1. The GP Registrar Contract of Employment and a few related issues
Viv Thompson
Derby GP Training Manager
As a Programme Manager in the North of the Deanery our input into the contracting process for GP Registrars may be totally different to that in the South.
I’m also aware that we are one of only two programmes that undertakes a medical staffing role in the North.
Trainer Conference January 2010

2. Common issues in Derby and how we have tried to manage them
Chart Toppers
Pay and the Supplement payment
Travel & Mileage claims
Annual Leave
Maternity pay and benefits
Medical Performers List and CRB Clearance
Four months rotations
To name just a few!
This is a list of the most common issues we have encountered in Derby and is by no means the complete list.
I intend to give you a brief overview of how we manage this is Derby which has reduced the number of queries /issues that we were receive which can’ be a bad thing!
It might be possible to have to have some time at the end of this presentation to share a burning issue!
Trainer Conference January 2010

3. “The Contract” Framework for a written contract of employment
Compiled in conjunction with
BMA regional services
British Medical Association
GPC
General Practitioners Committee
C O G P E D
Committee of General Practice Education
The framework document is the model for the Registrar contract of employment and as it has been compiled by two GP Committees and the BMA.... No problem then!
In Derby , we ensure all Trainers , Practice Managers and Trainees have access to a copy of this document .
It is also available on our website and is also on the Programme Information CDs for Trainers and Registrars.
The information CDs are updated annually usually before the new starters join in August.
In your practice is the Practice Manager involved?
Could it be done before the Registrar joins the practice? Should we try to insist that the Registrar visits the practice at least one week before he/she joins. You could then check the salary point, annual leave entitlement and explain mileage claims.
Trainer Conference January 2010

4. PAY Top of the Charts Salary and allowances
(This paragraph is taken directly from the contract)
Salary and allowances
The trainer/educational supervisor shall pay a salary and a motor vehicle allowance at rates in accordance with the
Schedules to Direction to Strategic Health Authorities Concerning GP Registrars with 2007 amendments (or subsequent) (or equivalent), as amended from time to time, concerning GP Specialty Registrars.
The most common problem we encounter is PAY.
When a trainee joins the Derby programme in our medical staffing capacity we endeavour to establish
the pay point on the salary scale
the increment date
and calculate the annual leave entitlement
We keep a record of these 3 pieces of information for reference at any time.
The Schedules document is a key reference document used by PCT Financial Services and is available on the Department of Health and NHS Employers websites .
Perhaps you Practice or Programme Manager has a copy to refer to.
The locality programmes receives updates from the deanery and any changes are brought our attention at the quarterly joint meetings with the deanery/PCT financial services.
In Derby, we disseminate this information to our practice managers
Trainer Conference January 2010

5. How can you establish the correct pay and supplement payment to complete this paragraph?
(This paragraph is taken directly from the contract)
Your basic salary will be [£………pa.] Your salary supplement will be [£……..pa.] Both annual salary and supplement will be amended in accordance with the annual recommendations of the Doctors’ and Dentists’ Review Body as implemented by government for GP Specialty Registrars. All payments will be made in arrears at the end of each completed calendar month, by payment into a bank or building society account, or by cheque.
Trainer Conference January 2010

6. We ask the Registrar to contribute!
Eight weeks before the rotation change the Registrar is asked to provide
A copy of their most recent pay slip and a completed K4 Form
The payslip will reveal the pay point on the StR (Specialist Training Registrar) salary scale.
This information will also help to establish the Registrars’ annual leave entitlement
Currently, we our Derby medical staffing hats on we send the relevant forms, documents etc for the registrar to complete.
Regarding pay, we ask for the K4 Form to be completed and returned to us with a copy of their most recent pay slip. This is sent a minimum 6 weeks before a rotation change in order for the registrar to be added to the relevant payroll system.
In Derby, the K4 has to be done every time the trainee joins a practice. This is because with the 4 months rotations the trainee terminates his/her contract and then has a new contract when joining another practice.
We send out the personal details, references etc to the Practice Manager, Trainer and the PCT at the same time.
The PCT services will use the Directions document and related amendments to establish the correct pay and supplement payment to complete the Salary and Allowances paragraph of the contract
The Practice Manager should also have this information.
We also ask all registrars to make arrangements to visit the practice BEFORE they join. Does the Registrar meet with the Practice Manager on that visit to establish pay so that a contract can be signed on the first day and any problems sorted beforehand????
Trainer Conference January 2010

7. Annual Leave Entitlement another common “issue”
GP Registrars’ annual leave entitlements are different in Primary and Secondary Care
Primary Care
StR scale: point 0-2
25 days
StR scale:
point 3 & above
30 days
Secondary Care
27 days
32 days
It is important to establish where the Registrar is on the pay scale at the beginning of their training to calculate their correct entitlement particularly when rotating in and out of four months posts
In Derby we monitor sickness and absence and also record annual leave taken to ensure that the correct amount is taken and any increases we inform the relevant specialty.
Trainer Conference January 2010

8. Motor Vehicle Allowance Rates
The rates etc can be found in the
Schedules to Direction to Strategic Health Authorities Concerning GP Registrars with 2007 amendments (or subsequent) (or equivalent).
That document again!
The Practices seem to have problems with “timely or should I say “untimely” claims from Registrars
The Registrar now has to claim mileage allowance.
The rates can be found in Click
We have a copy of the claim form on the website, in the Registrar practice pack and a copy is sent to your practice managers.
Some registrars claim each month, others leave it until the last day with the Practice!!!
I understand that the Trainer has to confirm the claim, expense which can take a few days by which time the Registrar may have left the practice and taken off the payroll
Trainer Conference January 2010

9. Maternity Leave and Pay
Four months posts and continuous service
Statutory Maternity Pay/Statutory Maternity Benefit
Annual Leave
In the first two years of training the registrar can have a least four changes of contract within their training programme.
This does cause a few problems satisfying the continuous employment rule to qualify for Statutory Maternity Pay (SMP).
You must have been employed by your employer for 26 weeks into the qualifying week (which is the 15th week before the week in which the baby is due). The 26 weeks must be with the same employer, so you do not qualify if you change PCT or move hospital trust.
This period must include at least one day's employment in the qualifying week. If you are not eligible for SMP you may apply for Statutory Maternity Allowance through your local Jobcentre Plus.
The GP Registrars do find this difficult to understand as they consider they work for the NHS.
Most secondary care Trusts are using the EPR (Electronic Personal Record) system which can be viewed by all HR personnel between Trusts. This system has made it easier to track doctors with regards to continuous service.
There is also the accrual of annual leave etc.
Annual leave continues to accrue during maternity leave so you still have your normal annual leave after returning to work. Your leave entitlement remains the same, so if you have 30 days leave remaining before going on maternity leave you still have 30 days remaining on returning. You might therefore wish to take a period of paid annual leave instead of, and at the end of your unpaid period of maternity leave. For example, if you took the maximum paid and unpaid maternity leave of 12 months and started with no annual leave outstanding, you would still accrue a further 25/30 annual leave during your maternity leave period. If you don't take this as part of your unpaid leave in the relevant leave period, you would normally lose all but 5 days of it under the General Whitley Council terms
You might therefore wish to take a period of paid annual leave instead of, and at the end of your unpaid period of maternity leave.
This information is available on the deanery website
Child care vouchers we refer to the practice manager as the employer – and the HMRC Revenue and customs website details of the scheme
Trainer Conference January 2010

10. CRB Clearance & the Medical Performers List
Enhanced CRB Clearance
A Registrar cannot work unsupervised without this
Medical Performers List
A Registrar cannot apply to be added to the Performers List without an enhanced CRB Certificate
When joining the programme all new starters receive an “offer letter”. This is not an offer of employment but an offer of a training programme which includes pre-empted documents relating to employment.
In Derby at this time we include all the paperwork required to provide the relevant information needed by the secondary or primary care Trust to prepare a contract of employment
It is the Registrar responsibility to return these documents in a timely fashion to ensure a contract can be drawn up and the trainee doesn’t miss out on pay etc.
This also includes Occupational Health Clearance, etc
We “chase” both the registrars and the relevant departments for all clearances and notify the relevant Trust, PCT and Practice of any problems. if this is held up for any reason.
In some instances it is the start of a very “beautiful” relationship with the Registrar usually those who are not particularly good at administration but must enjoy daily telephone calls and s!
Perhaps this should be part of their e-portfolio PDP.
Trainer Conference January 2010

11. Another issue Work Permits – Host Employers – Fines – Imprisonment!
There are numerous other problems that arise but to cover those would be impossible.
Perhaps an overarching contract? Who knows perhaps for the future
Trainer Conference January 2010

12. Summary Registrar has a new CRB Certificate
Establish pay point on the pay scale
Establish annual leave entitlement
Check passports/visa/work permit for expiry dates
Record all details
Summarise
When the Registrar joins the programme
Obtain new CRB Clearance – I understand that this is to change and it is to become the Registrar’s responsibility to apply for this.
Using the K4 as I said previously and we establish the correct point on the relevant pay scale and note the increment date
Therefore, we know the annual leave entitlement
When the CRB form is completed the registrar has to bring in certain documents including their passport . We check for visa etc expiry dates.
We record all of the above and at each rotation change use the information to notify relevant personnel.
It seems to have reduced the number of “queries, issues etc.....not a bad thing we think!
Trainer Conference January 2010

13. Finally
A Question for another day?
Does anyone have a burning issue that they would like to share with us?
An overarching contract would be the answer but how easy would that be?
This would be fabulous but a difficult one!
Trainer Conference January 2010