BMA Model Contract for Salaried General Practitioners

I am writing to all colleagues to clarify the contractual position in relation to the use of the BMA Model Contract when employing Salaried General Practitioners, following a number of queries the Office has received.

I should also note the LMC cannot provide formal HR Advice and because of the liabilities that may be incurred, the LMC recommends that if any HR issues are not straightforward, or are challenged in a way that may have merit, practices should obtain an HR opinion.

The GMS Regulations state:

15.4. Terms and conditions

Standard General Medical Services Contract

15.4.1. The Contractor may only offer employment to a general medical practitioner on terms and conditions which are no less favourable than those contained in the document entitled “Model terms and conditions of service for a salaried general practitioner employed by a GMS practice” published by the British Medical Association

Under the Interpretation to the Regulations, a General Medical Practitioner is defined as:

“general medical practitioner” means a medical practitioner whose name is included in the General Practitioner Register kept by the General Medical Council under section 2 of the Medical Act 1983.

Colleagues should note that, in the past, PMS Contractors were not required to offer the BMA Model Contract, but this changed several years ago, and the same provisions are included in the PMS Contract. APMS Contract holders, and other employers, such as for example, OOHs services, are not required to offer this Contract to employees, although are encouraged to do so. It would be open to a salaried GP, or for example, an HR representative, to raise this as an issue with the ICB.

The term “no less favourable” is not further defined but is usually taken as acknowledging that some degree of mutual negotiation may occur between the practice and any potential employee. This may be influenced by, for example, the specific expertise of the GP, practice expectations of the role, and other general factors. The LMC does not offer a Contract Review service and would signpost GPs to the BMA Industrial Relations Officers service for any specific queries. However, terms which if altered or omitted are likely to be regarded as “less favourable” would in the LMCs view include: length of NHS service start date; DDRB salary uplift entitlement, sickness, parental and holiday leave, and if applicable, London Weighting payment. This list is not exhaustive or determined by precedent but is the advice the LMC has provided salaried GP colleagues as examples. Other elements in the Contract may be more readily open to negotiation.

A GPs Job Plan is separate to their Contractual Terms and Conditions and should describe the way in which the GP undertakes their working responsibilities; this could be discussed at an annual appraisal.

Practices not offering the terms of the BMA Model Contract should consider if any
modifications made are counterbalanced by other negotiated features, which could include the salary paid within the Salaried GP salary range, published by the BMA annually and for 2024/25 is £73,114 to £110,330 with a FT being 37.5 hours [nine nominal sessions of 4 hours 10 minutes each].

Colleagues are also reminded that under the Equality Act 2010, it is generally illegal to pay employees differently when undertaking the same job if this difference is based on protected characteristics, such as age, gender, and race. This does not mean employers must pay all employees, such as salaried GPs, the same rate, because different pay rates may be justified by factors related to experience, qualifications, performance in the role, and market conditions, such as difficulty recruiting, providing these can be evidentially demonstrated. The Equality Act also applies to benefits such as holiday pay, sick pay, and pension benefits, although if using the Model Contract these will be the same for all employees.

Although not part of the BMA Model Contract, the LMC would also encourage all practices to make the BMA Safe Working Guidance a part of any discussions around the GP’s Job Plan.

I hope this background is helpful.

Dr Julius Parker, Chief Executive