General Practice Registrars

1

• General Practice Registrars
• -
• Contractual Issues
• Mike Beattie Pay and Negotiations
• Birmingham - March 2009

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Issues raised

• What is NHS Employers and how to best to use it
  for advice etc?
• GPR payment schedules - an overview
• GPR travel expenses - what can and cannot be
  claimed?
• How maternity leave applies to GPRs in
  particular problems being out of the hospital
  system and rotating through posts. Key dates for
  SMP etc.
• Removal expenses.

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NHS Confederation

• The NHS Confederation is the only independent
  membership body for the full range of
  organisations that make up todays NHS,
  representing over 95 of NHS organisations as
  well as a growing number of independent
  healthcare providers.
• We work with employers to reflect their views and
  act on their behalf in four priority areas
• pay and negotiations,
• recruitment and planning the workforce,
• healthy and productive workplaces,
• employment policy and practice.

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NHS Employers

• NHS Employers is the arm of the Confederation
  responsible for workforce and employment issues,
  working on behalf of NHS organisations in England
  and, for some activities, the devolved
  administrations.
• It is responsible for 75 of the turnover of the
  Confederation and c.130 staff.

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Key Document 2
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Key Document 1
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Background

• GP Registrars are employed by
• Trusts, during their hospital placements
• GP Practices during GP placements
• Contractual arrangements, pay, and entitlements
  are not the same in the two employments.

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Pay in hospital posts

• Basic salary is determined by
• Grade
• Length of service
• Pay supplements are determined by
• Hours worked
• Frequency of on-call
• Proportion of out-of-hours worked.

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Pay in GP placements

• Basic salary is determined by
• Grade
• Length of service
• The pay supplement is determined by
• Recruitment and retention issues.
• The level is set by DDRB

10
Working out Pay

• Pay in a GP Placement is determined by the
  doctors position on the Specialty Registrar pay
  spine, which they pass through by annual
  increments in both hospital and practice posts.
• The supplement payable in the practice placement
  is that in place when the training contract (R7)
  is signed by all parties.
• Career grade doctors on protected rates of pay do
  not receive a supplement. They receive only their
  basic salary on the pay point they were on before
  re-entering training, unless it would be
  financially beneficial for them to be paid as a
  trainee, on a point on the Specialty Registrar
  pay scale, plus supplement.

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Pay in GP placements
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Key Players

• GP Practices
• Primary Care Trusts
• Strategic Health Authorities
• Department of Health (NHS Employers)
• Committee of General Practice Education Directors
  (COGPED)
• BMA General Practitioners Committee
• BMA GP Trainees Committee
• BMA Junior Doctors Committee

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The Direction to Strategic Health Authorities
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Travelling Expenses

• Business mileage
• Daily commuting
• Excess mileage on rotational programmes
• Travel to educational/study opportunities
• Travel related to removals

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Mileage Allowances and Tax

• For cars and vans, employees are entitled to a
  deduction of 40p per mile for the first 10,000
  business miles, and 25p per mile thereafter. 
• Under the statutory arrangements, the employer
  can pay Mileage Allowance Payments (MAPs) up to
  the approved amount tax-free (and reduce pound
  for pound the amount of relief the employee is
  entitled to by so doing). 
• The approved amount is the number of business
  miles in the tax year multiplied by those
  statutory rates.  Anything in excess of the
  approved amount is taxable. 

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Mileage Allowances and Tax

• It is possible under these arrangements to pay
  more than 40p per mile without tax consequences. 
  If an employee does 10,000 miles per year and
  their employer pays (say) 50p per mile for the
  first 5,000 miles and 25p thereafter, the
  comparison is
• ? MAPs 5,000 _at_ 50p 5,000 _at_ 25p 3,750
• ? Approved amount 10,000 _at_ 40p 4,000
• The approved amount exceeds MAPs, so no taxable
  excess (even though some payments were at more
  than 40p per mile)

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Mileage Allowances and Tax
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Maternity Pay (Eligibility)

• The main reference documents are the Schedules to
  the Direction to Strategic Health Authorities in
  respect of GPRs. These are on our website.
• To be eligible to receive NHS Occupational
  Maternity Pay (OMP), the GPR has to have at least
  12 months continuous NHS service immediately
  before the 11th week before the expected date of
  delivery (EDD). There are some breaks in service
  you can discount these are set out in Schedule
  1 to the Direction.

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Maternity Pay (Eligibility 2)

• The GPR also has to be employed by the GP Trainer
  until immediately before the 11th week before
  EDD.
• In some cases a GPR has moved to a practice after
  the 11th week, and strictly speaking the
  Direction doesnt allow payment because the GPR
  hasnt been employed by that trainer at the right
  time.
• This is an anomaly and is being corrected in the
  next revision of the Schedule in the meantime
  and in future, we suggest deaneries should not
  allow trainees to start a new placement in the 11
  weeks prior to EDD.

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Maternity Pay (SMP)

• To be eligible for Statutory Maternity Pay (SMP),
  the GPR must have been employed by the practice
  for a continuous period of at least 26 weeks into
  the 15th week before the week in which the EDD
  falls.
• This period must include at least one day's
  employment in the 15th week. Continuous NHS
  employment does not count for SMP purposes a
  move between NHS trusts, between GP practices, or
  between a trust and a practice will generally
  break continuity of employment for SMP.
• If the body responsible for paying Class 1 NIC
  changes, theres a break in continuous
  employment.

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Maternity Pay (SMP/SMA)

• Worth noting that a move to a new practice at a
  late stage in the pregnancy will certainly remove
  eligibility for SMP if it existed before, and for
  that reason alone should probably be resisted.
• If the doctor is not eligible for SMP she may
  claim Statutory Maternity Allowance (SMA) from
  Jobcentre Plus.

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Maternity Pay

• Assuming the GPR is eligible for OMP, the PCT
  will reimburse the allowance at full pay for the
  first 8 weeks, and at half pay for the following
  18 weeks.
• If the doctor is eligible for SMA or SMP, the
  allowance from the PCT over the first 8 weeks is
  abated by the benefit received, so that the GPR
  receives no more than full pay.
• For the following 18 weeks the GPR receives half
  pay plus any benefits, and for the next 13 weeks
  to week 39, the GPR receives benefits only. If
  SMA is claimed the GPR will deal with that
  herself. SMP will be paid by the practice and
  reclaimed through their NI contributions.

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End of Contract

• If the contract would expire while the doctor was
  on maternity leave (or after the 11th week before
  EDD), then it should be extended to allow the
  doctor to receive the full maternity leave
  allowance.

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Removal Expenses

• Possible reimbursement is set out in Schedule 1
  to the Direction
• Overarching principles are set out in General
  Whitley Council Section 26
• Contractual entitlement to removal expenses is as
  set out in the BMA/COGPED model contract of
  employment and handbook

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Issues raised

• What is NHS Employers and how to best to use it
  for advice etc?
• GPR payment schedules - an overview
• GPR travel expenses - what can and cannot be
  claimed?
• How maternity leave applies to GPRs in
  particular problems being out of the hospital
  system and rotating through posts. Key dates for
  SMP etc.
• Removal expenses.

26
Information and Contacts

• Website
• http//www.nhsemployers.org
• Email queries to
• doctorsanddentists_at_nhsemployers.org
• Telephone queries
• Mike Beattie 0113 306 3074
• mike.beattie_at_nhsemployers.org
• (Note I normally only work Tuesday to Thursday)