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Changes made to the GMS contract in April have left many GPs and practice managers wondering just what protection they have if there’s a key absence through sickness or accident in the practice.

In this article we’ll look at two scenarios involving nurse practitioners, because the sickness absence funding under the GMS contract will not apply in either circumstance.

Protection for nurse practitioners and similar key staff

Many practices are utilising the skills of certain primary care practitioners, such as a nurses, paramedics and pharmacists as the front line and, alongside key staff like practice managers, their absence from work can leave a huge hole in daily clinical provision.

However, sickness absence funding from the NHS is only available for GP performers. If it’s not a GP that’s absent then there is no right to this type of reimbursement for the practice.

Locum insurance from Practice Cover, however, can be taken out to protect against sickness and absence of key staff. There’s also no restriction on how you use funds from a claim to cover the absence, which brings us on to our second point.

Absence cover from nurse practitioners and similar key staff

If the absence is that of a GP performer, then the guidance is relatively clear. Non-discretionary reimbursement is available to the practice. For more about how much you can claim through sickness absence funding under the GMS contract please email This email address is being protected from spambots. You need JavaScript enabled to view it. and ask for a PDF copy of our GP reimbursement leaflet.

The crucial point is that the NHS will only reimburse against your claim if you use a GP to provide cover. Many practices will utilise the skills available within the practice to cover for a GP’s absence, such as a nurse practitioner. However the new provisions do not allow for the cost of this. Practices can claim only if cover is provided by either locum GPs or by GPs who are already working part-time at the practice.

Formally: "The commissioner will not pay for cover provided by nurses or other healthcare professionals" (from NHSE document "Protocol in respect of locum cover or GP performer payments for parental and sickness leave").

So while is makes good sense to use the non-GP resources available to you, you’re not covered for this.

Again, it may be prudent to ‘top up’ your NHS provision with locum insurance cover. Any claim made under our locum insurance can be spent in the way you wish – so you could fund extra sessions for nurses as you see fit.

If you’re confused about the rules around sickness absence funding under the GMS contract, then speak to Lynda Cox on 0800 028 5633.


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

A few weeks into the new reimbursement regime and it’s clear that there are a number of areas which are causing practice managers some concern.

Understandably, practice managers are looking for certainty so that they can be sure to mitigate as far as possible the financial effects of GP absence.

Some of the questions we’re getting asked:

How much is payable by NHS England?

Here it’s important to appreciate that the numbers that everyone is focusing on – namely £1734.18 pw for 26 weeks followed by £867.09 pw for the next 26 weeks – are the maximum amounts which are available.

If it costs less than this to cover for your sick GP then you don’t get the full amount. If you claim, say, £1000 pw in the first period, you can’t claim more than £500 pw in the 2nd period – regardless of your costs in the 2nd period.

What is the effect of aggregation?

To further complicate matters, remember that, if you have claimed for a doctor’s sickness absence in the preceding 52 weeks, your new claim when they go off sick again is reduced: you’re no longer entitled to 52 weeks’ sickness absence reimbursement.

Who can cover for an absent GP?

Practices might prefer to use ANPs to cover some of an absent GP’s sessions (as long as they’re sure they wouldn’t be in breach of their contract). But if they do this, can they claim the cost of this from NHS England?  No, I’m afraid not. Only GPs can cover and there are rules around using FT GPs.

How much has NHS England budgeted for this?

The information published by NHS England indicates that £238.7m has been invested to cover all the GMS contract changes 2017/18.  We have been told that, as far as GP sickness absence is concerned, “There is no set amount to support these changes but NHS England will monitor ongoing spend.”

For help in interpreting how the changes could affect you and whether you need to make any changes to your locum insurance call Lynda Cox on 023 8051 3286.

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.

You may have heard about the ‘Don’t pay a premium’ campaign that was run by Which?.

The aim, from the perspective of consumers, has been to get insurers to be fairer about renewal premiums. Which? campaigned hard to get insurers to show the previous year’s premium on renewal documents, and in a survey an overwhelming 85% of consumers thought this would be useful. Well, their campaign has come to a successful end.

Change for the better

The debate kicked off much activity. The Association of British Insurers held talks with the Financial Conduct Authority, with a call for renewal documents to include the premium that the customer started the year paying, shown alongside the renewal quote for easy comparison.

The FCA agreed with this, and in December 2015 decided to this made sense. Wheels don’t turn fast in financial services, and in April this year the rules will finally change – at least, when it comes to motor and home insurance. From this date all insurers must flag up how much last year’s policy cost so you can see whether your premium has gone up – which gives you the chance to shop around.

Practice Cover right from the outset supported this change – and in fact we called for it to be introduced in our sector of locum insurance. While our customers are not strictly consumers, and are in fact GPs or their practice, we feel it’s important that they too see what our premiums are, and such a change would make our premiums transparent.

7 years of pegged premiums

While we’re not included in the FCA’s changes, the good news is that we truly are transparent about premiums. In fact, for the 7th year running, 100% of our renewing customers have paid the same or less for their insurance than they did the previous year. That’s why we already show last year’s premium on our renewal documents.

It’s one of the reasons why our customers are so loyal to us. But not the only one.

  • We can quote and have a practice, GP or key staff member insured in just a few hours.
  • We’re happy to speak to you on the phone, and help you choose the right cover at the right premium to meet your budget.
  • We have an enviable claims record, that ensures genuine claims are paid without quibble.
  • We can include continuity of cover, which means that if you make a claim for a certain type of illness, we’ll ensure you remain covered for that illness through the life of your policy. On other policies that illness would be excluded from cover.

I challenge you to find another locum insurance provider that does the same!

I’m available personally if a GP would like to discuss any situation in confidence. Call 023 8051 3286 and ask for Lynda Cox.

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.

The announcement from Chair of the GPC, Dr Chaand Nagpaul around sickness cover reimbursement for GPs has raised many issues regarding locum insurance cover.

The law of unintended consequences springs to mind when reviewing the changes to the GP contract, and we know it is early days.

It's great that NHS England is providing additional financial support to our hard-pressed GPs with an additional £238m going into the GP contract in 2017/18.

With £1734.18 pw being paid to practices for up to 6 months after 2 weeks' sickness absence, most doctors working less than about 7 sessions a week could find their locum costs being met – unless you're in an area of England where locum costs are particularly high.

Although we are still waiting for detail it is clear that the sometimes considerable sums that prudent practices were spending on locum insurance will fall, as practices reevaluate their need for insurance.

However, I urge GPs to consider their circumstances carefully. This doesn't mean that the need for locum insurance falls to zero and practices which cancel their locum insurance face a number of risks:

  1. In areas where locums are very costly – and I've heard of locums charging £1000 per day in some places – the sickness absence reimbursement of up to £1734.18 per week isn't going to cover the entire cost of a GP's absence.
  2. Reimbursement halves after 6 months' sickness absence. £867 doesn't make a big dent in locum costs to cover for a full-time GP.
  3. Reimbursement covers sickness absence of doctors only. The new proposals provide no cover for staff.
  4. Reimbursement covers doctors’ sickness absence only. It doesn't cover jury service, suspension from practice, revalidation leave, or compassionate leave. It doesn't meet funeral costs after accidental death. It doesn't meet private physiotherapy costs and a whole host of other things which typically fall within today's locum insurance policies.

On this latter point, our underwriters paid more claims for jury service in 2016 than I have ever known in 13 years running locum insurance businesses. Over 70% of our clients in 2016 chose to buy a policy which included these additional benefits.

So ditching your locum insurance and putting yourself in the hands of NHS England won't necessarily be the panacea you hoped it would be.

Unless you have insurance in place you will still be putting your hand in your pocket to meet locum costs.

I am confident that underwriters will rise to the challenge and will offer insurance to plug the gaps which NHS England's well-meaning intervention has caused. And, hopefully, should the NHS England funding be withdrawn once its cost to the public purse is deemed unacceptable, the skilled and proficient specialist providers will not have left the market.

Lynda Cox, Principal
Practice Cover

The opinions presented in this statement 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.

Locum insurance can be valuable for a practice and its GPs, but we know that there is a whole range of daily issues that surround a practice – and not least is recruitment and the need to find locums. 

Recently we set up some locum insurance for a hard-working GP and, as we like to do, at the end of the conversation I asked him if there was anything else I could help him with. 

He asked me – in his own words – to ‘knit’ him a couple of GPs. I wish I could.

The GP recruitment dilemma

He had tried everything to recruit GPs to his practice and nothing was working. This meant that he and his colleagues were not only working flat out to cover the vacancies, but also drawing on increasingly expensive locums to cover some of the shortfall.

As all of you working in General Practice know, this is a situation being replicated throughout the UK. The upshot is that, as a resource that’s in demand, locums can virtually name their price.

The burden of illness in the workplace

Practices are therefore on the back foot when they need to bring in a locum and they have little or no negotiating power. If they need someone, they need him or her now, and the cost has to be a secondary consideration.

However, in reality cost can’t simply be set aside as a ‘secondary issue’. GPs have to balance the books, and funds for a locum may not be unavailable. Gaps which locums could fill are often plugged by already overworked partners.

GPs are not superhuman. Like the common manthey can suffer the ‘normal’ range of illnesses that we all do. And when GPs unexpectedly get diagnosed with an illness where they cannot work, picture the situation: an already stretched practice is hit with one or two key staff absences through sickness and the workload becomes untenable for the remaining partners.

Returning power to the practice

So where does Practice Cover fit in this?

We specialise in locum insurance for GPs and their practices. This insures the partners – and anyone else at the practice - in case they are ill and can’t work.

When it comes to vacancies at your practice, our insurance can’t meet the cost of a locum. However, it can provide cover for doctors, nurses and staff members who fall ill and can’t work – or potentially when there are absences for other reasons, such as an accident, maternity/paternity or even jury service.
Our locum insurance pays an agreed sum to the practice (after expiry of the practice’s selected deferment period) for up to 52 weeks (or until the person returns to work, if sooner).

We can’t knit GPs, or nurses, but we can give you the money to go out and buy them. It’s a cash sum that the practice could choose to spend on a locum... but in fact, it comes with no restriction on what you do with it. So the practice could just as easily spend the cash on recruitment fees, overtime for staff or any other means that would relieve the practice’s burden after unexpected illness or accident strikes.

To help you make sense of locum insurance, call us on 023 8051 3286.

The views presented 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

If you’re considering locum insurance – and all its myriad options – you will eventually come across continuity of cover.  It’s an option that we offer.

Whether to buy a policy with ‘continuity of cover’ is arguably the most fundamental decision you need to make regarding your locum insurance. So let’s explore exactly what it is.

What happens if you claim – and you’ve bought continuity of cover?

When you opt for continuity of cover on your locum insurance policy with us, we will tell you up-front what you will and what you won’t be insured for.  If you go on to claim for something you’re insured for – say a bad back -  our underwriters will pay out for repeated claims. In other words, you will be covered every time your back problem returns (subject to the policy’s deferment period). Importantly, the underwriters won’t alter the underwriting terms of the policy at renewal in an attempt to restrict future claims.  The only time you’ll be re-underwritten is if you decide you want to change your policy.

What happens if you claim – and didn’t buy continuity of cover?

If you opt for a policy which does not provide continuity of cover, you and your back complaint will be reassessed by our underwriters at your policy’s first renewal date after the first claim is paid. In most cases a restriction will be placed on the policy stating that the underwriter will not pay any further claims for back-related absence.

The impact on the sums you and your practice would be able to claim from the policy as a result of your bad back would be significant.

Why do we give you a choice?

Some locum insurance providers don’t give you a choice – because continuity of cover does not feature in their policies. This often comes down to how much they want to charge – and how much you want to pay. Policies with continuity of cover built into them are more expensive than those without, because of the guarantees that the underwriters are giving.

So is the additional cost of continuity of cover worth it? Our experience here at Practice Cover is mixed. Many come to us because they think continuity of cover is vital. Others come to us for the range of cover, and take the opposite view over continuity of cover. 

What’s right for you?

Do you worry about whether a claim this year will lead to your claim in a later year being declined? If so, you might opt for continuity of cover. You might take the view that, although it costs more, saving money on your premium is a false economy.

Alternatively, you might think that someone who is regularly off ill is likely to take ill-health early retirement. If that’s the case, as a practice you may begrudge paying for cover you wouldn’t need because the person would simply leave the practice after suffering recurrent bouts of ill-health. 

MAKE SURE YOU KNOW WHAT YOU NEED. We can help you with your research, walk you through the jargon and put the locum insurance that you need in place. Call us on 023 8051 3286

You will speak to a person, not a machine and, as we have no sales force, you won’t be pushed into buying anything by someone who’s paid to sell.

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.

 

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