Guidance

Advice Regarding Salaried GP Contracts

The LMC has, for many years, offered basic advice in respect of contracts. However, over time this has become an increasingly complex area. We are not lawyers and cannot given a legal opinion. The BMA offer an extremely comprehensive contract checking service to its members and we would always recommend this as the preferred route for you to seek expert opinion regarding your contract. The BMA also have an employment advisory service for its members. There is a salaried GP handbook which is the best source document for you to cross check against, available here:

https://www.bma.org.uk/pay-and-contracts/contracts/salaried-gp-contract/sessional-and-locum-gp-contract-guidance

With this in mind, we can offer you the following generic guidance around what areas to particularly look for in your contract that seem to be commonly overlooked or disputed.

Since 1 April 2004, GMS practices have been obliged to offer a written contract to new salaried GPs in line with the model salaried GP contract.

The BMA model contract contains the minimum terms that must be offered to full-time salaried GPs (with these available on a pro rata basis for those who work part-time) employed by a GMS practice or PCO on or after 1 April 2004. The NHS England Standard Personal Medical Services Agreement in 2015/16 set out that PMS practices should also offer these terms as a minimum to salaried GPs

The ‘model’ contract for GMS practices consists of a model offer letter and model terms and conditions which provide the minimum that must be offered to a salaried GP employed by a GMS practice as originally agreed between the BMA and NHS Confederation in 2003.

The model contract can be altered in certain circumstances. It is certainly possible for employers to offer improved terms and conditions since these will be no less favourable to the model contract. Employers may wish to do this in order to aid recruitment and retention. It is possible for both parties mutually to agree a variation to the model contract. This is because the requirement on the employer is to ‘offer’ terms and conditions no less favourable. So if the model terms are offered it does not prevent the parties then agreeing to a variation. However, any such subsequent agreement must have been entered into without threat, so for example a requirement to accept altered terms or else be dismissed would be unacceptable.

Many practices will negotiate around study leave – if they reduce this (the LMC recommends no less than 1 week study leave pro-rata) – then some other aspect of the contract should be made more favourable eg pay.

You can find the Model BMA contract here:

https://www.bma.org.uk/advice/employment/contracts/sessional-and-locum-gp-contracts/salaried-gp-model-contract – if you look at the ‘downloads’ at the bottom of the page.

The BMA also provide useful guidance on minimum terms and conditions for salaried GPs https://www.bma.org.uk/advice/employment/contracts/sessional-and-locum-gp-contracts/salaried-gp-model-contract/minimum-terms-and-conditions .

Back to Top

 

Job Plan

You should receive a formal Job offer letter which should include details such as your job plan:

The Model contract notes that a job plan must be produced and appended to the salaried GP’s terms and conditions. The job plan is a key component of the Model contract.

The job plan produced should outline the employee’s normal duties, workload and important non-clinical roles undertaken within paid work time (such as participation in practice meetings, clinical governance, primary health care team meetings, etc).

An element of flexibility between both parties, for example regarding working later when busy and leaving early when not so busy and for childcare reasons, may be mutually agreed

You need to be clear about what is expected of you as a salaried doctor in the Practice before you start – mismatched expectations are the biggest cause of unhappiness we see.

When will you meet to discuss your job plan? When will you have a follow-up meeting to review it?

Are you expected to look after a list of patients – if so what size? How is this decided?

For a session – How many patients? How many phone calls? How many home visits? Any ‘extras’ on the day? Duty sessions? Prescription signing? Blood tests? Paperwork? Insurance reports? Extended hours sessions?

Are you expected to undertake private work on behalf of the practice eg Medical reports? If so how often? Who receives payment for this? You or the practice? Who pays any uplift in your indemnity required for private work ?

How will ‘extras be allocated and is there a limit for salaried GPs?

The BMA model contract suggests a session is 4 hours and 10 minutes ( usually 3 hours clinical and an hour admin)

If you are doing a late surgery will you start your morning session later or have time off in the middle of the day?

The BMA provides the following Job planning guidance https://www.bma.org.uk/advice/employment/job-planning/job-planning-guidance-for-gps .

A job plan review clause should also be included in your contract around varying the contract and any mechanisms of appeal.

Back to Top

 

The Contract

Continuous NHS Service

Your continuous NHS service should be recognised – not just from the start date in the practice but from when you first started work for the NHS providing you have not had more than a 12 month break in service. Maternity or shared parental leave doesn’t count as a break in service.

Back to Top

 

Employment Protection Rights/ Continuity of Service

Your contract should make reference to your employment protection rights under The Employment Rights Act 1996. For example, your right to bring a complaint of unfair dismissal, which is only available to someone who has a period of continuous employment beyond 12 months. This start date will normally be the date that you began working for your new employer, although you should note that this is not necessarily the date that you began working as a Salaried GP in this practice –eg retainer service should be recognised.

Further to this, your contract should also make reference to your accrued NHS entitlements. The date of continuous NHS service, for the purpose of calculating your reckonable service and your entitlement to certain occupational benefits, such as sick leave and maternity leave.

(NB maternity leave is not counted as a break in service and regular locum work in the UK is counted too) and will be used for the purposes of calculating certain occupational benefits.

For the purposes of assessing the period of continuous service the employment under this contract shall be deemed to have commenced on –

For the purposes of a dismissal claim – [insert start date of your salaried GP post]

For the purposes of calculating contractual maternity pay entitlement – [insert date when continuous NHS service began – see chapter 12, section 3.5 of the Salaried GPs’ Handbook for details on how to ascertain this date]

For the purposes of calculating contractual adoption leave pay – [insert start date of your salaried gp post, unless more favourable provisions agreed as suggested in chapter 13, sections 2 and 3 of the Salaried GPs’ Handbook]

For the purposes of calculating contractual paternity leave pay – [insert start date of your salaried gp post, unless more favourable provisions agreed as suggested in chapter 14, sections 3 and 4 of the Salaried GPs’ Handbook]

For the purposes of calculating contractual parental leave – [insert start date of your salaried gp post, unless more favourable provisions agreed as suggested in chapter 15, sections 1.2 and 1.3 of the Salaried GPs’ Handbook]

For the purposes of calculating contractual sick pay – [insert date when continuous NHS service began – see chapter 16, section 3.2 of the Salaried GPs’ Handbook for details on how to ascertain this date]

For the purposes of calculating contractual redundancy pay – [insert date when continuous NHS service began – see chapter 19, section 4.2 of the Salaried GPs’ Handbook for details on how to ascertain this date]’

Back to Top

 

Redundancy Provisions for Salaried GPs Employed Under the Model Contract

See the Salaried GP handbook for specifics on this, and how it is calculated which is specific to your own individual employment circumstances.

There is a stipulated procedure, which must be followed by the employer, from p120 of the Salaried GP BMA handbook. There are specific time limits for each step.

Statutory redundancy pay is detailed from p124, which is payable in certain circumstances. The amount, is calculated according to a formula that incorporates years of service, age, and weekly wage. It is currently capped at £15,750.

It should be noted on p126 that locum work does count towards continuous service.

Those not on a model contract should look at p129 for more information.

Back to Top

 

Review of Wage

We recommend that practices should uplift salaried GPs pay in line with the DDRB recommendation.

Under the Model contract a salaried GP’s salary must be uplifted annually at least in line with the DDRB recommended increase.

Back to Top

 

Hours of Work

Under the Model Contract, full-time is defined as 37.5 hours per week. The Model Contract breaks this amount down to nine notional sessions of 4 hours and 10 minutes per session – although the time of a session can be altered to suit the parties.

Working hours should be carefully defined in a job plan.

Back to Top

 

Annual Leave

Under the Model, full-time salaried GPs are entitled to a minimum of 30 working days per annum pro rata. They are also entitled to 10 statutory and public holidays per year (which includes two “NHS days” which NHS staff receive and these two days may be taken at any time by the salaried GP). These amounts of leave should be calculated pro rata for part-time salaried GPs.

To calculate the annual leave entitlement (minus statutory/public holidays):

  • number of contracted hours worked per week x 0.8 = number of days leave per year [D]
  • D x 7.5 = number of hours of leave per year.

If ‘NHS days’ are added to annual leave entitlement, then calculate the full entitlement as follows:

  • number of contracted hours worked per week x (32 divided by 37.5 = full entitlement

Please note that the above ready reckoner calculations do not include bank or public holidays.

The model contract provides that a full-time salaried GP is entitled to the public and bank holidays as paid time off, or where the salaried GP is required to work on these days to a day off in lieu. Good employment practice means that a part-time salaried GP would receive a pro rata of the total number of their country’s public/bank holiday days.

Back to Top

 

Study Leave / CPD

The model contract is extremely generous on this aspect and this is often negotiated on by practices by a benefit in another aspect eg pay.

The LMC recommends a minimum of 1 week pro rata for study leave.

CPD leave entitlements as per BMA model contract

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).

Back to Top

 

NHS GP Appraisal

All NHS GPs must participate in NHS GP appraisal and time must be set aside during working hours for a salaried GP to prepare for NHS GP appraisal, over and above the protected CPD time..

The appraisal interview itself should be taken outside of the minimum CPD time, but within normal working hours. If it is not possible for the appraisal interview to be conducted during normal working hours, the interview may be held outside of working hours provided the salaried GP agrees and receives appropriate reimbursement or time off in lieu.

Salaried GPs are not required to contribute financially for an NHS appraisal. Funding for appraisal for salaried GPs employed by a GMS practice is via an appraisal premium which is included in the practice’s global sum. Comparable arrangements should be in place for PMS practices.

Back to Top

 

Maternity Leave, Paternity Leave, and Shared Parental Leave and Adoptive Leave and Keeping in Touch Days

There are complex regulations surrounding these. It is best to refer to the BMA handbook for clarity on all aspects of this because these are dependent on your individual circumstancesAdditionally it would be prudent to get any decisions in writing from your employer so can refer back to them .

There are great differences in process and outcomes, contingent on whether you are an employed GP or a GP partner.

There are some statutory elements to leave, explained on p72 of the salaried GP handbook.

P74 details shared parental leave arrangements, which it is important to be clear on.

P74 explains about statutory maternity pay, which is subject to various conditions.

Annual leave does accrue during maternity leave, see chapter 9 section 2.2

Keeping in touch days could be of great benefit, with details on p75 and 76

Maternity pay is detailed from p77, based on the model contract. If you have a different contract, you will need to check your contract for details stipulated within it.

Requirement to return to work after maternity leave, in order to keep contractually payable maternity pay is discussed on p79

Variation to working hours is discussed on p80

Adoption leave and pay is covered from p83

Paternity leave is covered from p88 and can be taken by a male or female employee. There is also an entitlement in the case of adoption. Paternity pay is covered from p89.

Back to Top

 

Jury Service

The LMC recommends that you should have a discussion over this possibility. Jury service can be deferred once for up to a year. Doctors are no longer able to negotiate exemption from this. Some practice policies will cover this but this needs to be checked. Practices may or may not offer pay, 2 weeks or more missing pay may cause financial challenge.

Wessex LMCs: Jury Service for GPs

Back to Top

 

Working Time Regulations

See Chapter 8 , section 1 of the Salaried GP handbook. These are complex.

Salaried GPs can opt into the statutory 48 hour working week limit. This includes other (non – surgery) work . If this is breached, then the salaried GP could bring a claim against the employer.

If a salaried GP does want to work longer than 48 hours, then they can opt out of the statutory limit. An employer cannot compel an employee to opt out .

Rest periods are stipulated on p31- which a salaried GP cannot opt out of. Any failure to allow a salaried GP rest periods could be enforced through an employment tribunal.

Back to Top

 

Sick Pay

Your contract should take into account previous continuous NHS service to calculate entitlement to the following scale
1st year- 1 month full pay, 2 months half pay
2nd year – 2 months full pay, 2 months half pay
3rd year – 4 months full pay, 4 months half pay
4th/5th year – 5 months full pay, 5 months half pay
Over 5 years – 6 months full pay, 6 months half pay

Back to Top

 

Outside Activities

You need to clarify if you are still able to locum, work for out of hours, undertake private practice elsewhere etc? May you continue other business interests? Do these need to be declared and /or approved by the employer ?

Back to Top

 

Fees

You need to clarify what private fees generated by you will be kept by you. Eg cremation forms etc. If the practice expect you to undertake private work on their behalf eg medical reports etc then your medical defence organisation may charge you an additional premium as this wouldn’t be covered by the clinical negligence scheme for general practice. If this is the case and you are expected to undertake private work for the practice then you may wish to ask the practice to cover any additional MDO premium to cover this. Is the work to be done in working hours or outside of working hours?

Back to Top

 

LMC Levies

Under the Model contract, the employer (ie the practice or the PCO) will pay the LMC voluntary levy for the salaried GP

Back to Top

 

Practice Meetings

If you are required to make every effort to attend practice meetings such as significant event meetings, clinical governance, clinical review, audit, QOF reviews, in house educational meetings, Patient Satisfaction Survey, palliative care (this list is not exhaustive) which may or may not occur during your working time will you be paid for additional time or given time off in lieu?

Back to Top

 

Finally

It is important to remember that a contract is up for negotiation.

In the current climate some aspects of the BMA model contract may seem a little unrealistic for practices to deliver and you may wish to negotiate around these areas.

We hope that you also appreciate that this is an extremely complex/specialist area and we would again emphasise that we are not lawyers and cannot given a legal opinion.

Ultimately it is for you to decide if the contract offered to you adequately meets your expectations and requirements.

Back to Top

 

Bookmark
ClosePlease loginn

Last Reviewed Date
08/12/2023