Did you know that your medical practice might be eligible to recover locum or GP performer cover costs incurred when partners and employed GPs are away on parental or sickness leave?
It can be stressful to ensure your practice is fully operational and your patients are adequately cared for during periods when one or more of your GPs is unable to work.
In these cases, you can apply for reimbursements under the Statement of Financial Entitlements. The schemes have been updated over the last few years to enable practices to have easier access to this funding.
Here is some useful information about both the parental and sickness leave schemes and how they work.
Eligibility to claim
The costs of temporary cover can be claimed if a partner or salaried GP is absent from the practice and unable to carry out their duties due to parental or sick leave.
The claim covers a short-term replacement, whether that is an external hire or additional duties for a GP already employed by the practice. If it is an existing employee, this person should not already work full time.
In addition, the absent GP must be entitled to the respective leave in their contract of employment or partnership agreement.
For sickness leave, there are no exclusion criteria for the type of illness or injury that has led to absence. However, the GP is required to provide a fit note.
For parental leave, including maternity, paternity and adoption, payments can be claimed immediately of up to a maximum of £1,113.74 per week for the first two weeks and £1,734.18 a week thereafter.
There are no set timescales that you can claim for parental leave, although the expectation is that these do not exceed the length of maternity leave.
For sickness leave, payments cannot be claimed until the GP is absent for more than one week. After this qualifying week, locum costs can be claimed up to a maximum of £1,734.18 per week for the first six months (26 weeks) and at half this rate for another six months. The total eligible period is 52 weeks.
If the cost of having temporary cover for an absent GP is less than the maximum, you will only be able to claim for your invoice amount. Payments will not be pro-rated for part-time cover.
How to claim
When claiming for parental leave, practices need to submit paperwork to their commissioning body. When and how often should be agreed with the commissioner, although this should be within 14 days of the end of the month that costs have been incurred.
In terms of sickness absence, practices should submit costs incurred to their commissioning body at the end of month in which they are claiming for. Reimbursements should be paid at the end of the same day that the practice receives its next Global Sum monthly payment.
For more details, the most recent amends to the Statement of Financial Entitlements document is now available on the government website.
Locum insurance gives additional peace of mind
Even if you are eligible to claim locum costs under the Statement of Financial Entitlements, you should still consider locum insurance. A few reasons include:
The maximum weekly payments may not fully cover your costs to hire a temporary replacement, particularly if the absent GP is full-time.Practices may also wish to cover other key members of staff not eligible under the government schemes.
The British Medical Association (BMA) recommends that practices still maintain locum insurance, choosing a level of cover that allows a top-up of these payments based upon individual and local circumstances.
“Practices should be aware that the current maximum weekly payment may not fully cover the cost of a locum and the amount of time they are needed to work in the practice, particularly if they are replacing a full-time GP. For this reason we recommend that practices review their current cover and consider maintaining a level that will allow them to top up the national payments based upon their individual and local circumstances.” BMA
It is also important to remember that this is an NHS reimbursement scheme and private practices would not be covered. Locum insurance would be highly beneficial to a practice in this case to reclaim the amount spent on additional staff costs in the event of an absent GP on parental or sickness leave
Practices can speak to their insurance broker about what type and level of cover might be suitable for them.