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Return to Work - Keeping up to date Professionally

This section covers how to keep up to date professionally.

Performers List

Primary Care Support England (PCSE) is responsible for administering entry and status changes to Performer Lists on behalf of NHS England. The service moved to PCSE online from 2 December 2019 meaning paper, electronic/word/pdf are no longer accepted.

If off work for short periods of time, your performers list status may not change but there are circumstances you do need to inform PCSE of changes by updating online:

  • Movement to a different Area Team
  • 24 Hour Retirement
  • Change of Home Address
  • Change of Name
  • Change of Place of Work
  • Change of Status/Role e.g. becoming a partner

You can change your details whenever you like. You can track your changes as they are made, and you’ll receive an email notification when your change is complete. Full details on the new PCSE online service england/ can be found at the link from new registration to changes in details/status.

Registration process for PCSE online started on 2 December 2019. If you don’t already have access, you may need to verify your PCSE Online account. Check your junk or spam folder for a verification email. To have the email sent again, email or call the Customer Support Centre on 0333 014 2884.

Appraisal and Revalidation

Revalidation

The GMC requires that all licenced doctors who practice medicine in the UK to revalidate, usually once every 5 years. Revalidation is a formal process confirming your continued competence in all your medical roles.

Appraisal

COVID-19 – appraisal requirements have been changing since the onset of COVID-19 with the initial deferral of appraisal and then the resumption of a significantly scaled back version of appraisal focusing mainly on wellbeing. The guidance below outlines the traditional requirements but for the latest updates please email.

  • Continuing professional Development – Guidance is for 50 credits per 12 months in work. 1 credit = 1 hour of learning. If in doubt discuss with your appraiser.
  • Reflection – for GMC guidance on reflection visit their website
    curricula/guidance/reflective-practice/the-reflective-practitioner—-guidance- for-doctors-and-medical-students..
  • Quality Improvement Activities – Provide a balance of different types of QIA over the 5 year cycle including cases, events, data and feedback.
  • Significant events – GMC definition = events that reach significant level of actual or potential harm to patients
  • Patient and colleague feedback – 1 formal patient feedback exercise and 1 formal colleague feedback exercise both meeting GMC requirements per 5 year cycle
  • Review of compliments and complaints – Declaration and reflection on all complaints in which you have been named or involved must be recorded anonymising patient details. You must declare if you have not been involved in or named in any complaints.
  • Review of previous PDP – Achievements, challenges, aspirations, developmental needs for the upcoming year

Exceptional circumstances

If you are planning a break from practice it is a good idea to make your appraiser and responsible officer aware of this in advance to go through the options available to you. If volume of work is limited to less than 40 sessions in 1 year you will be required to complete a Low Volume of clinical Work Structured Reflective Template (LVCW SRT) as a QIA for discussion during your appraisal.

Mandatory training

  • BLS with AED and anaphylaxis annually
  • Child safeguarding – 12 hours overs over a rolling 3 year period.
  • Adult safeguarding – 8 hours over a rolling 3 years period

Safeguarding requirements are not set by NHS England, however the GMC require doctors to complete adequate safeguarding training; adequate is defined as ‘consistent with the Intercollegiate Guidelines’, and therefore changes whenever the intercollegiate guidelines change. Each of the documents mentioned below sets out ‘levels’ of competence and knowledge required, and the training requirement to meet these.

1. Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff development/publications/pub-007366. Fourth edition: January 2019 (1).

2. Adult Safeguarding: Roles and Competencies for Health Care Staff development/publications/pub-007069. Intercollegiate document. First edition: August 2018 (2).

Queries – Any queries about your appraiser or the appraisal process locally can be directed to the local appraisal team.

Indemnity Changes

In England, GPs, trainee GPs or locums under a medical services contract (GMS, PMS or APMS) receive indemnity for claims arising from incidents which took place on or after 1 April 2019) through the Clinical Negligence Scheme for GPs (CNSGP). This is administered by NHS Resolution. Further details can be found on their NHS website negligence-scheme-for-general-practice/ including how to report a claim.

Additional Cover

CNSGP will provide cover only for litigation by patients. You will need to maintain membership with an MDO or other indemnity provider or insurer to retain cover in respect of activities and services not covered by CNSGP. These need to be purchased separately through most MDOs including complaints, inquests, regulatory and disciplinary proceedings, employment and contractual disputes, non-NHS or private work and non-clinical liabilities.

Occurrence based cover vs claims-based cover

Most MDO indemnity products have been “occurrence based”. i.e. if you have paid for the year of (say) 2016 then that MDO will support and if needed, settle a claim for any event that took place in 2016 regardless of when the claim is made (which could be many years later).

A claims based product pays only for a claim that comes in during the year the indemnity is bought. This form of cover is usually cheaper, but it leaves the doctor exposed after the end of the indemnity year. To insure against a claim for something which happened in e.g. 2016 but where the claim comes later the doctor must purchase what is known as run-off cover.

It is important that you have appropriate arrangements in place for all aspects of your clinical practice. If you are unsure then you should contact your existing indemnity provider or insurer to check.

For full details and further guidance on specific roles please visit the BMA website practitioners-committee/gpc-england/gp-contract-agreement-england/gp- indemnity-overview.

IR35 Rules

The off-payroll working rules

The off-payroll working rules can apply if a worker provides their services through an intermediary but would be an employee if contracting their services directly. The intermediary would usually be the worker’s own personal service (limited) company, a partnership, a managed service company, or an individual. These rules are sometimes known as ‘IR35’ they apply to:

  • a worker who provides their services through their intermediary
  • a client who receives services from a worker through their intermediary
  • an agency providing workers’ services through their intermediary

If the rules apply, tax and National Insurance contributions must be deducted from fees and paid to HMRC.

When the rules apply

You can use the link to help you decide if the off-payroll working rules apply.

For public sector clients, it’s their responsibility to decide your employment status. For private sector clients, it’s your intermediary’s responsibility to decide your employment status. From April 2020 onwards medium and large sized private sector clients are responsible for deciding if the rules apply.

It is recommended for locums to check employment status for each new practice using the HMRC form.

GP Pensioning

PCSE online is responsible for managing the following GP pension processes:

  • Respond to GP pension queries
  • Receive estimates of profit for principal and non-clinical partners, salaried GPs to determine contributions and tier rate
  • Receive GP year end actual profit certificates on NHAIS
  • Record solo and locum forms on NHAIS
  • Make deductions from remuneration
  • Process refunds or additional payment requests via NHAIS monthly
  • Update members’ records on NHAIS and via NHS Pensions Online or manually for joiners, updates, leavers and retirements
  • Obtain pension estimates and confirm membership as required
  • Process retirement applications
  • Liaise with widows/widowers for death benefits applications
  • Administer additional pension applications for practitioners
  • Receive and process cheques, send to NHS SBS for banking and send remittances to stakeholders
  • Receive and process form A and B from Locums
  • Receive and process GP Solo form from GP’s
  • Recover employee pension contributions from the GP registrar payment (in specific areas)

Universal online enquiries form for any pension query

For Locums

GP locums pensioning for GMS, PMS, APMS or appraisal NHS work should:

  • Complete part 1 of the GP Locum A form and send with invoice to the GP practice to sign and pay.
  • Locums should also complete Locum B form and make the appropriate payment using the specified reference number (see link below)
  • Submit A&B forms to the PCSE online enquiries form using appropriate reference number.
  • Deadline is 10 weeks from the last day worked during a period of engagement to claim. Further details can be found on the PCSE website.

Freelance GP locums in NHS Pension Scheme terms are those working under a contract for services and deputising for an absent GP or engaged on a temporary basis. Type 2 medical Practitioners must be employed or engaged under a more permanent basis by the practice.

As you would no longer complete forms A and B, the surgery would inform PCSE of your estimated income and collect scheme employee contributions directly from you. They would then forward these plus employer contributions directly to PCSE. At year end you would have to complete the Type 2 Medical Practitioner self- assessment form.

For everyone

Every year, GPs are required to submit either a Type 2 Medical Practitioner Self- Assessment of Tiered Contributions Form or Annual Certificate of Pensionable Profit Certificate. Practices are required to submit Estimate of GP (and non-GP) Providers.

NHS Pensionable Profits/Pay

The table summarises what needs to be completed, by whom and the deadline for submission.

These forms are required so that PCSE can make any necessary adjustments to ensure the correct pension deductions are made from your practice in the following financial year (from April).

NB – if off on maternity leave you may be asked to complete an additional maternity leave form. Once complete, please submit these forms via the online enquiries form or post to Primary Care Support England, PO Box 350, Darlington, DL1 9QN.

A full guide to the pensioning process can be found on the NHSBSA website.

Total Rewards Statements

TRS are available to NHS Pension Scheme members working in NHS organisations who use the electronic staff record system (ESR). It provides an overview if your pension benefits each year. The statements are released in August each year and rely on employers providing up to date information to NHS pensions by 31 May.

A TRS summarises an individual employee’s employment package, including:

  • basic pay
  • allowances
  • pension benefits for NHS Pension scheme members

You can access your statement online through ‘ESR employee self-service’ or ‘GOV.UK Verify’ or telephone 0300 330 1351.

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