Salaried GP? Here's how to secure a model contract
In the first of a Pulse series of explainers for sessional GPs, Dr Zoe Norris outlines what salaried GPs need to know about securing a model contract
What is the model contract?
The model contract is an employment contract setting out the terms and conditions for any salaried GP. Written in 2004 as part of the new contract for all of general practice at that time, it defines what hours, workload and expectations practices should adhere to in the employment of a salaried GP.
So every salaried GP is on the model contract, right?
Wrong. It depends on the contract the employing practice holds. The model contract was built into the agreement for GMS practices – that is, GP practices that hold a General Medical Services contract with the NHS to provide primary care – which covers most ‘traditional’ GP practices. Under the GMS contract, practices must offer the BMA salaried model contract to employed GPs.
Since 2015/16, practices with PMS contracts (Primary Medical Services) – a newer type of contract for delivering GP services, which allow them greater freedom in how they run than the GMS contract – are contractually bound to offer salaried GPs ‘terms no less favourable’ than the model contract (see below).
The GPC recommends PMS practices with contracts signed before 2015/16 should also offer terms no less favourable.
Similarly APMS practices – those with an Alternative Primary Medical Services contract – should offer ‘terms no less favourable’. These practices are growing in number, with contracts often held by large organisations including private providers, and commonly to out-of-hours providers too. Most of the new models of care for general practice like hubs or federations, are on an APMS contract.
What does ‘terms no less favourable’ mean?
This means the clauses and provisions in the model contract are the minimum a salaried GP should expect. The idea behind this was to give practices greater flexibility in what they offer to employees, ideally terms and conditions that are better than those in the model contract. For example, the model contract includes a recommended pay range. This is a guide, but PMS and APMS practices are at liberty to offer pay above this range in order to recruit or retain staff. Equally practices may choose to offer added benefits like paying a salaried GP’s indemnity. This is not a requirement of the model contract. Key areas such as sick leave, maternity leave, and pay for each, should be the same as – or better than – they are in the model contract.
What if my practice does not offer a model contract, or refuses to when I ask for it?
It depends on which contract the practice holds. GMS practices are bound by their contract with the NHS to offer terms and conditions in the model contract. Any GP being offered a contract of employment is advised to send it to the BMA contract checking service to ensure it meets the requirements. If the offer from a GMS practice is not in line with a model contract, often passing on the BMA’s opinion and asking them to amend the contract solves the problem.
Rarely, a practice will refuse to change the contract. In this case a GMS practice is in breach of their contract, and can be served with a breach notice by NHS England. We would encourage salaried GPs to contact their LMC, or get in touch with their regional sessional representative if this happens so we can offer them advice. BMA members can also contact the employment advice service.
If the job offer comes from a PMS, or APMS practice, it is sensible to get the same checks carried out. The basic parts of the model contract should still be present (terms no less favourable). If this is not the case, approach the practice and highlight any areas that need amending. If the practice refuses, there are fewer levers that can be applied. However, in the current climate of recruitment in general practice, no GP should accept any offer of employment that is less favourable than the model contract unless they have a particular wish to.
What if I’m not employed by a ‘traditional’ practice?
In any role where you are employed as a GP (ie, where you pay tax and national insurance via your employing organisation, or where your job is identified as ‘employed’ on the HMRC online employment status calculator), you should expect the model contract, or better. There should be few occasions where a GMS, PMS or APMS contract won’t be held.
However, with private companies, hospital trusts and federations increasingly acting as employers, they are not necessarily bound to offer the model contract. If you are given a contract, get it checked. Insist on the terms and conditions for sick pay, annual leave, CPD entitlement and other employee benefits that are in the model contract. This contract was written by GPC to allow GPs to be employed in a safe and supported way. As more GPs move between partner, locum and salaried roles, keeping the contract as the basis for your work is vital.
How does the job plan fit in?
The job plan is an essential part of your employment contract. While the model contract covers the legal terms and conditions of your employment, your job plan contains the nitty gritty details of start and finish times, workload, visits, CPD and admin. It gives the GP and the employer the chance to make the role work for both of you, and helps use the model contract in settings including urgent care, out of hours and extended hours. You can ask the GPC sessional subcommittee for help with this, or look at the salaried handbook which all LMCs also have access to.
Further details on the model contract are available on the BMA website.
Dr Zoe Norris is a GP in East Yorkshire and chair of the sessional subcommittee at GPC UK
NB - Tuesday 27 July: This article has been corrected to indicate it is only since 2015/16 (and not before) that PMS practices are contractually obliged to offer terms no less favourable than the model contract