Explains the benefits of working in general practice for GPs and trainees.
Who this guidance applies to
This guidance is for all general practitioners who practice in Wales under the terms of the General Medical Services contract for the Welsh NHS. It is additionally useful to medical students and foundation trainees thinking of entering general practice and those who have already started GP speciality training.
General practice offers professional variety and the ability to provide continuity of care for patients. Many newly qualified GPs look forward to flexible working patterns and the ability to work part-time. Additional levels of responsibility and autonomy are available to those who take on the leadership role of practice partner.
Working in General Practice
Wales medical performers list
To provide primary medical services in Wales, a GP must be approved by the Local Health Board. Once approved the GP will be added to the Welsh Medical Performers List (MPL).
Any queries relating to the MPL should be directed to NHS Wales Shared Services Partnership – Primary Care Services.
Terms and conditions
General Medical Services (GMS) contracts are agreed annually between the BMA GP committee (GPC) Wales and Welsh Government and NHS Wales.
Salaried GPs employed by a GMS practice must be offered a set of minimum terms and conditions (BMA model contract). It is also possible for salaried GPs to be employed on enhanced terms and conditions.
Sessional GPs (Locum GP) should agree the terms of their engagement with their employing practice or local health board. BMA members are able to access resources and obtain advice and information.
The Doctors’ and Dentists Remuneration Body (DDRB) makes recommendations on an annual basis regarding pay uplifts for independent contractor GPs. This recommendation is then negotiated between Welsh Government and the BMA’s General Practitioners’ Committee Wales (GPC Wales); this discussion can be part of the overall contract negotiation process.
DDRB also recommend pay uplifts for salaried GPs. Additionally, pay ranges for salaried GPs are set by the Doctors’ and Dentists’ Remuneration Body (DDRB) annually
Eligible GPs who undertake GMS work may be eligible to join the NHS pension scheme.
Benefits for permanent GPs
For partner GPs, annual leave is defined in the partnership agreement and is normally a minimum of 6 weeks.
Salaried GPs have annual leave defined in their contract with the practice or employing authority and this, again, is normally 6 weeks.
All eligible practice staff are able to take 2 weeks paternity leave after birth or adoption. The contract of employment, terms and conditions continue and statutory paternity pay is received.
Enhanced paternity pay is available to eligible doctors working under the GMS contract. Under this arrangement the doctor will receive full pay rather than statutory paternity pay.
A GP who is employed under the Salaried GP model contract, or a contract including the same terms, is entitled to contractual maternity pay providing that she has 12 months of continuous NHS service at the beginning of the 11th week before the expected week for childbirth.
Employed GPs who are pregnant or have just given birth may be entitled to receive statutory maternity pay (SMP) from their employer for up to 39 weeks.
Shared parental leave
Enhanced Shared Parental leave arrangements are available to all salaried GP’s. BMA Cymru Wales will be issuing communications in due course regarding the process of contract variation for practice employed salaried GPs to enable this.
Protected learning time
GP practices are able to close to the public occasionally to enable staff to learn and train.
From 2021to 2022 six funded protected learning time sessions per annum will be available and targeted at all staff within the practice.
Of the 6 sessions:
- 2 will be health board driven and will include a national training offer on care navigation
- 2 cluster determined sessions; and
- 2 sessions, content determined at a practice level.
HEIW’s CPD On Demand offers flexibility to watch all live CPD events. All resources are designed with GPs in mind, but they are suitable for other healthcare professionals.
Financial benefits for permanent GPs
The partnership premium scheme provides payments to GP partners based on the number of clinical sessions undertaken.
An annual payment of £1,000 per clinical session up to a maximum of 8 sessions per week. In addition, in recognition of the need to reward and retain our most experienced GP Partners a senior premium of £200 per clinical session for GP partners with 16 years or more service.
Eligible GPs can claim a maximum of £9,600 per annum for an average of 8 sessions worked per week.
No new applications to join the Seniority scheme can be accepted after 30 September 2019. GPs who are already in receipt of payments under the existing Seniority Scheme are able to continue on that scheme. No changes have been made to the existing scheme. However, GPs can opt to migrate to the new Partnership Premium Scheme after which they will not be able to migrate back to Seniority.
The scheme provides educational support, mentoring and a financial package to GPs using the scheme. It is designed to help keep doctors working in general practice and is an option for:
- GPs approaching retirement age
- GPs wishing to reduce their contracted hours in order to undertake other work, either within or outside of general practice
- GPs with other reasons related to personal circumstances that the LHB considers to be an acceptable reason for the purposes of the scheme.
A GP retainer may work up to 4 clinical sessions per week and is employed on the terms of the BMA model contract of employment. Each Retainer qualifies for an annual professional expenses supplement of between £1000 and £4000 which is based on the number of sessions worked per week.
Help finding permanent posts and sessional work
Locum Hub Wales and GP Wales
LHW supports the temporary sessional needs of Practices and enables GP Practices across Wales to advertise their sessional needs, and choose and book a GP Locum, who’s preferences match those of the practice, quickly and efficiently.
For Practices, LHW has significantly increased the pool of locums who are available and accessible, especially at very short notice to meet temporary sessional needs.
For permanent posts, GP Wales - permanent jobs offers an easy way to advertise all GP practice jobs from GP to gardeners, pharmacists and receptionists. Jobs advertised on GP Wales are automatically added to NHS Jobs.
Medical practice indemnity
General Medical Practice Indemnity Scheme
From 1 April 2019 a discretionary state backed scheme of General Medical Practice Indemnity provision for general practitioners on the Welsh Medical Performers Lists (MPL), their staff and those engaged by the GP practice was established.
In relation to incidents occurring on or after 1 April 2019, the health board will provide the indemnity arrangement and will be the named defendant for clinical negligence litigation rather than the general medical practice.
In order to be fully covered for the discretionary scheme
- GP contractors, all their employed staff engaged in any of the primary medical services arrangements listed by the Regulations will automatically be covered by GMPI and do not need to take any further action unless, they wish to work as a GP Locum outside of their registered practice. The National Health Service (Clinical Negligence Scheme) (Wales) Regulations 2019 (legislation.gov.uk)
- GP locums are required to join the All Wales Locum Register and either book their shifts using LHW or record the shifts worked in LHW. Locum Shifts worked in Managed Practices are covered under the Health Board contract and do not fall under The Scheme for General Medical Practice Indemnity (GMPI).
The GMPI scheme not only eliminates the cost of indemnity for Practices and Locums, but also ensures medical practitioners can be confident in receiving the protection they require to deliver their vital services in the event of any indemnity claims.
Returning and overseas qualified GPs
The NHS GP Return to Practice (RtP) programme and GP International Induction Programme (IIP) are designed to be a safe, supported and direct route for qualified GPs to join or return to NHS General Practice.
The programmes are tailored to meet individual needs, experiences, and personal commitments and offer:
- a fee equivalent to an ST3 salary
- membership of the Wales scheme for General Medical Practice Indemnity
- help towards the costs of “top-up” indemnity to cover instances involving criminal proceedings and good Samaritan acts
- help towards the costs of childcare whilst in a supervised placement on the programme. Up to £2000 pro rata (a max of £333 pro rata per month per child) under the age of 11.
- help towards the costs of social care whilst in a supervised placement on the programme. Up to £2000 pro rata (a max of £333 pro rata per month per dependent) to meet the costs of providing care to a dependent in their absence.
- reimbursement of Visa fees depending on individual circumstances
- up to 4 fully funded attempts at the assessments
- access to a dedicated account manager
- options to complete parts of the scheme before moving to Wales if you are living overseas
GP return to practice programme
The NHS GP Return to Practice (RtP) programme is designed for qualified GPs who have previously been on the GMC GP Register and a UK Medical Performers List to return to NHS general practice after an absence of more than 2 years.
The RtP programme has two pathways:
- Return via learning needs assessment for GPS who have previously worked in the NHS as a GP but have not been working for 2 years or more
- Required to undertake the learning needs assessments:
- This is followed by a tailored clinical placement of up to 6 months (whole time equivalent)
- Return via portfolio route for GPs who have previously worked in the NHS as a GP but have not worked in the UK for 2 to 10 years but instead have been working in an equivalent primary care role elsewhere
- Evidence of current clinical work is submitted in a portfolio to the RCGP panel for review
- Followed by a re-orientation placement of up to 3 months
GP international induction programme
The NHS GP International Induction Programme (IIP) is for overseas qualified GPs who have never previously worked in NHS General Practice to be inducted safely.
The IIP must be completed before GPs can be approved for full inclusion on to the Wales Medical Performers List as an independent NHS general practitioner.
The IIP has two pathways:
- Induction as a standalone application by learning needs assessment for doctors who qualified as a GP overseas or in the European Economic Area (EEA) but who have never previously worked in the NHS as a GP.
- Required to undertake the learning needs assessments:
- Followed by a tailored clinical placement of up to 6 months (whole time equivalent)
- Induction via streamlined CEGPR process assessment for GPs who qualified in Australia, Canada, New Zealand and South Africa from designated GMC approved training programmes
- Submit a portfolio of current clinical work to the RCGP panel for evaluation and approval by the GMC
- Followed by a tailored clinical placement of up to 6 months (whole time equivalent)
Tailored clinical placements
The IIP and RtP Programmes include a tailored clinical placement. During the placement the individual completes a variety of workplace based assessments (observed consultations, case-based discussions, and multi-source feedback) along with:
- Career and Educational needs review – carried out by a local GP Associate Dean
- Access to online resources – HEIW will arrange access to online resources
- Practice Taster sessions – These are short 1-5 day placements at an approved GP Further Training Practice
Results are recorded in the Structured Trainers Report logbook and once the clinical placement is completed, is then submitted to the Medical Director for a decision on whether unconditional inclusion onto the Medical Performers List is granted.
Health and Care Worker visa
All EEA nationals (except Irish citizens) and international doctors will require a Skilled Worker visa to work in the UK. Skilled Worker visa - GOV.UK (www.gov.uk)
The introduction of the Health and Care visa means that applicants in certain healthcare professions within the NHS are able to enter and work in the UK with reduced application costs and with quicker decision times on their visa application. Health and Care Worker visa - GOV.UK (www.gov.uk)
To qualify for a Health and Care Worker visa the individual must:
- be a qualified doctor, nurse, health professional or adult social care professional
- work in an eligible health or social care job
- work for a UK employer that’s been approved by the Home Office
- have a ‘certificate of sponsorship’ from your employer with information about the role you’ve been offered in the UK
- be paid a minimum salary - how much depends on the type of work you do
- usually proving that you can read, write, speak and understand English
Train Work Live
Train, work, live (TWL) is a major campaign to promote Wales as an excellent place for doctors, including GPs, to train, work and live.
The campaign is primarily aimed at medical students yet to choose a medical specialty as well as trainees coming to the end of their training, recently qualified GPs, those in the early stages of their career and experienced GPs who may wish to work differently, or return to the workforce in Wales. The campaign encourages staying in Wales to live and work.
GP speciality training - universal incentive
All doctors who begin GP training in Wales will receive a universal incentive. This incentive means they will have their first Applied Knowledge Test (AKT) and first Recorded Consultation Assessment (RCA) fee paid for.
GP speciality training - targeted incentive
In certain areas of Wales, GP trainees who start training in Wales will also be eligible to receive a targeted incentive. This will be a payment of up to £20,000 should they remain in a targeted area for the time they are in training and for one year of practice after qualification. This incentive is targeted at selected training areas within Hywel Dda University Health Board, Betsi Cadwaladr University Health Board and Powys Teaching Health Board.
GP trainees are entitled to 15 days (30 sessions) per 6 month general practice post. The entitlements are the same whether the trainee is full or part time.