GP Partnership Agreements: Locum Reimbursements Available from the Health Board

GP Partners should review their partnership agreements to ensure that they are making the most of locum reimbursements available from the Health Board.

The 2018/2019 Scottish Statement of Financial Entitlements (“SFE”) took effect from 1 April 2018 and replaces the 2017/18 SFE.  The SFE relates to the payments to be made by Health Boards to a contractor under a general medical services (“GMS”) contract.

GP practices should consider updating their partnership agreements to reflect reimbursements available under the SFE where a GP partner is absent from the practice due to a period of parental or sick leave. 

MATERNITY, PATERNITY AND ADOPTION LEAVE (PARENTAL LEAVE)

In terms of the SFE, a GP contractor will be entitled to receive funding towards the cost of cover for a GP partner (or salaried GP) who is absent from the practice due to a period of parental leave.  Practices are eligible to receive up to a maximum of £1,131.74 per week for the first two weeks, and £1,734.18 per week thereafter.  If the actual cost of the locum is lower than these maximum levels, the practice will receive the invoiced amount. There are maximum periods for which such locum cover can be claimed:  for maternity leave, shared parental leave or adoption leave for the parent who is the main carer, reimbursements are available for a maximum of 26 weeks.  For paternity leave, or adoption leave for the parent who is not the main carer, the maximum period is 2 weeks.

GP practices should review the parental leave provisions in their partnership agreements and may want to consider the following:

• Bearing in mind the need (for most practices) to be competitive when it comes to recruiting new partners, partnerships are likely to want to offer the most attractive parental leave package they can, whilst ensuring that the practice does not lose out financially.  This may mean offering 26 weeks’ maternity leave (or adoptive leave for the parent who is the main carer) on full pay (during which period the practice will receive Health Board reimbursements), with any additional period of leave offered on the basis that the absent Partner will meet at least some of the locum costs, where not covered by a locum insurance policy.
• Speaking of which, partnerships should review their insurance arrangements to ensure that (a) the appropriate person (or persons) have policies in place; and (b) the partnership agreement covers what happens to any sums paid out under the policy. 
• Our understanding is that the reimbursements should be sufficient to cover the actual costs of hiring a locum.  However if the actual costs are likely to be higher than the maximum reimbursements available, the partners may want to provide that the absent Partner will meet any shortfall.

SICKNESS LEAVE

The sickness leave reimbursement policy is slightly different under the SFE.  A GP contractor will be entitled to receive funding towards the cost of a GP partner (or salaried GP) who is absent from the practice due to a period of sickness leave.  However, no reimbursements will be available for the first two weeks of absence.  After two weeks, practices are eligible to receive a maximum sum of £1,734.18 per week (or the actual costs of employing a locum, if lower than the maximum sum). 

The maximum periods for which sums locum cover can be claimed are as follows:

a)       practices will be entitled to receive the full agreed amount for the first 26 weeks of leave in a three year period (commencing after the initial 2 week qualifying period); and

b)       thereafter practices will be entitled to receive half that rate for the next 26 weeks.

Practices will likely want to consider reviewing their partnership agreements to take account of the following:

• What happens during the first two weeks of absence when no reimbursements are available? Many practices will opt to have the other partners cover the absent partner’s sessional workload during that time.
• Remember that partners may be absent long-term but a partner’s circumstances may also result in a number of shorter absences (together adding up to a longer period of time) which can be equally disruptive to the practice arrangements.  Consider how this should be dealt with in your partnership agreement.
• It can be useful for the remaining partners to have the right to require the absent partner to consult an occupational health specialist to give a professional opinion on whether or not the absent partner is likely to return to work in the near future.  The partnership agreement would then give the remaining partners options (such as the right to expel) in the event that the partner on sickness leave is likely to be absent long-term.
• You should consider having an “end point” in mind.  A good partnership agreement will provide that a partner can be absent on full pay for a defined period of time, after which he/she can be asked to retire or expelled.  That way, all parties know where they stand and can plan ahead.

As the market leading law firm in Scotland within the GP/Medical Partnership sector, we have prepared partnership agreements for more than 150 medical practices across the county. If you would like further information on medical partnership agreements, please contact our Healthcare team.

Disclaimer 
The matter in this publication is based on our current understanding of the law.  The information provides only an overview of the law in force at the date hereof and has been produced for general information purposes only. Professional advice should always be sought before taking any action in reliance of the information. Accordingly, Davidson Chalmers Stewart LLP does not take any responsibility for losses incurred by any person through acting or failing to act on the basis of anything contained in this publication.