These templates have been produced to provide a guideline for salaried GPs and their employers for what a job plan for salaried GPs could look like. These templates have adopted the principles of UEMO Safe Working Guidance for GPs, which dictates that 15-minute appointment and no more than 25 patient contacts per day constitutes safe working practices (Practices in Wales have been encouraged to develop their own protocols/safe limits rather than set a hard cap - for more information see the Safe Working guidance for Wales). Simultaneously, the templates incorporate the salaried GP model contract, which assumes a full-time salaried GP works 37.5 hours per week, with sessions that are 4 hours and 10 minutes long. The salaried GP handbook advises that for every 3 hours of clinical work, 1 hour of admin time is needed. The structure is based on the SystmOne IT system used by many practices but can be applied to other systems like EMIS.
Job plans must be mutually agreed between employer and employer, and changes should not be made to the job plan without consent of salaried GP. Job plans should be reviewed annually, or at any time during the year if there are significant changes to the salaried GPs working pattern.
The templates produced for this guidance should not be unilaterally imposed on salaried GPs and instead should represent a guideline for salaried GPs and their employers to use, adapt and tailor to each individual GP’s needs. Similarly, the templates may need to be adapted to the practice’s working patterns. A ‘one size fits all’ approach should not be taken with regard to these templates, and each employee and employer should discuss the individual’s job plan with due care to the patient population, the locality, the GP’s working style and career goals, and any special interests.
The Sessional GPs Committee advises using the BMA’s GP Diary to monitor your working hours.
Full-time equivalent salaried GP job planning template
The template for the salaried GP job planning template is based on the provisions of the salaried GP model contract and the UEMO Safe Working Guidance. The sessions have been blocked out in 3 hours of clinical time followed by 1 hour of admin time, but this could be changed according to the salaried GP’s preference, for example, 15 minutes of admin every third appointment.
Less than full time salaried GP job planning template
Research shows that the average number of contracted hours that salaried GPs work amounts to approximately 6 sessions per week, though often in reality most work more than their contracted hours. The template for a 6-session salaried GP also adopts the principles of the UEMO safe working limits, and includes pro-rata continuing professional development (CPD).
Set up and shut down
Setting up for the room for seeing patients, either face to face, virtually or via phone, should be part of the paid working day. Similarly, shutting down at the end of the day should have allocated paid time to safely and securely shut down, and prepare the room for whoever might be doing an evening clinic if applicable.
Home visits
While the template allows for an hour to complete home visits (including travel time), these blocks may need to be extended according to the practice location or the patient needs. Practices should be cognisant of the locality which their GP is working in and adapt the job plan accordingly. For example, a more rural setting may require more travel time if driving, or if the patient has complex needs preventing them from attending the surgery. Where possible, allocating more time for home visits as a ‘buffer’, in case of traffic, delays with the patient or travel time between patients could be applied.
Supervision
Salaried GPs should only undertake supervision of other practice staff or GP registrars if they want to, and this is agreed as part of a job plan discussion with their employer. Allocated time each session should be outlined in the salaried GP’s job plan for supervision, and according to how many members of staff they are supervising and their needs. For example, a GP registrar may need time to debrief following each session or, if the salaried GP is supervising a MAP colleague, time to discuss each patient and the treatment plan would be needed.
Further guidance on the supervision of MAPs and other members of an multidisciplinary team.
Return to work
Any prolonged period of time off of work, either due to sickness, bereavement, maternity or parental leave, should be followed by consideration for a phased return to work. The Sessional GPs Committee advises that more than 1 month of work should result in a conversation between employer and employee about options for a short, phased return to work if recommended as part of an occupational health review.
The salaried GP’s job plan should be amended to reflect the changes needed to facilitate the phased return to work. An outline of how the phasing will work and progress should also be made in writing, with specific dates set for reviewing how the return to work is going and whether further amendments need to be made.
Occupational health processes
Risk assessments for the salaried GP returning to work should be completed internally, following any recommendations from a qualified, external occupational health professional directly before the employee returns to work.
Considerations for disabilities and other protected characteristics, in line with the Equalities Act 2010, need to be made as part of good occupational health practice. Reasonable adjustments should be made where possible.
Members are disabled under the Equality Act 2010 if they have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities. ‘Substantial’ means more than minor or trivial, such as it taking much longer than it usually would to do a daily task like getting dressed. ‘Long term’ means occurring for 12 months or more.
There are special rules for recurring or fluctuating conditions. People with progressive conditions (those that worsen over time) can be classed as disabled. You automatically meet the disability definition under the Equality Act 2010 if you are diagnosed with HIV infection, cancer or multiple sclerosis.
The Equality Act 2010 does not apply to Northern Ireland. There are no state-backed occupational health services for general practice in Northern Ireland. Risk assessments are completed on a case-by-case basis.
Access to Work scheme
The Department of Work and Pensions’ (DWP) Access to Work scheme is a UK -wide program that provides support and assistance to individuals with disabilities or health conditions to help them overcome barriers they may face in the workplace. The scheme is available to both employed and self-employed individuals.
Financial support, such as to cover the cost of reasonable adjustments, specialised equipment, workplace adaptations and communications support, can be accessed under the Access to Work scheme.
Practical assistance for employees and employers to help implement adjustments and carrying out workplace assessments can be provided by the Access to Work scheme.
GP Retainer scheme
GPs who are seriously considering leaving or have left the profession, but remain on the Performers List, for reasons such as caring responsibilities, personal ill health, being close to retirement or other working responsibilities, can access the retainer scheme.
Applicants to the scheme will need to demonstrate that regular part time working does not meet their need for flexibility. There should also be a need for additional educational supervision.
Retainer GPs 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 (continuing professional development) with educational support. Practices can claim reimbursement for employing the retainer GP.
Retainer GPs can remain on the scheme for a maximum of five years, but the scheme can be extended in exceptional circumstances. Low volume of work appraisals are undertaken by retainer scheme GPs. More information on the retainer scheme can be found in the BMA salaried GP handbook.