Some GP practices are looking to extend their opening hours following the introduction of the new extended access Directed Enhanced Service (DES). Details of the DES can be found in the GPC guidance note, Focus on Extended Access 2008-09.
As noted under the 'Hours of work' section above, if a salaried GP is employed under the model salaried GP contract and the employer requests that the salaried GP to work different hours on a temporary basis, then if this is agreed the salaried GP will receive payment for this extra work based on a pro rata of their salary.
The following guidance is for salaried GPs and concerns where a permanent change to the salaried GP's terms and conditions is proposed.
1. If the employer wants to change your hours permanently, what should you do in the first instance?
We would hope that your employer would have a meaningful discussion with you before reaching any decisions.Certainly communication, involvement and engagement is generally the key to practices managing any change successfully.
If the employer suggests changing hours, then we advise salaried GPs to ask the employer (if they do not do it automatically) to put the details of the proposal in writing so that you can consider this fully and can use this to take advice as necessary. We recommend that the proposal should include the following:
- whether the proposal is for an increase in the individual's working hours or a re-arrangement in working hours;
- a range of alternative options to consider (e.g. in terms of the hours available since some staff may be able to cover different hours);
- whether the new hours will include time for administration;
- the impact that the re-arrangement of hours will have on team meetings and the ability for clinicians to communicate;
- details of the support staff that would also be working with you during the new hours;
- practice security and insurance arrangements that will be in place if you are being asked to work late or at weekends;
- whether the remuneration will remain the same or will be at a higher rate to take account of any anti-social hours;
- whether the proposal is a for a temporary or a permanent change to working hours; and
- the timescale for responding to the proposal and what opportunities there will be to discuss this in a meeting.
2. Could the permanent change in hours work for you?
The next step is for the salaried GP to consider the proposals fully. It may be that the proposed change to hours could work, or be rearranged to work, to your benefit. For example, if you can arrange childcare on a Saturday morning, then you may be able to negotiate that you start work later or leave earlier during the week. Alternatively you may prefer to start work later in the day and to work later in the evening.
In considering this, also bear in mind how the proposed change fits in with your professional development aspirations, your personal development plan and any actions agreed during your recent in-house performance review (internal appraisal).
Therefore, instead of rejecting immediately such a proposal it is worth at least considering whether it might be suitable for you and if so how you can make the proposed changes work for you. Of course, this will not be possible for everyone.
3. How your hours of work may be changed?
In considering whether to accept the changes proposed, you may wish to note the ways that an employer may amend your terms and conditions of employment within the law.
There are five main ways in which your terms and conditions can be changed:
- By explicit negotiated agreement between you and your employer.
- Where agreement is already contained within the contract prior to the change – i.e. if there is a contractual right to vary the contract. For example, the contract may reserve the right to change the timings of hours of work subject to consultation. If your contract contains such a provision, the employer would not need subsequently to negotiate and agree any change to your hours with you (although it would be good practice for the employer to do this). It might, however, still be possible to object to the change if it is excessive or unreasonable. This will depend on the circumstances*. To check whether your contract of employment contains such a term, BMA members should send their contract to the BMA.
- By collective agreement where the contract specifies that such changes will be incorporated. Again, to check whether your contract of employment contains such a contractual term please send it to the BMA.
- By performance of the contract - if you work to the new hours then you could be deemed to have accepted a change by performance. Thus if a change occurs which a salaried GP is concerned about then the salaried GP needs to clarify with the employer that he/she is not agreeing to the change and should seek further advice from the BMA.
- By you being dismissed from your contract and then you being offered a new contract on different terms. This would only be expected to occur in extreme circumstances. The employee does not, however, need to accept the change and may be able to seek legal redress for the dismissal. Furthermore, where an employee is qualified5 to make a claim for unfair dismissal the employer would have to show a fair reason (which may include business reorganisation/efficiency as 'some other substantial reason') and have acted reasonably.
It is also possible that, where a salaried GP is unable to change his/her hours, the employer may dismiss salaried GP without re-engaging him/her. As above, this is an extreme measure and legal redress may be available in such an instance if a fair reason is not given, the correct procedure for dismissal is not followed, or if adequate notice is not given.
* While the national model salaried GP contract refers to undertaking additional work (as follows) this is not a contractual right to vary the contract:
“A Practice may agree with the practitioner that he/she should undertake work which is not specified in his/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”.
4. Your response to the proposal
After considering the proposal, you should then carefully consider how you respond it. As in any negotiation, listening to the reasons for the change and engaging in the discussion is the key.
There may be parts of the proposal that you can support and other parts which you are unable to or which cause you concern. You should be clear about this in your response. For example, you may be willing in principle to consider working longer one night a week, but the specific hours suggested are impossible. Or the timescale for meeting the change may be too short if, for example, you have childcare cover to arrange.
Alternatively you may be unable to change your working hours at all. We recommend that in the first instance you explain to your employer your reasons for this – for example, for family or childcare reasons.
If you cannot accept the proposal as it stands or are unable to accept it at all, then by specifying your reasons when you respond may enable your employer to seek other GPs to cover the new hours or consider revising their proposals.
5. What if you cannot change your hours and your employer insists on a change?
If your employer is not willing or able to consider changing the proposal, then BMA members should contact the BMA immediately for individual expert advice on how to handle the particular situation and to discuss options.
6. What if you agree to a change to your hours of work?
If you agree to your hours being changed, then you should request a draft revised contract of employment and a draft new job plan. We advise that you have these checked prior to working to the new arrangements. BMA members should contact the BMA immediately so that the proposed revision to their contract and job plan can be checked.
Focus on Salaried GPs (PDF)
- The views of the GPC lawyer are based on expert opinion and confirmed by an external firm of lawyers. Please be aware however that because of the wording of the model contract it is not possible to give a definitive view.
- Please see footnote 1.
- Based on reading paragraph 7 of the model offer letter in conjunction with paragraphs 1.7 and 9 of the minimum terms and conditions, and these with the other relevant parts of the minimum terms. Also see footnote 1.
- Please see footnote 1.
- To be qualified to make a claim of unfair dismissal on general grounds, an employee must have been employed by the same employer for at least one year. Claims of unfair dismissal on some special grounds, such as any form of unlawful discrimination, may be made from day one of employment.
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