Although there may be some differences in process in each of the four countries of the UK, the principles of this guidance apply to all.
The GMS contract negotiations led to the NHS Confederation, Departments of Health and the GPC agreeing a model offer letter and set of minimum terms and conditions (which together are known as the model contract) to be used by a GMS practice or PCO when employing a salaried GP on or after 1 April 2004.
The model contract represents good employment practice and was designed to ensure a common standard for all GPs employed by GMS practices and PCOs.
The aim is also that this standard will have a knock-on effect with those employed by APMS (Alternative Provider Medical Services) being able to negotiate improved terms where those offered do not meet the minimum set out in the model contract.
The NHS England Standard Personal Medical Services Agreement 2015/16 set out that PMS practices shall also offer salaried GPs terms and conditions which are no less favourable than those in the model contract.
Who does the model contract apply to?
The model contract refers to a 'salaried general practitioner', and so includes the following employed GP:
- salaried GP who undertakes special interest work (a GPwSI)
- assistant
- associate
- GP retainee
- Flexible Career Scheme GP
- returner scheme GP
- salaried GP employed to work out-of-hours.
For the model to apply to these doctors, they must be:
- employed by a GMS practice or PCO with their employment commencing on or after 1 April 2004
- employed by a PMS practice that has signed the NHS England Standard Personal Medical Services Agreement 2015/16, with their employment commencing on or after July 2015.
If the above qualifying criteria are met then it is not possible for the employer to offer less favourable terms and conditions than those set out in the model contract. This is because the National Health Service (General Medical Services Contracts) Regulations 2004 (Statutory Instrument 2004, number 291) states as follows, and this is reflected also in the standard GMS contract between GMS practices and the PCO:
'The contractor shall only offer employment to a general medical practitioner on terms and conditions which are no less favourable than those contained in the "model terms and conditions of service for a salaried general practitioner employed by a GMS practice" [henceforth referred to as "the model"] published by the British Medical Association and the NHS Confederation as item 1.2 of the supplementary documents to the new GMS contract 2003.' (Schedule 6, part 4, paragraph 63.)
In addition, clause 20.17 of the NHS England Standard Personal Medical Services Agreement 2015/16 states:
“The Contractor shall only offer employment to a medical practitioner who is to be appointed as a salaried general practitioner on terms and conditions which are no less favourable than those contained in the "Model terms and conditions of service for a salaried general practitioner employed by a GMS practice" published by the British Medical Association and the NHS Confederation as item 1.2 of the supplementary documents to the new GMS contract 2003”.
The BMA strongly recommends that all practices should offer salaried GPs the model contract, regardless of whether they have signed this Agreement or not.
Consequences of not offering the model contract
There are severe consequences for a GMS practice which does not offer at least the model contract to a new salaried GP, with the ultimate sanction being the withdrawal by the PCO of the GMS provider contract. This is set out in schedule 6, paragraph 115 of the above Regulations.
PCOs are also obliged to offer at least the model contract. If this is not adhered to then ultimately an instruction can be sent from the Health Department.
PMS practices that have signed the NHS England Standard PMS Agreement 2015/16 must also offer at least the model contract, otherwise they may be subject to sanctions. These are set out in clause 66 of the Agreement.
BMA members should contact the BMA immediately if they are offered employment by a GMS or PMS practice or PCO without the minimum terms and conditions.
Please note that the BMA provides an employment contract checking service for BMA members. GPs are encouraged to take advantage of this service before signing an employment contract, as it is advisable to rectify any contractual problems before the contract is in force.
For those employed before 1 April 2004 or employed by an APMS practice, GPC recommends that all GPs, regardless of employer or when employed, should be employed on terms and conditions of service that are no less favourable than the model.
This will ensure that contractors will not face a discrimination claim (e.g. under the Part Time Workers Regulations or sex discrimination legislation) which may result from employing salaried GPs on different terms and conditions of employment.
It will also help to ensure good recruitment and retention of staff, particularly with the migration of salaried GPs to GMS practices.
Improvements to the model contract
The GMS contract negotiations led to the NHS Confederation, Departments of Health and the GPC agreeing a model offer letter and set of minimum terms and conditions (which together are known as the model contract) to be used by a GMS practice or PCO when employing a salaried GP on or after 1 April 2004.
The model contract represents good employment practice and was designed to ensure a common standard for all GPs employed by GMS practices and PCOs.
The aim is also that this standard will have a knock-on effect with those employed by APMS being able to negotiate improved terms where those offered do not meet the minimum set out in the model contract.
The NHS England Standard Personal Medical Services Agreement 2015/16 set out that PMS practices shall also offer salaried GPs terms and conditions which are no less favourable than those in the model contract.
Employers have the flexibility to offer enhanced terms and conditions – for example, to aid recruitment and retention.
Employment law protection for all salaried GPs.
All salaried GPs and employers should ensure that the terms and conditions offered complies with statutory employment law.
If in doubt, the BMA offers individual advice to GPs who are BMA members. Call us for advice on 0300 123 1233 or by contacting bma.org.uk/support.