Receiving payments through the National GP Retention Scheme

What is the GP Retention Scheme?

The National GP Retention Scheme was introduced on 1 April 2017 and replaced the Doctors’ Retainer Scheme.

The scheme provides financial and educational support to GPs who are considering leaving the profession to help them continue working in general practice. It provides financial support to both the GP and the practice that is employing them.

Details of the scheme are set out in Section 20A of the amended GMS Statement of Financial Entitlements Direction published in 2017.¹

How is it different to employing a part-time salaried GP?

The scheme recognises that for some GPs to continue working it will be necessary for their employer to provide greater flexibility or educational support than would be available under a standard part-time contract of employment.

Who is eligible for the scheme?

The scheme is open to doctors who meet all of the three following criteria:²

• Where a doctor is seriously considering leaving or has left general practice (but is still on the National Medical Performers List) due to:

1. Personal reasons – such as caring responsibilities for family members (children or adults) or personal health reasons
   or  
2. Approaching retirement
   or
3. Requiring greater flexibility in order to undertake other work either within or outside of general practice.

• A regular part-time role does not meet the doctor’s need for flexibility, for example the requirement for short clinics or annualised hours.
• And where there is a need for additional educational supervision. For example, a newly qualified doctor needing to work 1-4 sessions a week due to caring responsibilities, or those working only 1-2 sessions where pro-rata study leave allowance is inadequate to maintain continuing professional development and professional networks.

GPs must hold full registration and a license to practice with the GMC and be on the National Medical Performers List to be eligible.

GPs applying for the scheme must also be in good standing with the GMC without GMC conditions or undertakings – except those relating solely to health matters. The scheme is not intended for the purpose of supporting a doctor’s remediation and where the relevant NHS England Responsible Officer has concerns, the doctor would not usually be eligible for the scheme.

What financial support is provided to the retained GP?

The retained GP will be paid an annual allowance based on the number of annualised sessions, as detailed in the table below. The maximum number of annualised sessions per week that can be worked is 4. GPs wanting to work more sessions will not be eligible for the scheme. The full allowance must be paid to the retained GP by the practice, without any deductions except for tax and national insurance.

Annualised sessions*	Number of sessions per week	Allowance payment per annum £
Fewer than 104	1 – 2	1,000
104	2	2,000
156	3	3,000
208	4	4,000

* Annualised sessions include statutory holidays, annual leave and CPD sessions

What financial support is the practice employing a retained GP entitled to?

A practice employing a retained GP will be able to claim an allowance based on the number of sessions for which the Retained GP is employed. For each session that a retained GP works the practice will be paid £76.92. Therefore, a practice employing a retained GP for 2 sessions a week will be able to claim £8,000 per annum and a practice employing a retained GP for 4 sessions a week can claim £16,000 per annum.

In terms of requirements for the practice, very little is specified other than providing the educational supervisor.

It is designed to maintain maximum flexibility to encourage practices to consider the scheme.

For example, is it is cheaper to employ a part-time doctor to work four sessions a week all year than to employ a GP who works 208 sessions during 30 school term weeks, but requires locum cover during the school holidays.

How is a session defined?

A retained GP session is defined as 4 hours and 10 minutes and this includes time for administration, clinical meetings and dialogue with the clinical supervisor.

How is the contract for a retained GP different to a salaried GP’s?

A retained GP will be treated as an employee of the practice that engages them. The BMA has produced a Retained GP model contract which is based on the salaried GP contract.³ The retained GP will acquire full employment rights after completing 24 months with the same employer.

The contract is essentially the same as for a salaried GP but gives greater flexibility than part time working. For example, the annualised sessions would allow all the sessions to be worked in school term time.

Can a GP become a retained GP at their existing practice (whether an employee or partner)?

A salaried GP can become a retained GP in the practice currently employing them, provided the practice is able to offer them work to maintain their skills across the full range of general practice work. Practices must be able to demonstrate that they can meet the educational needs of the Retained GP and provide a named educational supervisor who is either a GP trainer or F2 supervisor, or who has recently accessed a suitable training course in supervision.

A GP partner wishing to become a retained GP in their practice will need to resign from the partnership. The scheme is set up to support GPs who are employed in a practice.

How long can a GP remain on the scheme for?

Retained GPs can continue on the scheme for a maximum of 5 years. Retained GPs will be subject to an annual review to ensure that they remain in need of the scheme and that the employing practice is meeting its obligations. When the scheme ends GPs may wish to return to a more substantive role, but this is not a requirement of the scheme.

It is possible to obtain an extension of up to 24 months in the following situations, after discussion with the designated Health Education England Retained GP Scheme Lead and subject to the agreement by NHS England’s Designated Clinical Officer or nominated deputy:

·         To replace time off the scheme relating to maternity, parental, adoption or sick leave.

·         Under special circumstances. For example, where a retained GP has had to change practices due to relocation or due to a breakdown in the placement and the Retained GP would not have enough time left on the scheme to acquire employment rights in the new post.

Where is the scheme available?

The scheme is available across England.

How should applications be made?

Doctors interested in applying to the scheme should contact their Health Education England (HEE) Scheme Lead who will be able to advise on their eligibility for the scheme.^4.5 If a practice has a GP who is considering leaving the profession then they should encourage them to consider applying for the scheme.

It is up to individual GPs to apply, but practices who have concerns that a GP might stop working and be lost to the profession should encourage them to look at the scheme. Training practices will automatically have an educational supervisor so are well placed to promote this.

Andrew Leal is a partner at Macintyre Hudson

References

1. NHS, England. The General Medical Services Statement of Financial Entitlements (Amendment) Directions 2017.

2. NHS England – GP Retention Scheme guidance and resources

3. BMA model contract for the GP retention scheme 2017

4. HEE Local Office and contact numbers

5. GP Retention Scheme guidance and application forms