individual is not already working full time.

 

Payments

After the first two weeks of absence practices are eligible to receive up to a maximum of £1,751.52 per week. If the full cost of the locum is lower than this maximum then the practice will receive the invoiced amount.

Practices should submit costs incurred to their commissioning body at the end of month in which they were incurred. Payment should then be made to the practice at the end of the same day that the practice receives its next Global Sum monthly payment.

These payments will not be pro-rated in line with the working pattern of the absence GP.

 

Time Scales

Practices will be eligible to receive the full agreed amount for the first 26 weeks (6 months) of leave, followed by 26 weeks (6 months) at half that rate. The 52 weeks begin after the initial 2 week qualifying period.

Commissioners will take into account any previous costs claimed for the absent GP within the same time financial year when calculating the number of weeks for which further payment scan be claimed.

For example, if a GP was on sick leave for 6 weeks during May/June and then had a further sickness rated absence in December, the 4 weeks of reimbursements claimed earlier in the year would be deducted from the 52 week annual total.

 

Payments for locums covering sick leave and phased return to work

Practices are entitled to reimbursement for locum cover, returns to work on adjusted hours under the advice of a fitnote. SFE protocols are as follows:

GP partners

The SFE makes no distinction on sickness leave (i.e. full and adjusted hours are viewed the same). This means that the commissioner should continue to reimburse locum cover irrespective of the working arrangements of the performer.

Salaried GPs

The SFE applies further requirements to qualify for reimbursement of locum cover. The requirement is for the contractor, as an employer, to pay Statutory Sick Pay (SSP) or the performer’s full salary during sickness leave under the terms of their contract of employment. However, a phased return arrangement may affect the contractor meeting these requirements. If they are not met, then the commissioner has the discretion to reimburse any locum costs. Whereas, if they are met then the commissioner should continue to cover the costs of locum cover as per above.

In respect of discretionary payments for cover of an employed GP, where requirements of the SFE are not met, the commissioner will make payments in the following circumstances:

  • The employed GP performer’s phased return arrangement directly follows sickness absence leave which attracted a locum payment under Section 16 of the SFE.
  • Where the phased return or adjusted hours arrangement has been advised under a fit note (and for the period only that fit note covers or advises).
  • Where the contractor is paying the employed GP performer their full salary in respect of their phased return or adjusted hours arrangement, for example taking account of both working and sickness absence days/sessions.

 

Joint FAQs can be found on the NHS Employers website.

 

More information

  • FAQs

    We are claiming for a part time GP. Will our payments be pro-rated?

    Payments in respect of locum cover sickness or parental leave will not be pro-rated. The practice will be paid at the invoiced cost up to the maximum amount of £1,751.52 (£1,143.06 for the first two weeks of parental leave).


    We currently have locum insurance to cover any absence within my practice. Do we still need this?

    Practices should be aware that the current maximum weekly payment may not fully cover the cost of a locum and the amount of time they are needed to work in the practice, particularly if they are replacing a full-time GP. For this reason we recommend that practices review their current cover and consider maintaining a level that will allow them to top up the national payments based upon their individual and local circumstances.


    We have a GP who has been on sick leave since before 1 April 2017. What payments can we claim?

    As long as the practice can provide evidence that the GP has been absent for at least two weeks practices will be able to begin claiming appropriate reimbursement from 1 April. However, this will not apply retrospectively to any period preceding 1 April.


    We are currently receiving pro-rated reimbursements. Will these now increase to the full rate?

    Practices will be eligible to receive the full rate of reimbursement from 1 April 2017.


    Are any medical conditions excluded under the new arrangements?

    There are no conditions excluded under the SFE.