GP practices should not furlough employees and claim back part of their wages under a Government scheme designed to help struggling businesses through the Covid-19 crisis, NHS England has advised.
NHS England said practices should not need to use the Government furlough scheme because their contractual funding is protected.
And specialist lawyers warned that GP practices may face repercussions in future if they inadvertently misuse the scheme.
However, it remains unclear how practices will be able seek reimbursement for costs of long-term locum cover for staff who are unable to work as a result of the pandemic.
The Government’s temporary Coronavirus Job Retention Scheme was set up in March and enables businesses to apply for a grant covering 80% of wage costs, up to £2,500 per month, for any staff placed on paid leave for at least three weeks as a result of the pandemic.
This includes staff who are temporarily unable to work because they, or someone in their household, are shielding in line with public health guidance, or they have caring responsibilities as a result of Covid-19, including childcare responsibilities.
Information on the Government scheme website states that it ‘expects that the scheme will not be used by many public sector organisations, as most public sector employees are continuing to provide essential public services or contribute to the response to the coronavirus outbreak’.
It adds: ‘Where employers receive public funding for staff costs, and that funding is continuing, we expect employers to use that money to continue to pay staff in the usual fashion – and correspondingly not furlough them. This also applies to non-public sector employers who receive public funding for staff costs.’
However, the site also notes that ‘all employers are eligible to claim under the scheme and the Government recognises different businesses will face different impacts from coronavirus’ and that the scheme may be appropriate for public sector organisations ‘in a small number of cases’.
Some GP practices are considering applying for the furlough scheme to help cover additional costs, for example, where locum cover is needed for employees on temporary leave because they are shielding and cannot be redeployed safely elsewhere.
HMRC confirmed to Management in Practice’s sister publication, Pulse, that GP practices can use the furlough scheme the same way as any other employer, ‘providing they meet the criteria’.
However, NHS England said there should be ‘no need’ for GP practices to access the scheme and it is ‘not expecting’ them to.
Asked directly by Pulse whether GP practices could access the Government furlough scheme, and, if not, whether there would be an alternative mechanism to reimburse practices for related staff costs, NHS England declined to comment.
However, the NHS England media office explained in background information that, as NHS England has announced protection of contractual funding to GPs, practices should continue to pay their staff as normal. It added that practices should therefore not need to furlough staff and that NHS England is not expecting that to happen.
Further financial arrangements for general practice would be announced in due course, the information noted. And a bulletin to primary care on 29 April noted that NHS England was ‘share more detailed advice soon’ in regard to the furlough scheme.
The bulletin stated: ’We have received a number of queries about eligibility for the Coronavirus Job Retention Scheme from the four contractor groups. The Gov.uk website advises that where employers receive public funding for staff costs, and where funding is continuing, they are to use that money to continue to pay staff in the usual fashion – and correspondingly not furlough them. We will share more detailed advice soon.’
It added: ’Given our commitments to maintain GP practice income during the outbreak… GP practice staff who are shielding because they are at highest clinical risk from Covid-19, should continue to receive full pay. They should also be encouraged and supported to work remotely where they are able to do so, in light of the home working solutions we are facilitating.’
BMA guidance indicates that practices should not furlough staff in this situation, stating: ‘As a general rule, if the funding that is used to employ staff members is maintained, as is the case for GMS funding for general practice, then furlough will not be permitted.’
Deborah Wood, vice chair of the Association of Independent Medical Specialist Accounts and healthcare services partner at MH Moore and Smalley commented: ‘I am anticipating that NHS England / Improvement will recognise that there is an issue regarding additional costs for cover with regard to self-isolation and shielding, and will deal with this by way of additional reimbursement funding.
‘Practices should therefore discuss this with their CCGs, and only consider the furlough scheme for staff who are funded from private income sources that have temporarily ceased.’
Julia Gray, specialist in health employment law at Hempsons, told Pulse that while she was aware of GP practices considering applying for the furlough scheme, there was still some uncertainty whether they would be eligible to claim the grant, even for privately funded staff – and she warned that practices could face financial penalties or even criminal sanctions if it turned out they had used the scheme inappropriately.
Ms Gray said: ‘My view is that exclusion in the scheme guidance for publicly funded bodies is such that a GP practice is unlikely to be eligible.
‘The risks for a practice of applying for the scheme when they are ineligible are mainly that their application is rejected at some point in the future, possibly when the initial grant has already been paid, and repayment (potentially of a large amount of money) is required.
‘Worse still, the claim could be deemed to be fraudulent, which carries a potential criminal sanction. I understand that HMRC have indicated they will continue checking applications for fraud for up to five years after submission, so there is scope for problems to be stored up for the future.
‘Practices that do apply therefore need to be reasonably confident that they can justify the claim and ensure that they provide complete and accurate information in their applications.’
NHS England has stated it will reimburse practices’ Covid-19 related costs. Previous bulletins to primary care noted that, in addition to reimbursing costs of staffing Easter opening, ‘further costs incurred as a result of the pandemic will be addressed in due course’, and that ‘details of the General Practice Covid support fund will soon be shared, and additional expenses will be considered within this’.
However, so far no details have been released, leading some CCGs to provide practices with an interim payment to cover pandemic related costs, to help prevent cashflow problems.
The BMA said in an update on 27 April: ‘We… expect general practice to be provided with additional funding to meet all extra costs associated with care in the community during the Covid emergency, and that the funding will be flexible to adapt to the changes that are required.
‘We expect NHS England to release information about funding for general practice very soon.’