GP sickness pay could leave practices facing five-figure shortfall

Sickness payments for GPs under the contract deal for 2017/18 could leave practices facing a shortfall of between £60,000 and close to £100,000 if a doctor is ill for a year, accountants and insurers have warned.

Under the £238m GP contract deal for 2017/18 announced earlier this month, after a partner or salaried GP has been off sick for two weeks, practices can begin to claim £1,734.18 per week.

Detailed guidance on how the funding will work has yet to be published by the GPC and NHS Employers, but agreement that sickness payments - which match the rate for maternity leave - will no longer be discretionary has been welcomed.

Flexibility for the funding to be used to pay existing practice staff to cover absent colleagues, removal of qualifying criteria based on list size and confirmation that there will be no specific medical exclusion criteria to qualify for the reimbursement have also been well received.

Announcing the deal earlier this month, the GPC said in a letter to practices: 'It should also reduce practice locum insurance cover expenses, and enable practices to offer better sickness absence terms for salaried GPs.'

GP sickness pay

But additional details emerging about the sickness payment suggest there could be a significant shortfall between the reimbursement and the likely actual cost of hiring someone to replace an ill GP.

Under existing sickness funding arrangements practices agree a payment with local commissioners up to a maximum £1,131.74 per week, and receive this in full for up to 26 weeks and half this amount for the following 26 weeks.

Specialist insurance company MIAB says it has received confirmation from NHS England that a similar arrangement will apply under the revised scheme - meaning the £1734.18 funding can be claimed in full for 26 weeks, then half that amount for the following 26 weeks.

This would mean that the maximum payout for a GP off sick for a year would be £67,033.02.

Specialist medical accountant and partner at Ramsay Brown and Partners Laurence Slavin told GPonline that the reimbursement was 'just a contribution' towards actual costs, which could be in excess of £150,000 for a full-time GP depending on locum rates in the area.

GP locum costs

'I would say that the current sessional locum rate is around £300 per session,' he said. 'Eight sessions would be £2,400 per week, so the reimbursement is just a contribution.' At £300 per session, the annual cost for a locum could come to £124,800 - £57,767 more than the maximum sickness payment.

Gianni Brancazio, of specialist insurance company MIAB, said locum fees generally ranged from £300 to £400 per session - which could come to £166,400 over a year at the upper end of the scale.

He said the company, which provides locum and premises insurance for thousands of practices in England, had seen a surge in calls from practices confused about the implications of the new contract. He said full guidance was likely to emerge before the new contract took effect in April.

'There are so many unanswered questions. Our advice is to stick with existing cover for now, until detailed guidance is published. But on what it doesn't cover - we went to NHS England, and practice managers are not covered. Support staff like receptionists are not covered, also other clinical staff like pharmacists and nurses are not covered - it is just for GP partners and salaried GPs.

Locum cover

'Reimbursement also does not cover non-sickness related causes, such as compassionate leave, jury service, suspension, revalidation,' Mr Brancazio added. 'Around 20% of our claims are for that kind of thing.'

He added that practices had called asking for information about how quickly payments would be made after a claim for sickness reimbursement. 'How quick will they get the money back? We don't know how that will be managed. Also the amount of funding - is there a cap on the total amount that can be paid out?'

Mr Slavin suggested that practices may be able to bring the cost of hiring a replacement GP closer to the sickness reimbursement if they hired a salaried GP on a short-term contract.

He said the annual cost of a salaried GP including on costs was now around £12,800 per session.'So a weekly equivalent for eight sessions is £1,969, which is closer to the reimbursement amount.'

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