By Robert Campbell 

This is the third ‘blog’ in a series looking at the pay and conditions ‘enjoyed’ by GP Practice Staff. In particular, this ‘blog’ will discuss sick pay, statutory and employers.

As an ‘employer’ a GP Practice must pay Statutory Sick Pay to staff but it is not required to continue to pay normal pay unless contracted to do so. When running a ‘profitable’ business it is quite legitimate to look for ways of managing expenditure. Reducing expenses and increasing profit is a key factor contributing to a successful business.  GP Practices are independent business operating under the cover of the NHS.  So there is nothing wrong with limiting ‘sick pay’, is there?

The NHS Sickness Pay Scheme

Staff employed by NHS Hospitals and Trusts ‘enjoy’ terms and conditions of service set out in the Agenda for Change settlements. Mainstream staff directly contracted by the NHS have dare I say a generous ‘sickness pay scheme’.

I have always thought that the progression from 1 to 2, then 4, 5 and 6 months’ sick pay was a bit odd, but that is an agreement reached between the Government and NHS Staff unions.  However, anecdotal evidence suggests that few GP practices offer their staff such generous terms. Instead, practices vary from paying SSP only to paying only a few weeks full and half pay. Some practices make exceptions for long term absences where staff are admitted to hospital and often consider each case on its merits. It sounds to me more like a case of if your face fits you may get better sick pay terms but there is no guarantee.

Questions and Arguments

What then are the arguments for not paying the NHS Sick pay scheme.

‘It’s too expensive’.

‘We don’t want to encourage staff to take time of sick’.

‘We would not have issued a sick note’.

What happens though if the employee is a registered patient of the practice and there are differing opinions amongst the doctors as to whether the absence should be prolonged. Then there are accusations of ‘milking’ the absence because there is six months’ full pay. In one case an employee submitted sick notes for six months and then resigned. However, another side to the argument is that practice staff have a right to join the NHS Pension scheme, and need continuity of contributions to the scheme whilst off sick. What then happens to their monthly contributions if they are only receiving SSP? In simple terms contributions can only be paid on whatever is earnt whether it be SSP only or employers sick pay. No pay no contributions. (See NHS Pension Scheme Sick Leave Factsheet)

Is the funding there anyway?

GP Practices are reimbursed for staff costs. Prior to 2004 it would have been 70% of gross pay plus employers National Insurance contributions, employer’s superannuation payments and training costs. After 2004 it could be argued that the practice budget effectively absorbed all the funds to pay practice staff. There are those who will argue it does not and to some extent I would agree, particularly on employer’s pension costs. But if practice income is supposed to cover employment costs whether it be 100% or 70% or somewhere between what then is the argument for using local or practice based pay rates and not the NHS pay system. I sit in the camp that does not see the argument for paying staff a pittance – sick pay or otherwise.

Differentials Widen

Historically, practice staff pay was based on the Whitley Council pay system and in my experience practices religiously followed the national pay scales, along with annual increases. Practices similarly adopted the sick pay arrangements. However, the Whitley A & C pay scales were last updated in 2005. Since then GP practices have gone their own way and the differentials between pay at one practice and another practice follow no national pattern.

Best possible terms

The purpose of this article is to encourage Practice Managers to argue for the best possible terms and conditions for themselves and their staff. Why not write to your MP? I did and got the standard Department of Health reply that GPs are independent employers. But in a national health service – not the lower case – I find that approach gloriously wrong. Am I the only one that does?