By Lynda Cox

Practice managers of English GMS practices are grappling with the recently announced changes to the 2017/18 contract which include increases in practice funding, among other things.

Most changes take effect in July 2017 – but the changes in GP sickness absence reimbursement start sooner, on 1st April.

To summarise the changes, reimbursement is no longer discretionary and, in future, you can claim reimbursement even if you don’t bring in a locum to cover for a sick GP.  This means that, if other doctors at your practice cover for their absent colleague, you can still claim. The only restriction here is that you can’t claim for a full-time doctor working extra sessions to cover.

From 1st April you’re eligible for a non-discretionary £1734.18 pw once a GP has been off sick for at least 2 weeks.  The payment reduces by half – to £867.09 pw – after 26 weeks’ absence.

You need invoices (and, presumably fit notes from the doctor) to support your claim, and you will get the lower of the amounts shown above and the invoiced costs. For full time doctors or in areas of high locum costs, where the amounts shown above will fall short of costs you actually incur, you will be facing a shortfall. Practice managers will be mindful of the potential impact on their practice’s cash flow.

The announcement of these changes says that no doctor is excluded on the grounds of health, so those who have found it difficult, in the past, to get locum insurance, would be able to claim reimbursement even if their sickness absence is linked to a pre-existing condition.

What are the limitations? Your claim can be for GP sickness absence only. You can’t claim for doctors who are absent for other reasons such as compassionate leave, jury service, maternity leave, suspension and so on. (Maternity leave and suspension are, of course, accommodated elsewhere within SFE). Likewise you can’t claim for other clinical or non-clinical staff.

The recent announcement makes no reference to the time it will take for reimbursement to reach the practice, but practice managers will have a view on this, based on their experience to date of the previous discretionary basis of payment.

How this will pan out in practice and how long these arrangements will pertain remains to be seen.

In the meantime, practice managers will evaluate the costs and benefits of locum insurance in a world where non-discretionary payments are being posited and will fire up their crystal balls to see just how long the public purse will be able to fund such payments.

Author: Lynda Cox, Practice Cover Limited

The opinions presented in this blog are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice. Practice Cover is a trading name of  Practice Cover Limited and is authorised and regulated by the Financial Conduct Authority.