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GPs go forth

GP maternity and sickness payments under threat as NHS England reviews all 'discretionary' funding

Exclusive GP practices face the loss of crucial funding for maternity leave and sickness locum cover after NHS England revealed that all discretionary payments formerly supplied by PCTs have been placed under review.

NHS England told Pulse it was looking at all payments for locum cover made to GP practices to provide for maternity, paternity and adoption leave, as well as sickness absence.

The move is part of a wider review into discretionary payments which Pulse revealed in February is targeting the occupational health services formerly provided by PCTs, and is also looking at locally run retainer and returner schemes.

Until April, payments to practices to provide locum cover for maternity leave and sickness were decided on a PCT-by-PCT basis. In London, some discretionary payments were stopped by the local area team in April, with Wandsworth LMC expressing particular concern over the loss of funding for maternity locum cover. But NHS England has since produced national advice to local area teams advising them to honour all legacy PCT-administered funding until at least September, when it hopes to announce an England-wide policy.

The delay has added to confusion in many areas, with Pulse reporting earlier this month that GPs across England were having to delay paying essential bills as a result of persistent problems with NHS England’s bookkeeping. LMCs conference delegates warned in May that some local area teams were now charging GPs for occupational health services, while elsewhere CCGs have been forced to step in to commission such services to ensure GPs can still access support.

NHS England said it had completed a fact-finding audit on a whole range of discretionary payments, including those for occupational health services.

A spokesperson said: ‘Work is now underway to analyse our findings and we hope to have draft proposals available by September. The other discretionary payments referred to relate to primary care organisation administered funds as referred to in the GMS contract. These include locum cover for sickness, maternity and paternity and retainer and returner schemes.’

She added that the work on the options for occupational health support would feed into the management of the national performers’ list.

She said: ‘We are consulting on a number of areas, which will impact on plans for the broader scope for occupational health service in primary care and hope to have draft proposals to area teams by September.’

NHS England said the intention behind the review was to develop a consistent policy across England that gives clarity to GPs about what they can expect in relation to discretionary support.  

But Wessex LMC chief executive Dr Nigel Watson said the review was worrying as the removal of the payments would have a significant effect on practices.

He said: ‘We are concerned because generally in these things people level down, they don’t level up.’

‘The area that I cover is generally less well-funded than other areas, where payments per patient were under the average, and therefore for some of these maternity and sick leave payments PCTs were giving a reasonable amount. There is concern everywhere that people will look at it, and then just level it down.’

Birmingham LMC executive secretary Dr Robert Morley said: ‘We have not heard anything yet regarding discretionary payment reviews but I have no doubt that will come soon. We have though had one victory over GP occupational health services, which have at least been rolled over for another year, but again I expect this to be reviewed for next year.’

Dr Michelle Drage, chief executive of Londonwide LMCs, said it was an ‘outrage’ that LMCs had not been consulted on the decision to review discretionary payments, or on the review itself.

‘We find it totally unacceptable that payments due to GPs under the Statement of Financial Entitlements are being held back,’ she said.

‘My teams at Londonwide LMCs is doing all they can to get this sorted. It feels as if every penny to do with GP payments are under intense scrutiny at every juncture, while hospitals remain immune.’

Readers' comments (26)

  • Dear Trainees...............................................

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  • NHS England are so cocky, that I find it amusing. They really seem to believe that they can just keep on crapping on GPs and still avoid the inevitable GP retention and workforce crises looming problems. Their naivety is staggering.

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  • Small businesses like GP practice cannot absorb the cost of maternity pay of a doctor.

    It will mean 3 things: practices will stop hiring females of child bearing age (illegal discrimination), practices will only have partners (perfectly legal) or BMA contract will have to be re-written to keep maternity pay at minimum.

    Either way, it will impact on recruitment.

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  • I totally agree.You cannot expect the taxpayer to fund self employed buisinesses for staff absences.If you want those benefits then become employees.You can't have your cake and eat it.

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  • You silly person. No where in the country an independent business is forced to offer a per-designed contract to it's most expensive employee.

    If you don't even understand what I'm talking about, don't bother spouting your ignorance on forums that's designed for professionals.

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  • In which case we should receive a reasonable sum to cover for all eventuallities - like any other business - unfortunately we don't - there has always been a series of fees and allowances not a rate for the job.

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  • Clearly although we are self employed, if a market model is to apply & a significant expense is added, then the price of our service must increase or other areas that are less profit making must be cut. We cannot do either sufficiently, so allowances must be built in to our income stream to cover the potential shortfall.

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  • When the GP model collapses and Richard Branson runs primary care those moaning taxpayers will be in for a shock-they will really be shelling out then. I really think the best outcome is for primary care to fail and private providers to come in...please.....I can't take all these constant media threats any longer......finish us off for god's sake BUT there's no bloody way that your dumb media mission can be reversed and as employees how can we be responsible 24/7 365 days per year!! Please bring it on-come on-you want us to fail-pull the trigger-do it, go on-because I personally could not care less.

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  • >If you want those benefits then become employees.You can't have your cake and eat it.

    The same goes for patients. Since we're having our funding cut, we'll cut access and we'll cut services. And all of the unfunded things that have been mopped up by primary care (removal of stitches etc) will cease. And fees will go up - next time you need an insurance form completed it'll cost double what it costs now.

    See how this ends? At the end of the day, this generation is so dependent on medical care (inability to deal with minor problems like sore throats) they'll still keep coming.

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  • Become salaried.

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