When taking up a salaried GP post, it is important to discuss and negotiate key areas in your contract and agree a job plan. In this article, Dr Mahibur Rahman explores some frequently asked questions about salaried GP contracts.

When should I ask for a contract?

Employers have to give you a written statement covering the main conditions of employment within 2 months of the start of your employment – however, it would be sensible to see this before you agree a start date, and to discuss and negotiate anything that is unclear. If you are a member of the BMA, they have a contract checking service which you can use to get a second opinion on your contract or help with discussions with the employing practice.

What are important areas in the contract to discuss?

A lot of job adverts are unclear with regards to the actual contract or terms of employment. It is important to discuss and clarify the following:

Pay – many jobs have no mention of the pay in the advert! You may also wish to discuss when your pay or package will be reviewed (there are no automatic pay rises once you are qualified!).
Job plan – including realistic hours or work – if you are expecting to work 9 hours a day, and end up working 12-13 hours most days, the pay that you agreed might not seem so attractive
Extended hours – evening or weekend working requirements
Leave entitlement – annual leave, CPD / study leave, maternity, sick leave
Indemnity cover – will the practice pay or do you have to cover yourself (this can be a significant cost)
Recognition of past NHS experience – this can have a big impact on your entitlement to things like sick leave, maternity

It can take some time to negotiate and discuss all the important areas, but this is really important as it can have a big impact once you are in post, and you may find it more difficult to make changes after you start.

What is a job plan?

A job plan should outline the details of your role. It could include areas such as:

Usual hours of work – including any extended hours
Usual number of patients per clinic (morning / afternoon)
Time allocated for administration
Allocation of home visits
Duty doctor or on call doctor sessions – frequency, duties
Meetings that you are expected to attend
Time allocated for CPD

It is important to agree a job plan before starting, so that both you and the practice are clear regarding the expected hours and workload. If your workload is significantly different or changes after you start, the job plan will be a useful reference point to highlight this. In some cases, this may be helpful to negotiate additional pay or time off in lieu, or to allow you to work more in line with the agreed job plan.

What is the BMA model contract?

The model contract sets out standard areas of the contract for a salaried GP that should be offered as a minimum by GMS, and PCO practices. It also applied to PMS practices in England since 2015. It includes the following areas:

Pay – the minimum annual salary for a full time post (9 sessions) is as follows:

Nation	Minimum (£)	Maximum (£)
England	68,974	104,086
Wales	71,738	108,249
Scotland	69,993	104,468
Northern Ireland	69,974	105,592

Many posts advertise pay per session rather than annual pay – at the bottom end of the BMA pay range, this equates to just £7,664 per session per year in England. The top end of the scale equates to just over £12,000 per session per year in Wales, although some practices may offer more than this.

Working hours – full time (9 sessions) is considered 37.5 hours – additional hours should be paid or time of in lieu offered – this is based on a session being 4 hours and 10 minutes
Paid CPD time – 4 hours per week paid CPD (1 in 9 sessions)
Annual leave – 30 days annual leave + 10 bank holidays / statutory days (effectively 32 days annual leave + 8 bank holidays)
Maternity leave – subject to qualification, 8 weeks full pay, 14 weeks half pay, 17 weeks SMP or MA, 13 weeks unpaid leave
Sick pay – based on continuous NHS service, up to 6 months full pay + 6 months half pay
NHS continuous service – all past continuous service to be recognised (not just employment with the current practice)

What does the term salaried GP cover?

It includes all of the following job titles as well as salaried GPs (this list is not exhaustive):

Salaried GP who undertakes special interest work (a GPwSI)
GP retainer
GP assistant / associate
Flexible Career Scheme GP
Returner scheme GP
Salaried GP employed to work out-of-hours via a PCO

I have a job offer from a PMS / APMS practice. The contract they have offered me has much less paid sick leave / maternity / annual leave / CPD compared to the BMA model contract. What can I do?

The model contract applies to GMS practices, and practices that are directly run by Primary Care Organisations (like Health Boards). PMS practices in England should also offer it for new contracts after June 2015. PMS practices outside England and APMS practices are not obliged to offer the BMA model contract, although some may offer some or all parts of it as an aid to recruitment. If you are not happy with any part of the offer, it is important to discuss and negotiate with the practice before accepting. Some doctors will be happy to have less paid CPD time in exchange for more annual leave or higher pay. Most areas of a contract are negotiable – hopefully you can come to an agreement that is mutually satisfactory. If you cannot, then there is no obligation to accept an offer that you feel is not adequate – you could look for another post.

There is a lot of variation in contracts offered to salaried GPs between practices, even in the same area. Each practice will have their own way of working and as a newly qualified GP, you may be unfamiliar with negotiating and discussing areas like pay – GP registrars have a standardised contract and the pay scales are nationally agreed. You may find it helpful to discuss any offer with an experienced colleague to get their advice.

Dr Mahibur Rahman is the medical director of Emedica and author of GP Jobs – a Guide to Career Options in General Practice. He teaches on the Emedica CCT+: course covering key skills for qualified GPs. The course includes sessions on salaried GP contracts, partnerships and succeeding as a GP locum / portfolio GP. It also includes practical advice and demonstrations on how to negotiate contracts, terms and more. You can see more details at www.emedica.co.uk/cct