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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

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I look forward to receiving the policy documentation in due course and would like to take this opportunity to thank you for your patience in dealing with this case!

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