GP Retainer Scheme

What should I know about the Retainer scheme?

February 2021 GPC GP Retention Scheme webinar recording You can now view a video of the GPC GP Retention Scheme webinar, where you will learn about how the GP Retention Scheme works for both employees and employers, and tackles some common misconceptions about the scheme.

There is also useful video here (12 minutes):

https://www.youtube.com/watch?v=-YSBe7vb__A&feature=youtu.be

For the practice

Benefits in short:

• Fully qualified GP on the Performers List
• Practice will get £4,000 per session per annum towards your cost of employing the GP ie a 4 session GP would have a subsidy of £16,000 per annum for up to 5 years
• They can work up to 4 funded sessions for you – the 23/24 contract allows for extra sessions at the expense of the practice.
• The retainer also gets £1k per session towards professional expenses (known as Professional Expenses Supplement)
• The salary and exact job plan is for negotiation between the GP and the practice

Requirements of the Practice

An appropriate induction programme

The scheme includes a requirement for protected time for supervision by the educational supervisor. The educational supervisor will provide one to one support in protected time, (fortnightly or monthly as discussed and agreed with the RGP). A minimum of 2 hrs a month would be recommended (additional to CPD entitlement).

The aim of the supervision is to provide individual support for the doctor, help facilitate their integration into the practice, ensure that their professional development needs are supported and avoid professional isolation. This support should be tailored to the individual needs of the RGP.

Release for study leave – minimum of 8 sessions per year – one session per week FTE pro rata

A practice may have more than one Retainer as long as they can meet the individual needs of each Retainer. If this applies to your practice or situation then we would advise an early conversation with your local HEE Associate Dean to check they are satisfied with the proposed arrangements.

 

To be a Retainer supervisor you will need to be either:

• A GP trainer
• An active Foundation supervisor
• Completed the ‘Retainer Supervisor’ course via HEE
• or Discuss your individual circumstances with the local Associate Dean from HEE

NB Medical student teaching alone would not be sufficient

 

What would you get from your Retainer?

** Minimum GP Retainer entitlement = 8 CPD session per year

*** See Annual leave and NHS Days below

 

The GP Retainer chapter in the BMA Salaried GP Handbook states: -

Retainer GPs (RGP) must work a minimum of 1 clinical session per week and maximum of 4 (16 hours 40 minutes – or 208 sessions) which includes protected time for CPD with educational support.

N.B. the maximum 4 sessions/week will be changed for 23/24 to maximum of 4 funded sessions, allowing practices to employ the retainer for more sessions.

All RGPs will be employed by the practice. GMS and PMS practices should offer terms and conditions that are no less favourable than the model salaried GP contract as determined in GMS/PMS regulations. For APMS employers the salaried model contract is considered as a benchmark

 

Based on the 2019 BMA Model Contract Salaried GP Handbook that says: -

(Column A, B & C)

CPD leave entitlements

A full-time salaried GP working 37.5 hours per week is entitled to 208 hours of CPD a year.

To calculate a part-time salaried GP’s CPD entitlement:

• Number of hours worked per week* x 6.4 = number of minutes of CPD per week [X]
• X divided by 60 = number of hours of CPD per week [Y]
• X or Y x 52 = annual entitlement to CPD (X= minutes; Y = hours) This is column B in the Table

37.5 hours a week = 9 session x 4hrs 10mins therefore 1 session = 4hrs 10mins

* Leave counts as time worked. Therefore, CPD entitlements should not be reduced in periods of annual leave

 

Annual Leave & NHS Days Leave Entitlements

(Column E)

The model salaried GP contract provides a full-time salaried GP with 30 working days leave per year.

A doctor who works less than 37.5 hours (full time) will be entitled to a pro rata of the 30 working days.

***To calculate the annual leave entitlement of a part-time salaried GP:

number of contracted hours worked x 0.8 = number of days leave per year

If the salaried GP works parts of a day, then it may be necessary to calculate the number of hours of leave per year. As a 37.5 hour working week over five days equates to 7.5 hours per day, the annual leave days under the model contract should be multiplied by 7.5 to give the annual number of hours of leave.

PLUS

NHS days as leave

The model salaried GP contract states that a full-time GP will receive two ‘NHS days’ as leave. These days are not on fixed dates.

A part-time salaried GP should receive a pro rata amount of the two NHS days, which can be taken at any time during the year as mutually agreed with the practice. For ease, the time off could be added to the annual leave entitlement.

If NHS days are added to annual leave entitlement, then this can be calculated as follows:

Number of contracted hours worked x (32 divided by 37.5) = number of days of annual leave + NHS days leave per year

To calculate the number of hours of such leave, multiply the annual leave and NHS days leave by 7.5

This is then divided by 4.17 to turn back into sessions

 

Public holidays for part-time salaried GP's should be looked at on an individual basis as per the BMA model contract handbook.

For the GP Retainer:

Are you eligible? The scheme is open to doctors who meet ALL 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:
   A. Personal reasons – such as caring responsibilities for family members (children or adults) or personal health reasons, or
   B. Approaching retirement, or
   C. Require 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 one to four sessions a week due to caring responsibilities or those working only one to two sessions where pro-rata study leave allowance is inadequate to maintain continuing professional development and professional networks.

It is a requirement for all RGP’s that you:

> Hold full registration and a licence to practice with the General Medical Council (GMC).

> Maintain membership of a medical defence organisation to the level required by NHS England.

> Notify the designated HEE RGP Scheme Lead, in advance where possible, of any changes in working arrangements (e.g. additional work) and domestic circumstances that may affect participation in the scheme.

> Notify the designated HEE RGP Scheme Lead of any long spells off work (over four weeks), e.g. maternity leave or long-term sick leave.

> Submit to the designated HEE RGP Scheme Lead an annual renewal form at least one month in advance of the joining anniversary, to allow time for discussion regarding continuity of the scheme and any adjustments required.

> Make every effort to attend any events organised by the designated HEE RGP Scheme Lead expressly for RGPs.

> Meet appraisal and revalidation requirements and make their responsible officer aware of the fact that they are a RGP.

 

The Professional Expenses Supplement:

This is paid to you (via the practice) in addition to your salary. It will be subject to NI and tax but is not pensionable income. It is requested on the payment from the practice submits every month to NHS England. Once a year you should receive the supplement (you are likely to need to request this).

Number of sessions per week	Annualised sessions*	Expenses supplement payment per annum (£)
1-2	Fewer than 104	1,000
2	104	2,000
3	156	3,000
4	208	4,000

 

Next steps:

1. If you are interested in becoming a Retainer then please look at our list of practices who are interested in hosting a Retainer. Remember that every practice’s needs are different, so if you have particular needs then you may need to talk to more than one practice to find the right fit.

The list can be found on this page: Wessex LMCs: Practice vacancies within Hampshire, Dorset, Wiltshire, Bath & North East Somerset. and click on the blue box ‘Practices who are happy to host a GP Retainer’

2. When you have found a practice and negotiated the role and salary you and the practice will need to jointly apply to HEE to get the post approved. This is a detailed document – https://www.england.nhs.uk/publication/gp-retention-scheme/

Note/ You will need to write a basic 1-page CV as part of the application to HEE to get the post approved.

3. Apply to HEE:-

Completed application forms for the Wessex Team can be sent to gp.wx@hee.nhs.uk

 

Click here for the details relating to HEE Severn

4. Then you will need to await approval from HEE who will then pass the application to NHS England to approve. Please factor in the time for these approvals as you cannot start as a Retainer until both organisations have approved. Do talk to your local Associate Dean who can advise on current timescales.

There is also a GP Retainer Facebook group that we can link you to – please contact the office to do this.

Host practices:

If you are interested in hosting a Retainer GP and are a member practice then please contact the office on office@wessexlmcs.org.uk and ask to be added to our list.

Retainers should be paid in line with the workload and responsibilities they are being asked to do recognising the subsidy that the practice is paid to support them.

Think creatively around what your practice might actually need – if someone is after term time only have you though about annualising the hours? Some practices have actually found that patient demand is less over summer holidays and depending on the current workforce and their families taking time out over the holidays is not bad – especially when countered with increased hours at other times.

State school holidays – 13 weeks per year ie 7 weeks beyond normal however they will work the other 39 weeks a year for you and could do more sessions then?

Or does your practice need the opposite – for those before or after caring responsibilities but requiring flexibility for other reasons they may be happy to work out of term time.

 

You can find more information on the following link or call the office for any other information:

GP Retention Scheme: step-by-step guide: https://www.bma.org.uk/advice/employment/gp-practices/general-practice-forward-view/workforce/retained-doctor-scheme

https://www.england.nhs.uk/publication/gp-retention-scheme/