General Practitioners Committee GP practices

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GP Retention Scheme FAQs

The GP Retention Scheme (formerly the Retained Doctor Scheme) is a package of support resources aimed at GPs who may be considering leaving the profession, to help them remain in clinical practice providing between one and four sessions per week. The resources also offer support to the GP practices employing them.

Read the FAQs to answer your questions

Read in conjunction with the GP Retention Scheme guidance.

FAQs

  • General

    What is the GP Retention Scheme?

    The GP Retention Scheme is a package of financial and educational support to help doctors, who might otherwise leave the profession, remain in clinical general practice.

    The scheme supports both the retained GP (RGP) and the practice employing them by offering financial support in recognition of the fact that this role is different to a ‘regular’ part-time, salaried GP post, offering greater flexibility and educational support. RGPs may be on the scheme for a maximum of five years with an annual review each year to ensure that the RGP remains in need of the scheme and that the practice is meeting its obligations.

     

    Who is eligible for the scheme?

    The scheme is open to all doctors who meet ALL of the following criteria:

    1. Where a doctor is seriously considering leaving or has left general practice (but is still on the National Medical Performers List) due to:
      1. Personal reasons – such as caring responsibilities for family members (children or adults) or personal health reasons; or
      2. Approaching retirement; or
      3. Requiring greater flexibility in order to undertake other work either within or outside of general practice.
    2. And when a regular part-time role does not meet the doctor’s need for flexibility, for example the requirement for short clinics or annualised hours.
    3. And where there is a need for additional educational supervision. For example a newly qualified doctor needing to work 1-4 sessions a week due to caring responsibilities or those working only 1-2 sessions where pro-rata study leave allowance is inadequate to maintain continuing professional development and professional networks.

    Retained GPs may work between one and four sessions per week and may be on the scheme for up to five years with an annual review each year to ensure that they remain eligible. The scheme supports both the RGP and the practice employing them by offering financial support in recognition of the fact that this role is different to a 'regular' salaried GP post, offering greater flexibility and educational support.

    Doctors must hold full registration and a licence to practice with the GMC and be on the National Medical Performers List.

     

    Why are we doing this?

    The General Practice Forward View (GPFV) has committed to introduce ‘a new GP retainer scheme more fit for purpose’ from 1 April 2017.

    Workforce data shows that the number of GPs leaving in most ages groups particularly those aged 55–59 and 60-64, has risen over the last 10 years. Data also shows peaks in GPs leaving practice aged in their 30s and aged 55-59. This scheme is aimed at anyone intending to leave general practice at anytime in their career and when a regular part-time role does not meet the doctor’s need for flexibility and where there is a need for additional educational supervision.

     

    How does the GP Retention Scheme differ to that of the Retained Doctors Scheme 2016?

    The GP Retention Scheme replaces the Retained Doctors Scheme 2016. The two schemes are similar in that they offer the same amount of funding – the practice still receives a payment of £76.92 per session that the RGP works, the annual expenses supplement for the RGP remains at between £1000 and £4000 and the new scheme retains much of the same approvals process as for the 2016 scheme. However the following changes have been made:

    • Further clarity on who can apply to the scheme.
    • Further clarity around what additional work can be undertaken while on the scheme.
    • Further clarity around extended absence and scheme extensions – for example when extensions are applicable and when payments should cease.
    • The introduction of a job plan to accompany the scheme to ensure that the RGP post delivers its aims including provision for CPD.
    • Clear guidance around the management/approval of the RGPs on to the scheme.
    • Introduction of a peer review process for unsuccessful applications.
    • A revised application form that reflects the changes made to the scheme.

     

    How is this scheme different to the Induction and Refresher (I&R) Scheme?

    The Induction & Refresher (I&R) Scheme in England provides an opportunity for GPs who have previously been on the General Medical Council’s (GMC) GP Register and on the NHS England National Medical Performers List (MPL), to safely return to general practice, following a career break or time spent working abroad. It also supports the safe introduction of EU and overseas GPs who have qualified outside the UK and have no previous NHS GP experience.

    The GP Retention Scheme is designed to support GPs who would otherwise leave, when a regular part-time role does not meet the doctor’s need for flexibility and where there is a need for additional educational supervision.

    To join the scheme doctors must hold full registration and a licence to practice with the GMC and be on the National Medical Performers List.

     

  • Prospective retained doctors

    Why should I apply for the scheme? How will it benefit me?

    The GP Retention Scheme is designed to support GPs who would otherwise leave (or have left), when a regular part-time role does not meet the doctor’s need for flexibility and where there is a need for additional educational supervision.

    RGPs may be on the scheme for a maximum of five years with an annual review each year to ensure that the RGP remains in need of the scheme and that the practice is meeting its obligations.

    Each RGP would qualify for an annual professional expenses supplement of between £1000 and £4000 which is based on the number of sessions worked per week. It is payable to the RGP via the practice. The professional expenses supplement is subject to deductions for tax and national insurance contributions but is not pensionable by the practice.

    This scheme enables a doctor to remain in clinical practice for a maximum of four clinical sessions (16 hours 40 minutes) per week - 208 sessions per year, which includes protected time for continuing professional development and educational support.

     

    Can I be a RGP in the practice that I already work in?

    Yes as long as the practice offers the RGP work which enables them to maintain their skills across the full spectrum of general practitioner work. The RGP should be embedded in one GP practice to enable peer support at work and continuity with patients.

    Practices must be able to demonstrate they can meet the educational needs of the RGP and that they understand the ethos of educational supervision. The designated RGP Scheme Lead from HEE will assess this based on the needs of the doctor who is applying. The practice must provide a named educational supervisor who is either a GP trainer, F2 supervisor or has recently accessed a suitable training course in supervision. The precise specification will be determined by the designated HEE RGP Scheme Lead.

    If the practice currently employs or has recently (within the last two years) employed a RGP, the outcomes should be discussed with the HEE RGP Scheme Lead before a second RGP is agreed.

     

    I am not on the National Medical Performers List but have practiced in the last 2 years, am I able to join the scheme?

    To join the scheme doctors must hold full registration and a licence to practice with the GMC and be on the National Medical Performers List. It is recommended to talk to your local Responsible Officer who will be able to advise on the best route to get back onto the National Medical Performers List.

     

    What evidence can be used to show that I am seriously considering leaving or have left general practice?

    Evidence to ascertain whether a doctor is seriously looking to leave general practice may include:

    • Proof from appraisal
    • Letter of resignation
    • Accessing or intention to take pension payment
    • Statement of intent to leave

     

    Is the money I receive through the expenses supplement taxable?

    The expenses supplement is subject to deductions for tax and national insurance contributions but is not pensionable by the practice.

    Certain expenses may be claimed against tax (e.g. subscriptions to medical defence organisations and membership of the BMA and GMC annual retention fee etc). GPs may want to take independent financial advice.

     

    What is the professional expenses supplement for?

    The whole of the professional expenses supplement payment will be passed on by the practice to the doctor to go towards the cost of indemnity cover, professional expenses and CPD needs. The practice should not automatically make any other deductions from the RGP expenses supplement except for tax and national insurance contributions.

     

    Where is the scheme available?

    The scheme is available across England. Doctors who are intrested in applying to the scheme should in the first instance contact their designated HEE RGP Scheme Lead who will be able to advise on their eligibility for the scheme including work and educational elements and the application process.

     

    Why can't I go on the scheme if I work more than four sessions per week?

    The number of sessions to be worked as a RGP is capped at four clinical sessions per week. If you want to work more than this, you are not eligible for the scheme.

    The scheme supports practices to provide the flexibility to doctors who for various reasons cannot undertake a regular part-time role, for example for the requirement for short clinics to work around health needs or annualised hours to allow for time off during school holidays. For annualised sessions there is the expectation that the RGP works a minimum of 30 weeks out of the 52.

     

    How long can I remain on the scheme?

    RGPs may be on the scheme for a maximum of five years with an annual review each year to ensure that the RGP remains in need of the scheme and that the practice is meeting its obligations.

     

    What happens when the scheme ends?

    Doctors may wish to return to a more substantive role if they so wish when the scheme ends, although this is not a requirement of the scheme.

    The RGP achieves full employment rights after 24 months with the same employer and the practice (employer) under employment law is obliged to continue the contract of employment after that time. Any changes in circumstance that may affect the employment of the RGP should be a matter of discussion between the RGP and the practice, and appropriate advice should be taken. The practice is expected to notify the designated HEE RGP Scheme Lead of any substantive changes that may affect employment of the RGP. Examples may include a practice merger, change to different premises, change of NHS England practice contract holder or contract type (e.g. following practice reprocurement).

    Advice should be sought from the BMA on issues of continuity of service and employment rights.

     

    Can I get an extension for my time on the scheme?

    The RGP in discussion with the designated HEE RGP Scheme Lead and subject to agreement by the NHS England’s DCO (or nominated deputy either within NHS England or delegated CCG), can extend their time on the scheme in the following circumstances.

    • To replace time off the scheme relating to maternity, parental, adoption or sick leave.
    • Under special circumstances e.g. where a RGP has had to change practices due to relocation or due to break down in placement and support and would not have enough time left on the scheme to acquire employment rights in a fresh post.

    In these circumstances an extension of up to 24 months would be deemed appropriate.

     

    What is my CPD allowance as a RGP?

    The RGP is entitled to the pro rata full time equivalent of CPD as set out within the salaried model contract.

    CPD is based on:

    • The needs of the individual, as established at their appraisal.
    • Discussion with the designated HEE RGP Scheme Lead.
    • Discussion with the practice supervisor.

    This is underpinned by a robust job plan and reviewed annually by the designated HEE RGP Scheme Lead.

    There should be an appropriate balance of CPD sessions spent in the practice (such as in house educational meetings, SEA and prescribing meetings, quality improvement activities) and activities outside the practice (such as learning groups, e-learning, self-directed learning, talks, courses and locality protected learning events).

    CPD activities may fall outside the RGPs contracted time. For example, if an RGP only works on Monday, it is highly likely that they may find the course they wish to access occur on Tuesday, Wednesday Thursday or Friday. The CPD time can then be taken on an “in lieu” basis on a mutually agreed date.

    CPD activities may include:

    • Self-directed/private study.
    • Developing and/or updating a personal development plan.
    • Practitioner or self-directed learning groups.
    • Local protected learning events.
    • Practice quality improvement activity.
    • In-house practice based educational meetings.

     

    Can I work extended hours, including Saturday and Sunday working?

    The RGP may work extended hours during the week or at weekends by mutual agreement, provided the total number of hours worked does not exceed those in the contract, and that the extended hours sessions are incorporated into the job plan where the balance of clinical work, admin, CPD can be assessed as balanced for the post.

     

    How do I go about applying to the scheme?

    Doctors who are intrested in applying to the scheme should in the first instance contact their designated HEE RGP Scheme Lead who will be able to advise on their eligibility for the scheme including work and educational elements and the application process.

    The designated HEE RGP Scheme Lead can be contacted through the local HEE office. The table below links to the various offices depending on which part of the country you are based in.

     

    HEE Local Office

     

    Telephone

    HEE East Midlands  0115 823 3399
    HEE East of England  01223 597 500
    HEE Kent Surrey & Sussex  01293 227102
    01293 227123
    HEE North East  0191 210 6400
    HEE London (Central and East, South, West)  0121 695 2276
    HEE North West (Mersey & North Western)  0151 479 2560
    HEE South West (Peninsula)  01725 676155
    HEE South West (Severn)  01454 252667
    HEE Thames Valley  01865 785583
    HEE Wessex  01962 718441
    HEE West Midlands  0121 695 2222
    HEE Yorkshire & Humber  0113 3433595

    Further information regarding the scheme can be found on the NHS England website

     

    What happens if my application is not recommended by the designated HEE RGP Scheme Lead for approval by NHS England?

    Where applications are not recommended by the designated HEE RGP Scheme Lead for approval by NHS England, RGPs should follow the local HEE office’s arrangements regarding appeals.

     

    What happens if I am already on the Retained Doctor Scheme 2016?

    GPs who have been accepted on to the Retained Doctor Scheme 2016 (where the application form has been approved by the NHS England DCO - or nominated deputy either within NHS England or delegated CCG) but who are not in post before 31 March 2017 will be accepted onto the GP Retention Scheme without the need to re-apply.

    Those RGPs who are retained under the Retained Doctor Scheme 2016 will continue on that scheme until July 2019 when they will transfer to the GP Retention Scheme if they still have time remaining on the scheme.

     

  • GP practices

    How will the GP practice benefit?

    Each practice employing a RGP will be able to claim an allowance relating to the number of sessions for which their retained doctor is engaged.

    The practice will qualify for a payment of £76.92 per clinical session (up to a maximum of four clinical sessions per week) that the doctor is employed for. This allowance will be paid for all sessions including sick leave, annual leave, educational, maternity, paternity and adoptive leave where the RGP is being paid by the practice. Evidence of this payment will be required.

    The practice and RGP will continue to receive payments under the terms of the scheme as long as the RGP remains contracted to the practice and the practice continues to pay the RGP.

     

    How many retained doctors can a practice take on at once?

    In exceptional circumstances practices may employ more than one RGP where there is capacity for support and long term career opportunities with the prior approval of the designated HEE RGP Scheme Lead.

     

    What constitutes as an appropriate induction for a RGP?

    A RGP is a qualified GP not a trainee. Any induction should take into account the specific needs of the individual RGP and so should be devised in discussion with them. It is important to ensure introduction to all key members of the primary care and allied teams and in addition ensure the RGP is informed of:

    • The computer system within the practice so that consultations, prescribing, templates, protocols, mentor, BNF, word processing and internal message systems etc. can be accessed and utilised.
    • Practice systems for Chronic Disease Management: adding to disease registers, care plans and patient alerts, familiarity with recall systems, targets, and team roles in their management.
    • Practice procedures and protocols and where to access these.
    • Knowledge of local and practice prescribing policies.
    • Familiarity with local referral pathways used by the practice, collaborative working arrangements and main providers together with services available.
    • Familiarity with in-house services, e.g. Phlebotomy, ECG etc.
    • Knowledge of any special services provided by the practice, e.g. drug dependence, physiotherapy, counselling, chiropody etc.
    • Provided with relevant and necessary telephone contact numbers.
    • Awareness of practice appointment systems and on-call arrangements.
    • Location of emergency drugs.
    • Procedures for reporting significant events.
    • Panic button location and protocol for reporting violent incidents.