MDO reimbursement (indemnity)

Londonwide LMCs Guidance for Sessional GPs and Indemnity Reimbursements from NHS England

As part of the 2017/18 GP contract agreement, it was agreed that £30m would be paid to practices to cover 2016/17 rises in indemnity insurance costs for all doctors delivering GMS work. It is acknowledged that this falls significantly short of the actual cost.

This amount has been based on average rises in costs using figures received from surveyed GPs and medical indemnity organisations. This has been paid to practices on a per patient basis, set out under the Statement of Financial Entitlements (SFE), and is not weighted as a result of the Carr-Hill formula. Practices should have now received a payment of 51.6p per patient based on their registered list as at December 2016. This funding was paid to practices in March 2017.

These payments are made to practices on the assumption that, where salaried GPs (and principals) are paying for part, or all of their indemnity costs, the practice will reimburse to them, from the payment received, an appropriate proportion of the amount which the GP has paid for their cover. The reimbursement amount should be based on the proportion of GMS services which the GP is providing for the practice. It is recognised that every practice will have its own arrangements in place.

In some practices, salaried GPs (and principals) are responsible for paying the entirety of their own indemnity costs. In some, part or all of the indemnity costs for salaried GPs (and principals) at the practice are paid for by the practice/reimbursed by the practice. Therefore, each practice will need to allocate payment to its GPs which is equitable and proportional based on their circumstances. The conditions are set out in the revised SFE which is in place from 1 April 2017. A similar funding arrangement has been confirmed for 2018 that will see payments made to practices in March/April 2018 for rises in 2017/18.

We cannot provide accurate estimates that will be applicable in every situation, and GPs who work in multiple settings will need to consider potentially multiple approaches to different employers or engaging practices. No additional resource has been made available to Out Of Hours organisations.

Locum GPs

Effectively it is appreciated that this means that salaried and principal GPs are receiving the monies retrospectively, and locums prospectively. Practically speaking, locums are not in a position to backdate their indemnity uplift to practices they worked for in the previous financial year. It is considered most sensible to consider the uplift funding received by practices in Spring 2017, paying for the uplift for the coming year for all GPs irrespective of contractual status.

If a practice does not engage any locum sessions in 2017/18, they will not be passing on the monies irrespective of their use in 2016/17. When the second part of funding is received in April 2018, that will provide similar funding for all GPs, again backdated for 2017/18.

NASGP (the National Association of Sessional GPs) has issued its own guidance: https://www.nasgp.org.uk/news/indemnity-inflation-payments-locum-gps/ and has a calculator which is available to NASGP members. 

We are aware that some locum GPs have divided the number of sessions by the total indemnity fee creating a 'fee per session' after calculating their rise from 16/17 – 17/18; but GPs must be mindful that the indemnity reimbursement only reflects the rise in core hours indemnity and cannot be conflated with work undertaken in the Out Of Hours setting.

Some locum GPs may decide to incorporate this figure into their hourly rate charged. A separate line can be added on the invoice for transparency. However, it is ultimately up to the locum GP themselves to ensure that, as with all other business expenses, their charges reflect their costs and that this issue is a matter for negotiation with their engaging practices.

Last updated : 25 Oct 2017

 

‘Innovative and interesting’ HCA course now incorporates the 15 Care Certificate Standards (21 Nov 2017)

“I would recommend it to other HCAs, a very good course”. “The trainers were excellent”. “Facilitators have a good knowledge of their subjects and they explained clearly”. These are just...
Read more »

London Health and Care Devolution Memorandum of Understanding signed (21 Nov 2017)

The London Health and Care Devolution Memorandum of Understanding (MoU) was signed last week by London, national partners and central government. We currently have some high-level details which we can...
Read more »

BMA referral to a specialist patient leaflet (17 Nov 2017)

The BMA has launched a new leaflet which is designed to provide patients with information on what to expect when referred to a specialist. The leaflet can be downloaded...
Read more »

Practice managers please respond to records update email (17 Nov 2017)

In the next few weeks, we will be sending an email to all practice managers asking them to confirm the GPs who are working at their practice, please look out...
Read more »

Request for hospitals to issue fit notes gets results (17 Nov 2017)

Our recent letters to hospital trusts asking them to issue fit notes to patients rather than referring them back to GPs has had a positive response from Imperial College Healthcare...
Read more »

Londonwide LMCs motions at England LMC Representative Conference (17 Nov 2017)

The first Conference of England LMCs took place on 10 November in London. The full list of motions, including which parts were carried can be downloaded here. A summary...
Read more »

Chairs and vice chairs look at cross-LMC working (25 Oct 2017)

Last week’s meeting of Londonwide LMCs’ leaders looked at cross-LMC working, to make sure we are ready to represent members as the NHS brings in new organisations as part of...
Read more »

Participant practices wanted for unique stress and workload study (25 Oct 2017)

Update February 2018: The Primary Care Barometer is now up and running! As of December 2017 practice managers across London have had the exciting opportunity to participate in a novel survey...
Read more »

GPC guidance on requirements for PREVENT training (23 Oct 2017)

Section 26 of the Counter-Terrorism and Security Act 2015 (the Act) places a duty on certain bodies (“specified authorities” listed in Schedule 6 to the Act), in the exercise of...
Read more »
Next Page »
« Previous Page