GPs sickness absence: a CCG lottery?

I was listening to radio 4’s ‘You and Yours’ and they were talking about NHS funding of IVF.

The issue was around the NICE guidelines* which say that women over 40 should be allowed 3 cycles of treatment and that this is at odds with what is happening in reality. It appears that the dreaded ‘postcode lottery’ comes into play and, in some CCG areas you’d be lucky to get one cycle, never mind 3.

What’s this got to do with locum insurance?

Their interviewee – a GP and Chief Clinical Officer at a CCG – said that, notwithstanding the NICE guidelines, they had ‘difficult decisions’ to make as regards utilising the ‘set amount of money’ they have been allocated, they had to ‘prioritise’, and CCGs had to take into account ‘their financial position’.

As a locum insurance provider, this makes my alarm bells ring. In February 2017 a number of measures were announced to improve the financial position of GP practices and, in most part, the measures were costed: £156.7m to cover for the discontinuance of AUA DES, £30m for indemnity insurance costs, and so on.

One of the measures to which, as far as I can ascertain, no cost has ever been publicly attributed was a significant change in sickness cover reimbursement for GPs.

This was followed by speculation that this had killed off the need for locum insurance.

In the months that have followed we’ve seen that many GP practices have taken the NHS announcement with a pinch of salt. I have lost count of the number of GPs and practice managers who have told me they can’t see where the funding is coming from, they don’t think it will last, they will have to fight to get the money to which they are entitled and that, essentially, handing over their insurance to the NHS could be a very bad move.

In my view the NHS provision should be a safety net for those GPs whose health renders them either uninsurable or for whom locum insurance may be punitively expensive.

Where’s your peace of mind coming from?

If your practice is in an area where ‘difficult decisions’ need to be made and your CCG has only a ‘set amount of money’ which it has already spent it is not inconceivable that obstacles will be put in your way if you try to claim under your GMS contract for GP sickness absence.

In fact we have already had reports from GPs and practice managers of this happening.

So, what price can you put on that type of lottery? Locum insurance doesn’t come with such uncertainty. Cover for a full-time GP would cost around £120 pm (after tax relief) and, for this, the practice would receive £2,500 pw for up to 52 weeks (after a 4 week waiting period) in the event of a valid claim.

Unlike the payment from the NHS:

• the practice wouldn’t need to submit locum invoices
• the practice wouldn’t need to show proof of who’s covered the absent doctor’s sessions
• payment would be prompt.

In the event of receiving a payment from the NHS, your locum insurance will not be affected – potentially a win-win for the practice.

If you’d like to know more, please call me.

Lynda Cox