Family Doctor Association For Patients who want to see a GP they know and who knows them.

News - Sickness Cover Reimbursement for GPs: 2017/18 GP Contract

Date: 16/03/2017

With thanks to MIAB for this helpful update.

Sickness Cover Reimbursement for GPs: 2017/18 GP Contract

The General Medical Services (GMS) contract in England for 2017/18, published on 7th February 2017, includes changes to the existing contract around sickness cover reimbursement for GPs from 1st April 2017. The weekly maximum amount payable has been uplifted to £1,734.18 per week and qualification criteria have been made simpler. For example, payments will no longer be discretionary and qualifying criteria for reimbursement will commence when the absence is two or more weeks (as opposed to previous arrangements, which are linked to patient numbers and the period of absence).

 Chair of the GPC, Dr Chaand Nagpaul, believes the changes should ‘reduce practice locum insurance cover expenses, and enable practices to offer better sickness absence terms for salaried GPs.’

 However, medical insurance expert, MIAB, has received many enquiries from practices unsure about the implications of the reimbursement contract on their Locum Insurance, whether the changes replace the need for Locum Insurance, and how the repayment process will work.

 It has been in discussions with senior management at NHS England for clarification of some of the issues and has been exploring the reimbursement and its impact on practices.

 For example, the payments are a maximum of £1,734.18 per week but MIAB reports that its typical GP customers need around £2,500 per week for cover – leaving a gap of £765 to be found.

 It has confirmed that non-sickness-related absences, like jury service, compassionate leave, suspension and revalidation, won’t be covered. These account for 20% of its Locum Insurance claims, and without it, practices may be liable for the whole cost of cover.

 Similarly, MIAB has confirmation that Practice Managers, Nurses and other staff are not covered.

 It’s also not known how long the gap would be between claiming payments and the money arriving in the practice’s bank account, and how much funding is available (or for how long).

 From what is known so far, these payments may not be a suitable, like-for-like replacement for Locum Insurance. “We have a duty to our customers to ensure they can make informed decisions about their risk and protection, and we don’t want them exposed to risks they can’t cover after April 1st - whether they purchase Insurance or not”, said MIAB. “Our recommendation is to not cancel or reduce Locum Insurance cover until full details of the reimbursement are established.”

 MIAB have compiled an extensive FAQ document for FDA members to download, which summarises the available information and important points to consider. The document covers questions and answers on payment, funding and staff coverage surrounding the new contract.

Read the Frequently Asked Questions here

Latest News

Rising cost of clinical negligence claims is ‘unsustainable’, health bosses warn
Leaders of several health organisations have called for urgent reform as li...
Read the latest Member Bulletin
February update for our members.  Read more here....
FDA Chairman applauds Peppa Pig article in Christmas BMJ
Sheffield GP Dr Catherine Bell warned that the children’s television ...
Our unique platform for you to exchange ideas. Views on NHS changes, Solutions to a problem, Idea to share, Your concerns, Your opinions, Find out more