What indemnity cover do I need for a HUB session?
MPS define Scheduled Care as work undertaken during the scheduled opening hours of a practice (within 8am-8pm seven days a week) where registered patients are seen by appointment and where staff have access to the patient’s full general practice records. This also includes patients from other practices where there’s an arrangement to provide care during scheduled opening hours and there is access to full patient records.
Out of Hours sessions are now called Unscheduled Care sessions. These are defined as any work that falls outside the above Scheduled Care criteria, such as sessions undertaken at any time of day in walk-in/urgent care centres.
It is of course important that members are indemnified with MPS for the correct total number of weekly sessions undertaken.
If 9 sessions or more per week are undertaken, then two of these sessions can be in Unscheduled Care without incurring higher subscription charges.
If 4 – 8 sessions per week are undertaken, then one of these sessions can be in Unscheduled Care without incurring higher subscription charges.
If fewer than 4 sessions per week (involving Unscheduled Care work) are undertaken or if a higher ratio of Unscheduled Care work than that indicated above is undertaken, then higher subscription charges would apply.
What is IR35?
IR35 is an anti-tax avoidance measure introduced by the Government in April 2000. It is also known as the 'intermediaries legislation'.
Its purpose is to prevent workers from avoiding paying employee income tax and NICs (national insurance contributions) by supplying their services through an intermediary (usually a 'personal service company') and paying themselves dividends rather than as employees. The rules apply across the UK.
It is important to note that IR35 only applies where locums (or other individuals) are engaged via an intermediary. IR35 does not apply to genuine self-employed locums providing their services directly to practices.
The IR35 rules have to date required the intermediary to establish the nature of the relationship between the locum and the practice. Where an employment contract would have existed between the locum and the practice in the absence of the intermediary, the intermediary has had an obligation to pay the locum as if an employee net of tax and NIC.
IR35 changes will affect 'public sector bodies' – including general medical services and personal medical services practices and NHS trusts – who engage locums to provide services via an intermediary. Non-public sector bodies such as APMS (alternative provider medical services) providers or commercial providers that provide some out-of-hours services are not affected by the changes.
Under the new rules, the responsibility for determining whether IR35 is applicable is shifting from the intermediary to the public sector body (or recruitment agency, if it uses one to engage the locum).
This means that public sector bodies – including GMS and PMS practices – and agencies will now be responsible for deducting tax and NIC from any payments made to the intermediary supplying a locum, where they deem IR35 applies. This will require additional administration by the practice for processing PAYE as well as bearing the cost of employer NICs.
If practices do not deduct tax and NICs from a locum who should have been considered to be within IR35 rules, this could result in HMRC requesting the practice pays back any taxes and NICs due as well as penalties. These taxes could be clawed back on payments as far back as 6 April 2017 when the new rules will have taken effect.
All locums providing services via an intermediary need to be considered on a case-by-case basis – this does not mean that such locums need to automatically be paid net of tax and NICs.
In the first instance, read the BMA’s general guidance on IR35 and employment status.
HMRC has also published useful guidance on IR35 , and launched a new employment status tool for practices to determine whether any current or prospective locums would fall within the new IR35 rules.
HMRC has stated that it will stand by the result its online tool produces, unless it is based on inaccurate information.
A set of FAQs on IR35 for locums has also been written by BMA sessional GP committee member Matt Mayer.
If you are a BMA member, the BMA can provide initial support for IR35 queries, as well as general support for members with employment issues.
To speak to a BMA adviser about IR35 please call 0300 123 1233 or email firstname.lastname@example.org
As a Pallanteer, am I self-employed?
Yes – you’ll still be able to contribute to the NHS pension scheme and you are liable for your own tax and national insurance. The chambers managers facilitate all your bookings and bill the practices on your behalf; the practice writes the payment out in your name and either pays the full amount direct to you your bank account, or we’ll pay the cheque into your account for you.
What is a chambers lead?
This is a member of your local chambers who acts as your clinical governance lead. Their role includes interviewing new applicants, chairing monthly meetings and managing significant events. They receive a reduction in their chamber’s fees which equates for an honorarium for this work. If you’re interested in being, or even sharing, the chamber’s lead role then let us know.
Who selects the members to our chambers?
This becomes the responsibility of the new chambers, under the direction of the chamber’s lead. Potential members apply via the Pallant Medical website, and we advise you whether we believe there is enough work coming into the chambers to sustain a new member. The chambers lead will arrange a time to interview the new applicant and our managers will arrange for their references etc and take it from there.
Can I develop my career as a GP within Pallant Medical Chambers?
Yes, Pallant Medical Chambers take every opportunity to help you progress professionally. As a freelance GP you have the flexibility and time to develop specialist areas of interest. Also within Pallant Medical Chambers we support a range of lead posts including mentoring, teaching and taking on audit projects.
How can you help me improve my clinical governance?
There is a comprehensive system of feedback between Pallanteers and patients, practices and specialists. All feedback is handled sensitively and confidentially in the most productive way possible to ensure positive outcomes that benefit both the patient and the clinician concerned.
How do I advertise my availability to practices?
We do it for you. You are responsible for updating the Pallant calendar we allocate to you when you join, and we then advertise your availability to practices.
How is the Employer Contribution for the GPs pension calculated?
As Pallanteers are self-employed, from April 2013 the practice is now the locum GP's Employing Authority and is now liable to pay the 14.3% Employer Contribution. It is calculated on 90% of the session fees and added to the invoice. We then advise Pallanteers of this extra sum of money that they add to their monthly pension payments to the NHS pension fund.
What does it cost to be a Pallanteer?
Pallant Medical Chambers charges each member a management fee. The sheer efficiency of the chambers will ultimately lead to an increase in the number of sessions you’ll be booked for, and you will no longer have to spend time on administration and could choose to work more sessions with this freed-up time. The fee is fully tax deductible as you are self-employed. We can discuss details of our fee structures with you.
What happens regarding a Pallanteers' medical indemnity?
Pallant Medical Chambers is is considered a 'virtual practice' by the MPS, so Pallanteers benefit from their Practice Xtra scheme, so with them you’ll pay 10% less.
What if I already have work booked?
That's no problem. We will honour all your existing bookings at the rates you have independently agreed. We will place all your existing bookings in our booking system and - for no charge - we’ll do your billing and invoicing for these bookings. We actively encourage this as it allows us to build up relationships very quickly with practices near you. Going forward however, these practices will have to book you through Pallant Medical Chambers at your chambers' rates.
What would the chambers managers do for me?
Dedicated Pallant managers organise your workload and tend to the administrative duties of being a locum, such as invoicing, chasing payments. They also assist in advising you of and organising educational and training opportunities.