Locums to raise fees as contract offers £4,000 indemnity top up per average practice

An average 7,000-patient GP practice will receive around £4,000 to cover rises in indemnity costs as part of the 2017/18 GP contract, with locums told to raise their fees by up to 2% to claim a share of the top-up.

The BMA has told locum GPs to up their fees from April following the announcement that £30m in funding will be paid to practices to cover rises in indemnity costs as part of the 2017/18 contract.

The National Association of Sessional GPs (NASGP) said most locums will have to up their fees by 1% to 2% to cover the expected rise in indemnity costs, depending on their individual circumstances.

GPonline analysis has previously shown that indemnity fees have risen year-on-year for most GPs, with a quarter paying 20% more last year than they did the year before.

Read more: full detail of GP contract 2017/18

The 2017/18 contract, which takes effect from April, comes with a promise of £30m in funding to offset any further rises in indemnity insurance costs GPs are expected to face.

NHS England will pay this to practices on a per patient basis – meaning it will be up to GP partners to ensure salaried GPs receive their fair share.

Locum GPs will have to ensure that their invoices/agreements with practices are ‘uplifted appropriately to take account of this business expense’.

NHS England and GPC England are drawing up practical guidance ‘to facilitate the appropriate dispersal of this resource to all sectors of the GP workforce’, the GPC said.

It added that the £30m figure had been based on recommendations from medical indemnity organisations to cover GMS work.

GP funding

With 53m people in England, this equates to almost 60p per patient, awarding the average practice of 7,000 patients around £4,200 each.

Dr Richard Fieldhouse, chairman of the NASGP, said locums had ‘been stranded’ and left with very little advice just months before the changes are set to kick in – with many locums already planning and booking sessions for later in the year.

‘What the DH should have done is given money straight to the medical defence organisations, and then they could freeze their rates,’ he said.

‘This is a really bureaucratic, round-the-houses way of reimbursing GPs. This will keep everyone busy. It’s just more paperwork for practices to do, NHS England should have cut out the middle man and paid the MDOs direct.’

Dr Nigel Watson, chief executive of Wessex LMCs, said the £30m boost should stretch to cover the rise in indemnity for most GPs. ‘It covers the expected rise but does not sort the problem,’ he warned.

Some GPs will still be paying well into the double figures to maintain legal cover, he added, and many part-timers face difficulties trying to temporarily increase the number of their sessions due to the huge hikes in fees this entails.

The BMA said the funding 'will be paid to practices on a per patient basis, set out under the statement of financial entitlements (SFE), and will not be weighted as a result of the Carr-Hill formula'.

It added: 'As this funding will be paid direct to practices, GPC is clear that GP principals must ensure that the appropriate amount of funding reaches their salaried GP colleagues.

‘Locum GPs will need to ensure that their invoices/agreements with practices are uplifted appropriately to take account of this business expense if they have not already done so.'

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