Introduction
The Department of Health is encouraging all doctors who are able to assist in the efforts to manage the COVID-19 pandemic, including GPs who are no longer practising. If you are willing to help and have not already responded please email us at gprevalidation@hscni.net to indicate whether this is something you would be willing to consider.
This document sets out Frequently Asked Questions to help advise you about how this will work. If you have any questions that are not answered here, please forward them to our mailbox: gprevalidation@hscni.net.
Will I be paid? If so, how much and how regularly?
GPs who return to work in GP practices will be paid in line with arrangements for locum doctors by the practice. Those working in COVID-19 Centres or Out of Hours will be paid according to their contract with the organisation.
What are the implications on my pension and tax?
What if I am post-pension?
If you are post-pension, this will not have an impact.
What will be the pension payment arrangements for staff returning to the NHS to assist in the response to the COVID-19 outbreak?
The government is bringing forward emergency legislation in response to the COVID-19 outbreak that contains important information on pension arrangements for extra HSC staff.
The legislation provides for the suspension of the 16-hour rule which currently prevents staff who return to work after retirement from the 1995 NHS/HSC Pension Scheme from working more than 16 hours per week, in the first four weeks after retirement.
The legislation also provides for the suspension of both the abatement for special class status holders in the 1995 Scheme and the requirement for staff in the 2008 Section and 2015 NHS/HSC Pension Scheme to reduce their pensionable pay by 10% if they elect to ‘draw down’ a portion of their benefits and continue working. Taken together, these measures will allow skilled and experienced staff who have recently retired from the HSC to return to work, and they will also allow retired staff who have already returned to work to increase their commitments if required, without having their pension benefits suspended.
These measures are important in allowing individuals to return to work during a critical period for the HSC with clarity around their pension arrangements.
When will these measures take effect?
The legislation will give the Government the power to immediately bring these measures into effect, if required.
What will happen when these measures are no longer needed?
A 6-month notice period will be given to staff and employers before these measures will cease to apply, at which point the relevant sections of the scheme regulations will take effect again. Staff and employers will therefore have 6 months’ notice to readjust their working patterns.
The impact of pension tax on high-earning clinicians or GPs is a big issue and a barrier to extra capacity. What are you doing about that?
The Chancellor will do this via a tax solution, as follows:
The annual allowance taper thresholds are increased by £90,000 from 6 April 2020. The taxable pay threshold rises from £110,000 to £200,000, and adjusted income threshold from £150,000 to £240,000.
However, to ensure that the very highest earners pay their fair share of pension tax, the minimum level to which the annual allowance can taper down will reduce from £10,000 to £4,000. This will only affect those with total income (including pension accrual) over £300,000.
Can I help without being in a directly patient-facing role?
Yes. There are also opportunities for non-patient facing roles.
Where will I be placed
If you have identified a practice you will be asked to make arrangements with them. If you have identified an area this information will be shared with the GP Federation managing workforce in that area, they will contact you re possible cover. You may also choose to work in one of the new primary care COVID-19 Centres or in Out of Hours.
Will returning GPs be provided with clinical indemnity cover?
The Department of Health will provide clinical negligence indemnity cover for returning GPs who do not have existing clinical negligence cover. Further information is available from gprevalidation@hscni.net.
Where do I go for more advice and support about indemnity?
We recognise that returning doctors may also want to access medico-legal advice and support, and it is the Government’s intention to ensure this is not a barrier to their return. The Medical and Dental Defence Union of Scotland (MDDUS), the Medical Defence Union (MDU), and the Medical Protection Society (MPS) have confirmed that they will provide medico-legal advice and support at no cost to their retired members who return to work on the COVID-19 response.
For retired MPS and MDDUS members this is automatic. MDU is asking retired members to complete a short form. More information for returning members is available at www.mddus.com/coronavirus; themdu.com/coronavirus; or www.medicalprotection.org/uk/articles/information-for-retired-doctors.
If I opt to see patients remotely, does this affect my indemnity?
In making the decision to consult and advise patients remotely, doctors must balance the risks and benefits and be satisfied that they can adequately clinically assess the patient remotely. Medical Defence Organisations advise doctors to make a record of the reasoning behind any decisions made and the information they give to patients in case they need to explain the approach they’ve taken later on.
Will I have to pay to go back onto the GMC register?
No, you will not have to pay to temporarily return to the GMC register.
Do I need to be on the Performers List to be able to work in a GP practice?
Yes, you will need to be on the Performers List to work in general practice, GP Out of Hours or a COVID-19 Centre. The Health and Social Care Board have put in place an expedited route to cover the COVID-19 pandemic. Please send your contact details to gprevalidation@hscni.net for more information on this process.
Will I be expected to re-do an appraisal or re-validation process?
No, this will not be necessary.
I am a retired GP who now has been given GMC registration and licence to practice. What should I do to arrange work?
Please send your contact details to gprevalidation@hscni.net and someone will be in touch.
Will I receive an induction process?
Yes this process is being organised centrally by NIMDTA and they will be in touch when you are re-admitted to the performers list.
My Access NI is out of date – does it matter?
An Access NI will be required. Arrangements are in place for a remote, fast-tracked process for this. Payment of the fee will be covered. Further information is available from gprevalidation@hscni.net.
I have a co-morbidity or am a primary carer, can I also work?
Given the increased risk of COVID-19 in those with co-morbidity and in the elderly population, we would advise this group against returning to patient facing clinical work. However, there may be a non-patient facing role that you are interested in exploring.
I have advised that I want to return/work additional sessions. What will happen next? How will I find out where I’ll be working?
Once you have registered your interest in returning to work, we will contact you to request information about your availability, geographical areas where you would be willing to work and an indication of the type of work you would be willing to do. You will then be contacted by an appropriate person from the area you expressed an interest in working in. If you have made informal arrangements with a practice these can commence as soon as you are on the performers list and have had an appropriate induction.
Will I need to learn new skills?
Induction will be provided locally by the practice/centre to which you are deployed. This will include refreshing on old skills, such as death certification and prescribing, as well as new skills such as training in the appropriate use of Personal Protective Equipment (PPE).
What if I become ill when I am working?
If you become ill while working, you should immediately inform the appropriate person in the practice or centre in which you are working and withdraw from work. If you think you may be ill due to COVID-19 you should follow national guidance in place at the time.
What if I change my mind and don’t want to work anymore – who do I tell?
If you change your mind and don't want to work anymore you should tell the appropriate person in the practice or centre in which you are working. You should also advise the HSCB GMS Team by contacting gprevalidation@hscni.net.
How long will I be needed for?
At this stage, the exact length is unpredictable. You are free to stop working at any point subject to appropriate notice.
Will I have a contract?
Yes, if working in a COVID Centre or Out of Hours. If working in a practice it will be as a locum. You will have a contract that reflects all the working hour protections, pay arrangements, annual leave entitlement and hospital inductions that are provided to new doctors.
Will you check that I don’t have coronavirus?
If you develop symptoms, national guidance for testing will be followed.
Will I be provided with personal protective equipment?
Yes, if required.
What happens if I treat patients while having coronavirus?
As soon as coronavirus is identified a GP will be withdrawn from work.
I haven’t been fit tested for the correct masks (FFP3)? Could I be asked to go into a room with a patient with suspected or confirmed covid-19?
Clinicians preparing to assess a patient with suspected COVID-19 will be given appropriate Personal Protective Equipment (PPE).
Is there specific advice for high risk chronic diseases?
People with chronic heart and lung disease have a higher risk of complications and higher mortality than the general population. We would not advise this group to return to directly patient facing roles.
Can I decline if I am asked to work beyond my clinical competence?
Yes you can. If the epidemic worsens it is likely that doctors will have to work outside their normal field of practice. When deciding the safest and best course of action in the circumstances, a GP should consider factors including what is within their knowledge and skills; the protection and needs of all patients they have a responsibility towards; and minimising the risk of transmission and protecting their own health.
Medical Defence Organisations advise that any doctor faced with clinical duties outside their clinical competence should explain their concerns clearly to someone with responsibility for providing the service to determine the safest way to proceed who should respond supportively. If they have done so and still feel uncomfortable, their medical defence organisations can advise them further. The GMC’s Good Medial Practice should be followed.
The GMC acknowledges that doctors may be anxious about context not being taken into account when concerns are raised about their actions in very challenging circumstances. Where a concern is raised about a registered professional, it will always be considered on the specific facts of the case, taking into account the factors relevant to the environment in which the professional is working. The GMC would also take account of any relevant information about resources, guidelines, or protocols in place at the time.
How would I handle patients’ requests for extra medication?
While there are currently no reported medicine shortages as a result of COVID-19, GPs may face requests from patients for extra medication to stockpile. We advise that GPs resist pressure to overprescribe and stick to existing policy on repeat prescribing unless they receive official advice stating otherwise.
Will travel be paid?
We would not be expecting to pay for home to work travel. Other travel arrangements would be set out in contracts where appropriate.
What are line management arrangements?
These arrangements would be set out in contracts where appropriate.
How will any issues be escalated?
Arrangements would be set out in contracts where appropriate