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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.


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