Securing payments to cover for GPs on Prolonged Study Leave

The GMS contract includes provisions that may entitle GP performers to take Prolonged Study Leave and to receive an educational allowance and a contribution towards the cost of their locum cover. The details are outlined in Section 18 of the Statement of Financial Entitlement (SFE) Directions.¹

These provisions are rarely used, but it is important not to forget that they exist.

What types of study qualify for Prolonged Study Leave?

Payments for Prolonged Study Leave taken by a GP performer under the SFE can only be made where:

• the study leave is for a period of at least 10 weeks but not more than 12 months;
• the educational aspects of the study leave have been approved by Health Education England, or a committee or person recognised by Health Education England, having regard to any nationally agreed guidance on Prolonged Study Leave; and
• the Board has determined that the payments to the contractor under this Section in respect of the Prolonged Study Leave are affordable, with regard to its budgetary targets.

Therefore, an application for prolonged study leave will need to demonstrate how it enhances the objectives of the NHS plans, develops the individual and benefits primary care in the NHS. There will also need to be funding available within the NHS England regional office budget as they will need to agree the availability of funding. Before embarking on an application for Prolonged Study Leave costs it is advisable to check with your local NHS England team, or CCG, to establish whether funding is likely to be available.

What payments are available for Prolonged Study Leave?

Where a GP performer has successful applied for Prolonged Study Leave an Educational Allowance of £133.68 per week is payable to the contractor, to be forwarded to the GP performer taking study leave.

Where a contractor needs to, and actually does, engage a locum to cover for the absence of the GP performer on Prolonged Study Leave, then subject to certain conditions, financial assistance will be payable to the contractor towards the costs of engaging the locum. According to the 2013 SFE Directions the reimbursement can be up to a maximum amount of £1,131.74 per week.

Section 18.6 of the SFE states: ‘It is for the Board to determine whether or not it was in fact necessary to engage the locum, or to continue to engage the locum, but it is to have regard to the following principles –

‘(a) it should not normally be considered necessary to employ a locum if the GP performer on leave had a right to return but that right has been extinguished; and

‘(b) it should not normally be considered necessary to employ a locum if the contractor has engaged a new employee or partner to perform the duties of the performer on leave and it is not carrying a vacancy in respect of another position which the performer on leave will fill on that performer’s return.’

How does a practice claim for the locum cover?

At the end of each month the practice must submit a claim for the costs actually incurred during that month and the payment will then be due on the same day of the following month that its global sum monthly payment is due.

What other conditions apply to claiming for locum cover?

Section 18.9 of the SFE states that;

‘Payments or any part of a payment in respect of locum cover under this Section are only payable if the following conditions are satisfied –

‘(a) the contractor must obtain the prior agreement of the Board to the engagement of the locum (but its request to do so must be determined as quickly as possible by the Board), including agreement as to the amount that is to be paid for the locum cover;

‘(b) the locum must not be a partner or shareholder in the contractor, or already an employee of the contractor, unless the performer on leave is a job-sharer;

‘(c) the contractor must, on request, provide the Board with written records demonstrating the actual cost to it of the locum cover; and

‘(d) once the locum arrangements are in place, the contractor must inform the Board—

‘(i) if there is to be any change to the locum arrangements; or

‘(ii) if, for any other reason, there is to be a change to the contractor’s arrangements for performing the duties of the performer on leave,

at which point the Board is to determine whether it still considers the locum cover necessary.’

What if the locum allowance doesn’t cover the actual costs in full?

It is unlikely that the locum allowance will cover the actual locum costs. The practice will therefore need to consider whether it can sustain this loss of income over the period of the study leave.

What if the GP provider is studying on a part time basis?

Where studying is undertaken on a part time basis, the educational allowance is still paid in full, but typically the maximum amount payable for locum cover is reduced on a pro rata basis. Therefore, if the GP was studying for 2 days a week the practice would be able to claim up to two fifths of the maximum locum allowance.

How is the payment affected if grants or other funding towards this studying are received?

If a GP receives any payments towards the costs of studying or to cover locum costs from any other organisation, it is likely to result in an abatement of the amounts payable under the provisions for Prolonged Study Leave. If any other funding is to be received, or becomes payable after approval has been granted, it is essential that the NHS England regional office is notified as soon as possible. Failure to declare such payments could be perceived as fraud.

What proportion of claims for Prolonged Study Leave are successful?

It is not known how many applications are made for Prolonged Study Leave each year. However, NHS digital data indicates that two practices in England received payments in 2017/18.²

If an application fails, what other options are available?

A significant number of GPs are choosing to self-fund further studying. Others will pursue alternative sources of funding and this could include the RCGP, Health Foundation, ASME or a Darzi Fellowship.

Andrew Leal is a partner at Macintyre Hudson LLP

References

1. NHS, England. General Medical Services Statement of Financial Entitlements Directions 2013

2. NHS Digital. NHS Payments to General Practice – England, 2017/18.