It is not obligatory for Alternative Provider Medical Services (APMS) employers to offer the Model salaried GP contract. Nevertheless, the GPC recommends the model contract (or improved terms) for all salaried GPs, regardless of their employer.
APMS GPs should seek to ensure that they receive at least the minimum, particularly the recognition of previous NHS continuous service.
GPs on the Flexible Career Scheme, retainer scheme and returner scheme
Flexible Career Scheme (FCS), retainer and returner scheme GPs who are employed by a GMS practice or PCO since 1 April 2004 must be offered terms and conditions that are no less favourable than the agreed Model salaried GP contract but have specific features, particularly regarding educational time.
The GPC has produced model contracts of employment for retainer scheme and FCS GP. Many PCOs/deaneries require GP practices who wish to employ a GP retainee or FCS GP to use these model contracts.
The FCS scheme is no longer available to new recruits.
Fixed term contracts
The funding received for the retainer scheme and FCS are for fixed terms, as such, employers tend to offer the retainee/FCS GP a fixed-term contract for the period of the funding.
Any fixed-term contract should not be regarded as simply ending at the end of a fixed term period. It is still a dismissal in law. We advise that salaried doctors on a fixed-term contract formally request to their employer for their contract to be made permanent.
Those employed for a period of two years or more are entitled to full employment rights. In addition, fixed term contracts for four years or more are automatically in law considered to be permanent. Appendix A of the Handbook provides a summary of some of the legal entitlements for an employee. These apply equally to a salaried GP on a fixed term contract.
Continuity of service
If a GP's employment contract uses the GPC model FCS contract or the GPC model retainer contract, then previous NHS service will be considered to determine NHS continuity of service for:
- contractual redundancy pay
- contractual maternity pay
- contractual sick pay
Previous NHS service will not be used to calculate eligibility for statutory redundancy pay or for an unfair dismissal claim.
Unfair dismissal
Where a salaried GP has been employed for at least two years, employers are obliged to ensure that they have a fair reason for dismissal and that dismissal is reasonable in all the circumstances e.g. that they have followed the correct dismissal procedure.
Our lawyer's view is that the withdrawal of funding alone may not be a fair ground for dismissal, particularly if someone else is recruited to fill the vacant post. Consideration is likely to be given to the proportion of the previous funding received by the practice vis-à-vis the salary of the FCS/retainee GP.
Salaried GPs and their employers are advised to seek individual expert advice from the BMA should a problem arise.
Risk management by the practice
If a salaried GP takes leave for maternity, paternity, adoption or sickness leave, their practice will typically employ locums to maintain the level of services that it normally provides. A practice's entitlements to the funding for such locums is detailed in the Statement of Financial Entitlements (SFE).
The provision for locum funding allows PCO discretion, with the SFE suggested condition that external locum GPs be employed to cover the work of the absent doctor and that full entitlements are paid to the absent doctor. The GPC continues to press the Departments of Health for more definitive entitlements to practices for locums covering maternity, paternity, adoption and sickness leave.
The GPC recommends the following actions:
- LMCs should discuss the local funding of locum arrangements with their PCOs to ensure that practices in their area will receive funding for locum cover of salaried GPs in the event of sickness, maternity, paternity, adoption or sickness leave
- practices should consider purchasing insurance for locum cover during sickness absence to cover all of their salaried GPs (and possibly other staff as well). This would ensure that a practice would not be out of pocket if a salaried GP had to take sick leave.