The hidden costs of appointing salaried GPs
- Focus on Salaried GPs (amended April 2008) issued by the GPC
This updated guidance on the terms and conditions of salaried GPs gives further clarification of the importance of “continuous NHS service” when calculating entitlement to sickness, maternity and redundancy payments. This is one of the hidden costs in the employment of salaried GPs and although the regulations only relate to those in GMS practices, the guidance emphasises to salaried GPs in PMS and APMS practices that they should negotiate terms which are equal to or better than their GMS counterparts.
We are not convinced that even after more than four years, all GMS practices understand that it is compulsory to offer the Model Terms or better to their salaried GPs and, those practices that don’t do so (and are shopped by a disgruntled salaried GP), can have their GMS contract withdrawn by their PCO.
The continuous NHS service provisions mean that a salaried GP may have an entitlement to “contractual maternity pay” from the practice from day 1 of employment in the practice (even if they don’t qualify for SMP). This can put practices in the position of appointing a salaried GP say in April who starts work in May only to announce on arrival at work that she is pregnant and will be leaving in August for her 12 months maternity leave. In the worst scenario, if she has come from another NHS post and qualifies for continuous service under the terms set out in the Model Contract, she will be entitled to contractual maternity pay of 8 weeks full pay less SMP or Maternity Allowance, 14 weeks half pay plus SMP or MA plus 17 weeks of SMP or MA. She may decide at the end of her maternity leave that she will not return but moves onto another practice (it has happened!). The practice has paid out thousands of pounds in contractual pay which is not reimbursable with no comeback.
“Contractual redundancy pay” based on total continuous NHS service as set out in the old Whitley Council rules, even though Whitley Council as such no longer exists, can cost practices tens of thousands of pounds if redundancy is the only option, with no recompense as you can only reclaim Statutory Redundancy Pay, and a salaried GP will not be entitled to this if he / she has less than two years service in the practice (previous NHS service is not taken into account when calculating Statutory Redundancy Pay). A salaried GP aged 41 or over with many years of previous continuous NHS service may have an entitlement to up to 66 weeks full pay as a contractual redundancy payment!
The rules for salaried GPs are complex and the BMA / GPC have only in the last year (August 2007, October 2007 and now April 2008) decided to notify practices of legal opinions which they have sought to interpret the rules. They accept that changes to the Model Contract are necessary and that this is being explored to make it more understandable. We doubt whether the fundamental principles of the contract as highlighted above will change though.
BMA Focus on salaried GPs (updated February 2009)