When a GP is ill and can’t work, what will the Primary Care Trust pay towards any locum costs that the practice may incur?
The answer to this should be pretty straightforward. It’s all in the GMS Statement of Financial Entitlements , a 391 page document available at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_112959.pdf which says that the PCT will pay eligible practices up to £987.91 for the first 26 weeks of a GP’s absence and half that for the next 26 weeks.
Many practices assume that this is what they would receive and budget accordingly.
At Practice Cover we have spoken to a number of PCTs to ask what they are currently paying. The answers varied around the country from 100% (i.e. the full £987.91), to 50%, to nothing.
So, once again the postcode lottery comes into play. To be fair, many practices will know what the stance is of their PCT and will make locum insurance arrangements accordingly.
But last week we came across a practice which thought it had done just that. They had insured their GPs for locum costs, taking into account their PCT’s contribution i.e. they insured for the shortfall.
When one of the part-time GPs became ill, locum costs amounted to £1,200 a week. The GP – in an eligible practice – was insured for a few hundred pounds a week, meaning that the practice looked to the PCT to make up the shortfall.
The PCT’s response was that, because the practice had arranged locum insurance, the PCT would make no payment at all.
Had the practice not arranged locum insurance the PCT, due to its published ceiling on reimbursement, would not have met the locum costs in full.
So where does this leave practices which are trying to ensure they won’t be out of pocket?
The only option appears to be to ‘go it alone’, ignore the PCT and consider insuring for 100% of locum costs.
Author: Lynda Cox, April 2012
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.
