Guidance

August 2023 – NHSE updated their guidance with a notable scheme change that says:-

From 1 April 2023, the formal four-session cap that a retained GP can work per week has been removed. Reimbursement will remain for up to four sessions but this does not preclude a contractor from directly employing or engaging a member of the GP Retention Scheme, at their own expense, for service sessions which are in addition to the maximum four sessions for which the contractor is eligible for payment under the 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):

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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.

It is worth noting that the BMA handbook contains the model contract for retainers (appendix H) and on page 227 refers to annualised hours:

Sessions of Work

  1. Under the terms of the Scheme the minimum number of sessions that may be worked per week is 1 session, and the maximum of sessions is 4 sessions per week, up to a maximum of 208 sessions per year (to include annual leave, statutory holidays and continuing professional development time). The number of sessions can be annualised with the expectation that you work for a minimum of 30 weeks out of the 52. If there is a substantial variation in the number of sessions per week, the prior agreement of the HEE RGP Scheme Lead is required. The definition of full time and the length of a session is contained in Appendix A.
Based on the 2022 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.

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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

*annualised sessions include statutory holidays, annual leave and sessions used for CPD.

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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/

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Last Reviewed Date
08/12/2023