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GP partner denied golden hello after NHS England U-turns on ‘catch-22’ rules

partner payments

Exclusive A GP partner has been denied a £20,000 new-to-partnership payment after NHS England U-turned on changes to eligibility rules, Pulse has learned.

Wolverhampton GP partner Dr Ian Martin’s application for the payment was originally rejected in September 2020 but after Pulse brought the case to the BMA, NHS England said it had amended its rules.

Now Pulse has learned that Dr Martin was again rejected for the payment last year on the same grounds as the first time, against the promised rule change.

How were the eligibility rules changed?

The controversy centres around ‘fixed-share’ GP partners. These are partners who are entitled to a fixed share of partnership profits but may not be required to contribute to losses, depending on their partnership agreement. They may also have more limited voting rights than equity partners.

Equity partners are those who enjoy full partnership rights, including participating in profits and losses and voting on all partnership matters.

In October 2020, Pulse reported that new fixed-share partners had been told they were not eligible for the new-to-partnership payment. They were also told they would also be ineligible to reapply to the scheme when they became a full equity partner because they would no longer be a ‘first-time’ partner.

After Pulse raised the issue with the BMA, the ‘Catch-22’ rules were amended so that new partners can get the payment without holding an equity share. NHS England said that first-time partners with a fixed share of practice profits who receive equal shares to other partners or a share of no less than 10% would be eligible.

NHS England also agreed that when partners begin with a fixed-share ‘probationary’ period before moving to a full equity share, they would be accepted onto the scheme once they become a shareholding partner on an equity basis, as long as the probationary period started after the scheme began on 1 April 2020.

Sources: Thomson Reuters and Pulse reporting

Dr Martin lodged an appeal in October 2020, confirming that his share was ‘not less than 10%’, but in January last year this was formally rejected by NHS England ‘in direct contradiction to the assurances that they gave me, you and the BMA’, he told Pulse.

In an email seen by Pulse, NHS England said: ‘Our scheme eligibility sets out that an individual must be an equity-share partner and, in your case, you signed a fixed-share agreement on the 1 April 2020 and are receiving a salary. 

‘Our scheme eligibility also sets out that an individual cannot have been a partner of any type prior to their application to the scheme. This includes fixed-salary partnership, and in your case your current role which commenced on the 1 April 2020.’

It added: ‘The reason for this criterion is that the scheme intends to encourage clinicians to make a fresh choice to accept a partnership role, whereas we consider you are already on your partnership journey. 

‘I therefore regret to inform you that we have deemed you are not eligible for the scheme and your current role prohibits you from applying to the scheme if you were to become an equity-share partner in the future.’

Dr Martin – who is moving to an equity share from the start of the next financial year – told Pulse the situation is ‘demoralising’, ‘doesn’t make sense’ and makes it feel as though GPs and NHS England are ‘not on the same team’.

He said: ‘Basically if you have a fixed-drawings partnership, it doesn’t count as a partnership for applying to the new-to-partnership payment. I can see there is an argument for that, but you can’t also use that as an exclusion from being able to apply for it in the future. It just doesn’t make sense. 

‘You just feel like we’re not on the same team. I don’t have many dealings with NHS England, but everything I do seems to be a fight, really.’

‘The longer this goes on the more demoralising it becomes,’ he added.

Meanwhile, Dr Martin said that although he is now recruiting new partners due to his current partner retiring, he doesn’t feel he can tell them ‘in good faith’ that NHS England is offering the payment.

He told Pulse: ‘It would be great if I could give them some assurance – if I could try and attract people on the basis of the fact there was a new-to-partnership payment that we could apply for.

‘[And] it would be nice to be able to have the option of giving them a fixed share if that’s what they want or it’s the right thing for the practice without that disadvantaging them and us going forward.’

He added: ‘But I can’t in good faith go to people saying, “if you come and join me as a partner, there’s this”, because I’m pretty sure they’re not going to give it to them.

‘I don’t know whether they’re actually giving any of these out.’

A BMA spokesperson told Pulse: ‘All GPs who became a first-time partner on an equity-share basis after 1 April 2020 are eligible for the New to Partnership scheme, including those who became partners on a fixed share basis after 1 April 2020, but who then moved to an equity share.

‘If any such GPs have been denied access to the scheme, we would encourage them to reach out to the BMA for support.’

Pulse has approached NHS England for comment.

NHS England announced last month that the new-to-partnership payment scheme would be extended for another financial year into 2022/23.

It also removed the requirement to apply within six months of starting a partnership role ‘in acknowledgement of the challenges the deadline presented to busy new partners as well as the additional pressures created by the Covid-19 pandemic’.

In October, NHS England confirmed that GP practice managers will be excluded from the scheme, despite having previously stated they would be included.

The golden handshake-style scheme was launched in July 2020 and also offers up to £3,000 as a training fund to support staff to transition to practice partnership. 

Currently, 12 professions are eligible for the scheme, which is due to end in March 2023 – GPs, nurses, pharmacists, pharmacy technicians, physios, paramedics, midwives, dietitians, podiatrists, occupational therapists, mental health practitioners and physician associates.

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David Church 25 January, 2022 10:20 am

We cannot argue that a fixed share agreement is not a salaried employment, it is a less-than-transparent policy to try to describe it as any kind of partnership ; and clearly if it was corectly referred to as a salaried period ( in line with transparent compliance with HMRC rules), then the NHSE would not have been able to claim it was a form of ‘partnership journey’ so it is clearly the terminology used by the Practice that is to blame.
However, there is no change from the position when I was refused Golden Hello in 1999, (after being told I was eligible!), on the basis that it only applied to whole time jobs, and then when I moved up to whole time, that “I was already a Partner, so you are not taking on whole time partnership”.
It is disrespect and dishonesty in the NHSE, just as back in 1998/99.

Ian Jacobs 25 January, 2022 10:27 am

Does the BMA have knowledge supported by data regarding the proportion of current GP partners started off as a fixed share partner.

As far as I am aware it was very common for a new partner to start on a 6 / 9 or 12 month mutual approval period and that during this time they would receive a ” fixed share “.

Although ” usual practice ” may not be the soundest reason to defend Dr Martin’s case. There are good accounting reasons as well – as a new partner starting from scratch as a profit sharing partner would require the practice to have a new set of accounts not only when he starts but also if he were to leave during the mutual approval period – to calculate his share of the practice profits for the period that he worked there. Having a fixed share makes it much more straightforward to calculate his liability to tax / NI and superannuation contributions for that period – and some of this liability may need to be ( temporarily ) retained by the practice to ensure they end up with no liability for the individual’s tax/NI and pension contribution affairs.

It seems very unfair that Dr Martin is being excluded from the welcome £20 K payment on grounds that seem spurious to me , reveal NHS England as acting in bad faith and potentially being in breach of their own regulations . The BMA should pursue his case ( on his behalf ) until a satisfactory conclusion is reached and he should receive compensation for the anxiety and distress caused as well as any potential delay to appointing a new partner partly due to them not being able to receive the £20K welcome payment as well.

Do NHS England not recognise the severe recruitment and retention crisis in UK general practice ? and pretend to offer a carrot only to take it away for no good reason ?

Bonglim Bong 25 January, 2022 11:37 am

As some have suggested it is crazy, but just a case of wording it as Salaried then moving to equity partner, rather than fixed share partner –> moving to equity partner.

It could be that the salaried contact includes the right to vote on things etc – if that is what everyone wants.

The Prime Minister 25 January, 2022 8:12 pm

NHS England are penny wise and pound foolish-while being experts in bullying GPs they waste vast amounts elsewhere.

General Practice is doomed and the only losers will be NHS England and patients but NHS England are too dumb to see this sad outcome.

Ashley Krotosky 26 January, 2022 2:25 pm

When I started, there was a clause saying I would either be paid a particular fixed amount or a % share – whichever was the larger sum. The % for this ‘probationary’ period was set at an artificially low level so it would almost certainly not have come into play and i would get the stated fixed amount as a minimum.
But I was technically an equity partner.
Isn’t it a question of boxing cutely to comply with the rules?