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Contract rules on taking your leave

Dr Stephen Gardiner looks at how the new contract guidance affects maternity, paternity and adoption leave

The new contract changes the way in which we perceive ourselves within the contractual framework. GPs become 'performers' employed within the practice. The practice now holds the contract and is termed a 'provider'. It is important to bear this in mind when considering the new regulations regarding maternity, paternity and adoption leave.

Under GMS2 it is recognised that locums may need to be employed to replace performers and PCTs are allowed to reimburse the cost of such locums. The contract currently excludes non-GP performers from the arrangements for funding maternity, paternity and adoption leave which I believe is an oversight given the move towards service provision by clinicians other than doctors. Performers should include nurses, nurse practitioners, physiotherapists, dietitians and other practice workers.

Under the Red Book, GPs were automatically allowed locum fees for maternity leave but in GMS2 all payments are made at the discretion of PCTs. Moreover while PCTs are asked to have regard to certain principles, there is no compulsion in GMS2 for PCTs to pay any locum payments at all. It is likely therefore that disputes will arise due to disparities when PCTs start to exercise this discretion.

A PCT is also allowed to offer its own locum as an alternative to the practice employing a locum. This option cannot be refused 'without good reason' or else locum payments may be withheld.

In other respects the criteria for employing a locum are basically fair and straightforward and relate to the performer returning after leave and the post not already having been filled.

The only other questionable element is that the locum cannot be a partner or shareholder in the contractor. The reasons for this appear unclear.

For GP partners the amount of leave allowed remains a partnership decision as employment law does not cover self-employed contractors. For salaried doctors and other performers the amount of leave is either according to statute or as contained in your contract of employment with a GMS2 provider.

Once the payment of locum fees has been agreed then the performers will be allowed a maximum of:

 · 26 weeks' maternity or main-carer adoption leave

ltwo weeks' paternity or non main-carer adoption leave

The PCT may then reimburse the actual cost of employing a locum up to a maximum of £948.33 per week compared with £890 currently. The timescales for making claims can be either as agreed with the PCT or, if agreement cannot be reached, within 14 days of the end of the month to which the

claim refers. Payments are then due 14 days after

the claim has been submitted.

The PCT may request written records showing the actual locum costs.

For maternity leave the performer must supply a certificate of confinement or private certificate containing the same information. For paternity leave the performer must provide a letter confirming prospective fatherhood.

In the case of adoption leave the performer must provide a letter confirming the date of adoption and the name of the main care-giver, countersigned by the adoption agency.

Stephen Gardiner is a GP in Bridgwater, Somerset

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