Q Why is it so important young GPs use the model contract?
It is not only important that young GPs use the model contract, all salaried GPs – both young and old – should use the contract, which will make clear what their working arrangements are and what is expected of them in that role. This is the basis for a solid working relationship based on mutual respect.
The contract was first drawn up in 2004 as part of GMS contract negotiations. This agreed a set of minimum terms and conditions to be used by a GMS practice or PCO when employing a salaried GP. It provides an important national standard that not only helps to support and protect salaried GPs but also formalises good working practices, which the BMA is very keen to encourage and support.
At a time of rising stress and burnout among GPs, the model contract also helps to safeguard GPs from inadvertently working in ways that might not be helpful to them or their patients in the long run.
Q How can newly qualified GPs persuade employers to use it?
Any salaried GP negotiating a job offer should not have to persuade an employer to use the model contract. All GMS practices should be offering this as a matter of standard practice. Under NHS regulations they are required to ‘only offer employment to a general medical practitioner on terms and conditions which are no less favourable’ than those contained in the model contract.
By not offering a model contract, a GMS practice is putting their own provider contract in jeopardy. If anyone is presented with a contract that does not contain the basic minimum terms and conditions, they need to get in touch with the BMA.
Although PMS practices have more choice in the matter, it’s in their own business interest to ensure they recruit and retain salaried GPs who feel they are valued by the practice. The BMA therefore recommends that all GPs employed by PMS and APMS practices should also be offered a contract with the minimum terms and conditions laid out by national model.
When a practice suggests a variation to the model contract it’s important for potential salaried GPs to be sure it is right for them and to look at the terms and conditions carefully. The BMA offers an employment contract checking service for its members, which can identify problems before a contract is in place. If you are not happy with what is being offered or that it differs greatly, you need to speak to the BMA or your local medical committee.
Q What parts are the most important?
The model contract has to be seen as a whole and while some practices or salaried GPs may focus on some elements of the contract its best not to cherry pick the bits you like or don’t like because it’s designed to cover all eventualities. None of us know precisely what the future might hold, and having a comprehensive national model contract may be something that many GPs who are currently partners might find useful in the future should they wish to change their contractual status.
It’s only fair that a GP and practice clearly know what their working hours will be, how many patients they will be seeing, what their holiday entitlement is, what their maternity allowance would be, what protected time they will have for continuing professional development and so on. Having a clear contract in place from the outset avoids conflicts and disputes later.
It also puts GPs on a par with doctors working in other parts of the NHS, something that is important if we want to make general practice attractive to young doctors deciding on what career path to take.
Q What should go in the job plan?
One key aspect to the model contract is the job plan. This should outline the employee’s normal duties, workload and important non-clinical roles undertaken within paid work time (such as participation in practice meetings, clinical governance, primary health care team meetings, and so on). It is possible for both parties to agree to some flexibility within the job plan, for example regarding working later when busy and leaving early when not so busy and for childcare reasons and this needs to be clear and stated within the contract.
Q When should a GP ask an employer/prospective employer if they offer terms based on the model contract?
You need to have these discussions before you take up employment. When you are offered a position and provided with a contract you need to read through it very carefully and see if it matches up in all areas with the model contract.
If there is any of the contract that differs from the BMA model, think carefully about what that means, whether or not that is acceptable to you and have an honest discussion with the employer about why if differs. For example, if there have been modifications to the protected time for educational development then it would be important to question how that has been compensated for through enhancement elsewhere in the contract. Some practices will use a contract that is better than the model and that is something that many salaried GPs would welcome. For instance there may be an increased holiday allocation in exchange for a modified on-call commitment.
Whatever change is suggested it should be something that is mutually acceptable (and the BMA can offer individual advice on this if needed).
There is also nothing wrong with asking to see a contract before a job interview so you can be clear about the terms and conditions being offered.
What is included in the model contract?
– Hours of work, including additional hours
– Annual leave
– Job plan (normal duties, workload and non-clinical responsibilities)
– CPD entitlement
– Appraisal arrangements
– Maternity leave benefits
– Continuity of NHS service
– Sickness leave benefits
– Provision for unfair dismissal and redundancy
Dr Richard Vautrey is the deputy chair of the GPC and a GP in Leeds.