Boost your practice income through GP training

Key points

• Training practices have a significant advantage in recruiting new GPs. They will be exposed to new talent, and tend to be recognised as more supportive environments.
• You will need MRCGP (or equivalent) and around two years of experience as a full-time GP to complete a course for educational supervisors.
• There are a host of different funding streams, with plenty of opportunities to increase practice income.

On average, a GP trainer can expect to receive an estimated £9,000 a year, but you can boost this by around 30% by maximising all the opportunities.

How to get started

Once you have decided to become a GP trainer, contact your local Health Education England (HEE) office. GPs wishing to develop their educational career as a GP trainer must have MRCGP (or equivalent). Usually, there is a requirement to have at least two years of experience as a full-time GP before one can apply to become a trainer and complete the prospective Educational Supervisors Course (or equivalent) run by HEE. The selection process varies slightly in different parts of the country but generally involves submitting consultation videos, a review of practice notes to ensure they are well summarised and an audit. Most applicants get through the process – generally most training schemes encourage entry in order to have a big enough pool of GP trainers.

What funding you are entitled to

This list is not exhaustive and the available funding streams will vary from region to region. Many areas also have additional payments to support trainees who require extra supervision and input. These payments acknowledge the extra time needed, though this must usually be agreed in advance, or at the earliest opportunity. Some areas also provide payments for associate trainers to guide and support the trainee alongside the trainer.

* In the 2018/19 pay award, the trainer grant was increased by 3%

**In some areas, this is paid as an annual payment for each trainee

Receiving payment

Once you receive your first trainee, the local primary care school will set up payment of the GP trainer grant to the practice. The school will also pay the trainer CPD grant directly to the practice. Trainee salary is usually handled by the lead employer trust (LET), see below. For all the other payments, the claim is submitted to the local division of HEE.

The biggest stream is the trainer grant which is paid monthly, irrespective of whether the trainee is full time or part time. If a trainee takes sick leave, the full 12 months is still paid. Trainee maternity leave is not covered.

In most areas, lead trusts now employ GP trainees and deal with many aspects of their employment. In other areas where practices still employ and pay trainees directly, Primary Care Support England (PCSE) provides claim forms with guidance explaining how to claim reimbursement for salaries and other expenses and view your payments. Practices need to complete salary set-up forms to receive reimbursement for the trainee salary. The payments can be seen under the GP payments section, with a full breakdown in the section labelled ‘trainee payments’.

It may be possible to claim relocation payments for trainees with prior approval from regional HEE and NHS England. GP trainees can also claim for excess mileage and their medical indemnity while working in general practice. Though the amounts are small, they are still significant for the trainees. In areas where there is a LET this payment can be claimed from the trust, after the practice has authorised it.

For reimbursement of additional work – for example, educational supervisor reviews and annual competency progression reviews for the workplace-based assessment – most training schemes now set a time limit on when you can submit claims, such as at least three months from the time the work was carried out. It is becoming increasingly difficult to receive reimbursement sooner. It is not uncommon to have to chase up the payments, due to staffing cuts and various inefficiencies. To ensure that claim forms are submitted in a timely manner, it’s a good idea to have a dedicated admin staff member who deals with this. A lot of the basic information can be copied over from previous claims forms, so you can process this more quickly.

How training can boost practice resources

If all the GP trainer’s work is carried out in their own time, the grant is usually paid solely to the trainer. However, practices that allow GP trainers to work on tutorials, preparation and reports during practice time can benefit from funding that goes directly into the partnership pot.

Such arrangements are subject to agreement between the GP trainer and the practice. However, it is a recommendation in the trainer standards that practices allow the trainer sufficient time to prepare for training.

Trainees remain supernumerary, but are expected to gain relevant exposure about ground realities and pressures of general practice. An ST1 trainee can also work up to an estimated 40% of a full-time GP and an ST3 can work around 60% – providing an additional valuable resource for the practice in terms of patient contact. In addition, having a trainee in the practice has a significant impact on the practice ethos, improving morale and giving patients more choice, as well as helping trainees in their learning. Trainees also participate in areas of clinical governance, such as significant event analyses and audits.

Sustainability

Probably the biggest advantage in the current climate for training practices is in GP recruitment. These practices will be exposed to new talent and they are recognised as more collaborative environments, giving them a competitive edge. New graduates often find the open and supportive environment in training practices very attractive.

Moreover, other recruitment initiatives – for example, the induction and refresher scheme, overseas recruitment – tend to gravitate towards training practices.

Being involved as a GP trainer is also a great way of diversifying and hence avoiding burnout.

Dr Kamal Sidhu is a GP partner and trainer in Blackhall, County Durham