Contracts of employment for salaried GPs

The most important aspects of your employment can be found in your contract, which include your work responsibilities, how much you are to be paid, how many hours you are to work and what other benefits you’re entitled to. Each GP practice is different, and with that can come a wide range of contracts on offer.

In this article, we run through the most important features of your contract. Understanding these features and knowing what can and can’t be negotiated can help you make the most of your employment - and it will help if there any disputes further down the line.

Dr Murali Muniyappa, salaried GP, says: "Working as a salaried GP is a good way to dip your toe into a permanent role without the responsibilities of partnership. It still allows you the flexibility of working in other areas, whether that be within Primary Care (e.g. as a locum) or exploring other ventures outside of medicine whist still having financial security."

Do you always get a contract of employment?

It might seem like a given, but not always. It is strongly recommended that a written contract of employment is agreed and issued prior to a new job starting. Don’t wait until you’ve started working at a practice to negotiate and get things agreed.

Having an agreed upon contract means you and your employer have a clear understanding of what is expected from commencement.

What are the areas to look out for?

Some of the more obvious ones are:

• Salary

This may be given as an ‘annual salary’, or they may give a ‘per session per year’ figure (e.g. £8,500 per session per year). There are variances across the country and even in the same area you can see big ranges. BMA give a range of £60,455 and £91,229 for a nine session salaried GP in England, so don’t be shocked by what you find.* The most important thing here is that this figure can be negotiated, and it can be agreed that regular reviews take place to ensure you are paid what you are worth.

• Contracted hours

Fairly self-explanatory, but take note of any ‘extended access’ hours the practice wants you to work or any compulsory overtime.

• Annual leave 

Whilst also self-explanatory, you’ll want to take note as to whether public holidays are included.

• Permanent or fixed term contract 

Most salaried GP contracts will be permanent (i.e. there is no end date for your employment), but some contracts may just be for covering another GP’s maternity leave. This means you may only have the job for a set period of time (e.g. 12 months).

Then there are the less obvious ones:

• Indemnity

Will the practice pay for this? How much cover will they pay for? Will you have to top-up your indemnity if you do locum sessions elsewhere in addition to your salaried work?

• Sick pay

Most practices will offer some form of sick pay, but it can range from no sick pay whatsoever to six months full pay followed by six months half pay. Your sick pay may accrue with length of service, but something important to note will be the date when your ‘continued employment started’ for the purposes of your sick pay. Some contracts will treat it as being when you first joined the NHS (assuming you have no career breaks or gaps), whereas other contracts will treat your start date as when you joined that particular practice (meaning your length of service is much lower and therefore your sick pay is lower).

• Maternity leave

If you are planning on having children, you may be entitled to at least 26 weeks leave. Legally, minimum pay during this time is 90% of your average weekly earnings for the first six weeks. It will be £151.20 per week or 90% of your average weekly earnings (whichever is lower) for the next 33 weeks. That may seem low, so fortunately most practices are more generous than that and will give maternity leave in line with the BMA contract. To be eligible, you should have been continuously employed by the practice for at least 26 weeks up to any day in the ‘qualifying week’ (the 15th week before the baby is due).

• Paternity leave

Future fathers may be entitled to one or two weeks paid paternity leave. Like maternity leave, you should have been continuously employed by the practice for at least 26 weeks up to any day in the ‘qualifying week’. Qualifying week is deemed the 15th week before the baby is due.

• Notice of termination

How much notice do you have to give to leave? Four weeks? Three months? Six months? This can vary from contract to contract. Another important aspect may be if there are any restrictive covenants in the contract to stop you from working within a certain radius of the practice should you leave.

• Teaching or supervision obligations

Some practices may require you to help with the teaching or supervision of GP registrars or medical students.

All aspects of your contract can be negotiated (usually with the Practice Manager or GP Partners), but be realistic and don’t give unreasonable requests, as this may affect your future relationship with them.

Speaking with your colleagues and other experts will be useful as they may be able to give you a steer as to whether you can ask for more or not. There is no harm in asking, but remember this is a negotiation, so you should accept reasonable compromises- after all, no-one is indispensable.

What is meant by 'BMA contract'?

A lot of practices will refer to the ‘BMA contract’, which generally means it’s a good contract - although you should still check the various sections to ensure it is fair and suitable for you.

• Salary

The BMA dictate the minimum pay for a full time (nine sessions per week) salaried GP in England is between £60,455 and £91,229 (Scotland between £61,346 - £91,564 , Northern Ireland between £58,205 and £87,831 and Wales between £61,045 and £93,474).

• Sick pay

Will usually be in line with what you receive when employed by a hospital trust. This is accrued with service and after five years continuous service you should be entitled to six months full sick pay, followed by six months half sick pay.

• Maternity leave

Again, maternity leave should be in line with what you would receive if employed by a hospital trust. As long as you have been with the practice for a set period of time you should be entitled to eight weeks full pay and 14 weeks half pay, plus statutory maternity pay (currently £151.20 per week or 90% of your average weekly earnings, whichever is lower), followed by 17 weeks statutory maternity pay only, followed by 13 weeks unpaid leave.

• Paternity leave

In line with a Hospital Trust, paternity leave should be two weeks fully paid leave.

• Annual leave

In line with a Hospital Trust, annual leave should be 27 days (plus Bank Holidays) on commencement, 29 days (plus Bank Holidays) after 5 years’ service, and 33 days (plus Bank Holidays) after 10 years’ service.

This is by no means an exhaustive list. If you wish you read further into other elements of the contract you can view the BMA 'Model Contract’ online or ask the BMA to review your contract themselves.

Is there anyone who can help me understand and negotiate?

There are various people out there who can help you understand and negotiate your contract – these include the BMA, your colleagues as well as us at Wesleyan. The BMA have even published a ‘Salaried GPs Handbook’ to help you.