When a salaried GP or GP partner is absent due to parental (maternity, paternity or adoption) or sickness leave, the practice is eligible to receive funding towards the cost of cover for that GP.
This is an outline of the reimbursement schemes, as set out in the SFE (Statement of Financial Entitlements).
Locum reimbursement for parental leave
Eligibility
The GP must be on leave for longer than one week and must be entitled to parental (maternity, paternity and adoption) leave under statute, their contract of employment (in the case of salaried GPs), the partnership agreement or other agreement between the partnership (for GP partners).
Cover for the absent GP can be provided by either an external locum or another GP already employed in the practice.
Payments
Under the SFE, practices are eligible for a maximum of £1,143.06 (£1,113.74 in Wales) a week for the first two weeks and £1,751.52 (£1,734.18 in Wales) a week thereafter. If the full cost of the locum is lower than the maximum, the practice will receive the invoiced amount.
Practices should submit costs at a frequency agreed with the commissioner, or within 14 days of the end of the month for which they are claiming reimbursement.
These payments will not be pro-rated in line with the working pattern of the absent GP.
Timescales
There are no timescales set out in the SFE for locum reimbursements for parental leave. Whilst NHS England’s policy protocol sets out that the practice will receive the stated reimbursements for weeks 1 to 26, we would expect payments to be in line with the length of maternity leave.
Locum reimbursement for sickness leave
Eligibility
The GP must be absent for more than two weeks before reimbursement costs will be paid. The only requirement is that the absent GP provides a fit note.
Cover for the absent GP can be provided by either an external locum or another GP already employed in the practice, provided they do not already work full-time.
Payments
After the first two weeks of absence, practices are eligible to receive up to £1,751.52 (£1,734.18 in Wales) per week. If the full cost of the locum is lower than this, the practice will receive the invoiced amount.
Practices should submit costs to their commissioner/health board at the end of the month in which they were incurred. Payment should then be made to the practice on the day that it receives its next global sum monthly payment.
These payments will not be pro-rated in line with the working pattern of the absent GP.
Timescales
Practices should receive the full agreed amount for the first 26 weeks (six months) of leave, followed by 26 weeks at half that rate. This begins after the initial two-week qualifying period.
Commissioners will account for any previous costs claimed for the absent GP in the same financial year, when calculating the number of weeks for which further payments can be claimed.
For example, if a GP was on sick leave for six weeks during May/June and then had a further sickness absence in December, the four weeks of reimbursements claimed earlier in the year would be deducted from the 52-week annual total.
Payments for locums covering sick leave and phased return
Practices are entitled to be reimbursed for locum cover and returns to work on adjusted hours under the advice of a fit note.
GP partners
The SFE makes no distinction on sickness leave (ie full and adjusted hours are viewed the same). This means the commissioner should continue to reimburse locum cover irrespective of the working arrangements of the performer.
Salaried GPs
The SFE applies further requirements to qualify for reimbursement of locum cover. The requirement is for the contractor, as an employer, to pay statutory sick pay or the performer’s full salary during sickness leave under the terms of their employment.
However, a phased return arrangement may affect the contractor meeting these requirements. If the requirements are not met, the commissioner has the discretion to reimburse locum costs. If they are met, the commissioner should continue to cover the costs of locum cover as above.
Regarding discretionary payments for covering an employed GP, if the SFE requirements are not met, the commissioner will make payments in these circumstances:
- The employed GP performer’s phased return arrangement directly follows sickness absence leave which attracted a locum payment under section 16 of the SFE.
- Where the phased return or adjusted hours arrangement has been advised under a fit note (and only for the period that fit note covers or advises).
- Where the contractor is paying the employed GP performer their full salary in respect of their phased return or adjusted hours arrangement, for example taking account of both working and sickness absence days/sessions.
Other considerations
Claiming for a part-time GP
Payments in respect of locum cover for sickness or parental leave will not be pro-rated. The practice will be paid at the invoiced cost, and up to a maximum of £1,751.52 (£1,143.06 for the first two weeks of parental leave).
Locum insurance
Practices should be aware the current maximum weekly payment may not fully cover the cost of a locum and the amount of time they are needed, particularly if they are replacing a full-time GP.
We recommend that practices review their current cover and consider maintaining a level that will allow them to top up the national payments based on their individual circumstances.