Salaried GPs should refuse overtime unless rate is agreed, advises BMA

The BMA has advised salaried GPs to refuse to work overtime unless appropriate rates are discussed and agreed within their contracts.

The union’s Sessional GP Committee and GPC England have produced new guidance for managing the workload and overtime for salaried GPs.

They developed a toolkit specifically for sessional GPs ‘as patient demand and workload in primary care continues to grow’.

The BMA said that data shows that salaried GPs work, on average, an extra 25% of their contracted hours and that overtime is ‘a leading factor in their decision to resign’.

The guidance said: ‘Overtime is a key factor in driving salaried GPs to resign from their posts, move to locum work or leave general practice as a whole.

‘Addressing this issue is therefore a matter of wellbeing, fairness and retention.’

It encouraged all salaried doctors to discuss remuneration for all periods of time whether planned or unplanned where they find themselves working beyond their hours.

It added: ‘If your contract does not contain an agreed rate for overtime which is acceptable to you, you can either refuse to work overtime or discuss and agree a rate of pay which is acceptable to you for overtime work requested by your employer.’

Sessional GP Committee chair Dr Mark Steggles said that introducing this guidance is one way that sessional GPs can better control their workload.

He said: ‘GPs continue to go above and beyond for our patients – it’s what we do. Relentless demand on our services in recent years, however, has meant that working overtime, staying late, and taking paperwork home has become commonplace – and it’s pushing many of us to the limit.

‘Introducing this guidance is one way that sessional GPs can better control their workload and work with their employer to find ways to mitigate overtime, or ensure they are being fairly remunerated for it.

‘Making doctors feel valued and supported is essential to retaining them – we’re already 2,118 full-time, fully-qualified GPs down since 2015 and it’s getting worse.

‘The fact that overtime guidance is necessary speaks to the pressures in the NHS and the urgent need for proper investment and resources in general practice.

‘We simply cannot afford to lose any more doctors, and hope this guidance, supported by our colleagues on GPC England, goes some way to encouraging the talented and experienced sessional GPs that we so desperately need, to stay in NHS general practice.’

GPC England chair Dr Katie Bramall-Stainer said: ‘GPs are a vital part of the team in general practice and work hard to support their practices across the country in delivering more than a million appointments every day. This toolkit builds on, and is a natural extension of, the BMA’s existing Safer Working Guidance.

‘It is essential that we seek to retain the GPs that we have in our practice teams, and to give all GPs, irrespective of their contractual status, access to advice and support they need.

‘We hope this guidance may encourage more open conversations where needed, about sustainable job plans and flexibility – not merely a rate card – but let us be clear: the real solution here lies with the Government in redressing years of underinvestment and making sure that general practice has the resources it needs to safely and effectively meet patient demand in the first place.’

In new guidance, the BMA also said GP practices should do a data protection impact assessment (DPIA) before enabling patient records access, and consider an opt-in model if risks identified.

Meanwhile, GP locums have been asked to consider reductions in their expected hourly rate amid a reduction in available roles, in part due to the increase in ARRS staff.