Top-Up Locum Insurance
From the 1st April 2017 GMS Contract changes now entitle GP practices to a Sickness Reimbursement payment for GPs. However, the NHSE Reimbursement is not 'full-service' and practices should still consider the detail of the Reimbursement:
- We would refer you to point 16.4 in the 2013 SFE, which still applies to the current amendment and states;
"it is for the board to determine whether or not it was in fact necessary for the contractor to engage the locum, or continue to engage the locum"
- The practice must produce evidence of costs incurred (locum cover, or part-time internal cover) in order to qualify for the Sickness Reimbursement. Any sessions you cannot fill with a locum or another partner/salaried GP you will receive no reimbursement for.
- The maximum amount you can claim is:
Weeks 2-26 of absence - Costs of up to a maximum of £1,751.52 per week.
Consider that average locum costs are in excess of £300 per session, or £2,700 per week for a full-time GP.
Weeks 26-52 of absence - A maximum of 50% of the amount claimed during the first 26 weeks, capped at £875.67 per week.
Consider that if the practice can no longer cover 'in house' for a sick GP and has to bring in expensive locums, you can only claim at half the rate you claimed at previously for weeks 26 to 52.
- Cover can only be provided by doctors already at your practice if they are not already working full-time and they were already working at the practice when the GP went off sick.
- Reimbursement covers core hours only.
- A 2 week 'waiting period' applies to each period of sickness leave before you can claim Reimbursement. If a doctor returns to work and goes off again, you have to wait 2 weeks each time before you can claim reimbursement.
- Aggregation means the above periods (weeks 2-26 and weeks 27-52) are reduced if the practice has claimed for the doctor in the preceding 52 weeks. This means the viability of the Reimbursement as a solution to recurring medical issues is questionable at best.
- No information has been provided by NHSE as to the maximum budget that supports this initiative.
- NHSE has not guaranteed the reimbursement will be in place for any minimum term beyond the 2017/18 SFE amendments.