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Working through the weekend – meeting NHS demands

by in Bank holidays, GP Practice Management, Managing staff

For most GP practice staff, Easter 2020 is anything but a holiday, following confirmation by NHS England that Good Friday and Easter Monday would need to look ‘as close to normal working days as possible’.

The instruction comes as Covid-19 demands are ‘anticipated to be at their highest so far in many areas’ this weekend. ‘We have previously asked for primary care to align with the rest of the NHS, and to treat the Easter bank holiday as a normal working day,’ the bulletin said. All GP practices will be open across core hours, unless alternative arrangements are agreed in advance with respective CCGs.

While the NHS England bulletin confirming the move arrived at ridiculously short notice, the move shouldn’t have come as a surprise to practice managers – earlier this month NHS England medical director for primary care Dr Nikki Kanani and director for primary care strategy and NHS contracts Ed Waller outlined the idea. At that time, it was stated GPs will get reimbursed in full for their costs relating to the extra opening.

Staff headache

While all of this is totally understandable given the times we find ourselves in with the coronavirus outbreak, it does leave practice managers with a headache around staffing – and pay.

The NHS clearly recognises the problem – it’s bulletin said: ‘We recognise that this short notice change presents challenges for you and your staff,’ before adding ‘Practices should discuss with their local CCG the level of service required on the bank holiday, and agree what staff cover is needed’. But how are practices dealing with the problem and how much are they paying staff to work over Easter?

It’s a topic that has been covered in detail on the Practice Index Forum. While it seems remuneration/compensation levels vary – one thing that doesn’t is the willingness of staff to work overtime. Most practices have had enough volunteers to cover the extra opening, some before they even shared details of overtime pay.

“We’ve had no problem finding staff to cover the whole weekend,” one PM from a London practice told us. “We’ve agreed with our CCG to open across all four days of the Easter weekend, so it was a big ask of staff, but luckily we’ve had more volunteers than we need. I just think they’re happy to play their part in the fight – and perhaps now more than ever they see themselves as an integral part of the NHS. For that reason, I would say it’s only fair that NHS England has asked us to open.”

Another practice manager, this time from a rural practice in Cumbria added: “Finding staff wasn’t a problem at all. The offer of time off in lieu (TOIL) was actually welcomed. The view of our team across the board is that they want to help – and there’s very little for them to do over Easter with the social distancing rules, so they might as well work now and enjoy the time off later in the year when they can do something with it.”

If you need to work out leave for the bank holiday, have a look the bank holiday toolkit [PLUS]

The overtime pay debate

Talk of TOIL takes us on nicely to the subject of overtime – which is varying from practice to practice according to chat on the Forum. Some practices are paying double or even triple time, others are paying usual salaries plus TOIL, while others are treating it as a normal day and not offering over and above the usual hourly rates.

The position has been muddied somewhat by the NHS saying bank holidays should be treated as normal working days – with the bank holidays being given back to NHS staff later in the year. This has caused headaches around minimum holiday entitlements and so on, especially as the policy is up in the air (at the time of writing).

However, the following clarification was issued by the NHS just before Easter:

Good Friday and Easter Monday reimbursement rates: 

Where it is determined that a practice must open on Good Friday or Easter Monday, practices can seek reimbursement for additional staffing costs incurred on these days, in line with the respective rates as set out below. That includes: ·

Sessional GPs: up to a maximum of £250 a session or £500 per day; Overtime for salaried GPs in line with the individual’s contractual arrangements.

Additional capacity from GP Partners to recognise up to two additional sessions on each of Good Friday and Easter Monday at a rate of £289 per session plus applicable employer National Insurance and pension costs

Overtime for non-GP practice staff in line with the individual’s contractual arrangements.

Practices should discuss with their local commissioner the level of service required on bank holidays and agree in advance what additional staffing costs will be reimbursed.

It’s a good idea to check what you have included in your team’s contracts. If you need to update contracts [PLUS] or job descriptions [PLUS], there are templates for Practice Index PLUS members.

Valued staff

“While we are being reimbursed for staffing costs including enhancements for bank holiday working, how much we pay goes way beyond pounds, shillings and pence,” a PM commented to us. “Any GP partner or practice manager that doesn’t see this is extremely short-sighted in my opinion.

“I saw a comment on the Practice Index Forum about a practice paying double time and a day off in lieu because they value their receptionists and wouldn’t be able to function without them. While I would add that this applies to all practice staff, the comment is so spot on. The Easter bank holidays haven’t been cancelled for the majority of people, so we should respect this, demonstrate how much we value our staff and give them a much-needed morale boost.”

Another PM echoes these thoughts and adds that demonstrating value today will pay dividend going forward. “COVID-19 isn’t going anywhere soon, and the May bank holidays aren’t far away, so I would say it’s likely we’ll be asking staff to give up their time off once again. If we’ve rewarded their overtime this time, we’re more likely to get help next time. Whatever happens, we’re going to be asking a lot of our people over the coming weeks.”

Finally, another PM told us that it’s the practice managers responsibility to manage staff effectively at times like these.

“We have a responsibility to our staff to manage them at times like these,” they said. “You’ll naturally get some people who put their hand up and take on more than others. While there can be a genuine need – staff maybe need the overtime if their partner has been furloughed or made redundant, for example – it’s important individuals don’t get overloaded. We’ve set up our rota so that everyone gets at least one day off over the weekend, which is important.

“It’s also essential to communicate the reasons for requests. I saw somebody has posted a line on Practice Index about Easter working being a national decision – that’s something that should be shared. I think what I’m trying to say is that we need to be sensitive to staff – more so in fact – if we’re to come out the other side unscathed.”

As our contributors have pointed out in this article, this is a subject that needs careful management – and there’s plenty of information on the Practice Index Forum to help you navigate a way through.

Topics trending in the forum

What steps are you taking to make your staff safe?
Working from home in a pandemic
Bank holiday working
Response letters to patient complaint

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