GP practices are entitled to claim allowances for the cost of providing GP cover when a GP partner or salaried GP is on parental leave – whether maternity, paternity or adoption. This is in respect of cover for their core hours only – 8.00am to 6.30pm Monday to Friday, excluding Bank Holidays.
Details of the scheme were set out in the General Medical Services Statement of Financial Entitlements (SFE) Directions 2013, with amendments made in the SFE (amendment) Directions 2017.1,2 NHS England also produced separate guidance in 2017.3
The reimbursement can be claimed where cover is provided by a locum, salaried GP on a fixed term contract or a GP already working in the practice who is not full time (this can be a GP partner or existing employee). For the purposes of claiming the reimbursement, full time is considered to be nine sessions per week.
Importantly, the NHS will not reimburse these costs if the sessions are covered by an Advanced Nurse Practitioner or other healthcare professional.
If the sessions are covered by a GP already working at the practice, then the amount invoiced must be reasonable and in line with locum charges the practice would expect to pay if they hired an external locum.
The maximum amount a practice can claim in respect of a GP who is the main carer going on leave is £1,143.06 per week for the first two weeks and £1,751.52 thereafter.3
If the practice spends less than this, it is only entitled to claim the cost incurred, if it spends more than the allowance it can only claim up to the maximum amount. The allowance covers the employer’s national insurance and pension costs where applicable.
If the GP going on leave is not the main carer, then the practice is able to claim £1,143.06 for the first two weeks of leave only.
There are no timescales set out in the SFE for locum reimbursements for parental leave.
We would expect such payments to be in line with the length of maternity leave.
To make the claim practices need to complete the relevant claim form to the NHS England regional team and submit copies of the corresponding invoices. If this is not done it may delay the reimbursements being received by the practice. The claim should be made within 14 days of the month end that the reimbursement is being claimed for.
Top-ups
In exceptional circumstances, top-up payments may be made above the agreed weekly maximum. Reasons for this may include:
In these circumstances, practices should always ensure that they have written confirmation of the agreed additional funding before arranging the cover.
Practices are reportedly continuing to face issues with making these claims because some regional NHS England teams are still treating the reimbursement as discretionary rather than mandatory and refusing or delaying payments.
If practices have problems with making claims they should raise this with their LMC for further guidance.
There can often be time differences between the practice paying for the locum cover and the reimbursement coming through from the NHS. Practices should prepare for the effect that this may have on their cashflow.
Colin Haw is healthcare partner at BHP LLP, a member of the Association of Independent Specialist Medical Accountants
1. NHS, England. General Medical Services Statement of Financial Entitlements Directions 2013. Part 4; Section15: Payments for Locums covering maternity, paternity and adoption leave
2. NHS, England. General Medical Services Statement of Financial Entitlements (Amendment) Directions 2017. Part 5; 13: Amendment of Section 15 of the principal Directions c
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