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Four-session cap for GPs on retention scheme is removed

by Julie Griffiths
16 August 2023

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New NHS England guidance out yesterday confirms the permanent removal of the four-session cap for doctors on the national GP Retention Scheme, as promised in the new GP contract.

Reimbursement paid to practices will remain at up to four sessions. However, surgeries can now request a retained GP (RGP) do additional work provided the practice funds it themselves.

The GP Retention Scheme aims to help eligible doctors, who might otherwise leave the profession, remain in clinical general practice by offering greater flexibility (see box below).

The scheme also gives financial support to both the RGP and the practice employing them.

The programme had previously stipulated  that to be eligible a retained GP could only work a maximum of four sessions a week.

That cap was lifted during the pandemic but has now been made a fixed feature of the scheme.

The NHS England guidance, published yesterday, said: ‘From 1 April 2023, the formal four-session cap that a retained GP can work per week has been removed.

‘Reimbursement will remain for up to four sessions but this does not preclude a contractor from directly employing or engaging a member of the GP Retention Scheme, at their own expense, for service sessions which are in addition to the maximum four sessions for which the contractor is eligible for payment under the Scheme.’

The guidance also sets out that retained GPs can do paid work outside their RGP post with no upper limit.

This includes:

  • GP out-of-hours work and urgent care work
  • Other kinds of non-GP clinical work (e.g. family planning, dermatology, occupational health etc.) which allows them to retain or extend their skills outside of general practice
  • Other kinds of non-clinical work (e.g. education, appraisal, management etc.) which enables them to retain or extend their skills.
  • In-hours GP work beyond their retained GP post, in the same or a different practice

Previously, retained GPs could only work extended hours during the week or at weekends if the total number of hours worked did not exceed those in the contract with their practice.

NHS England said this flexibility had benefits such as allowing a GP to ‘test the water’ as they increase their hours and encouraging participation by those who felt restricted by the four-session cap. It could also benefit a GP moving to a new practice or to a different type of primary care work, such as a walk-in centre, it explained.

Reimbursement to practices for the four sessions by retained GPs remains the same at £76.92 per session. 

Retained GPs are still required to be embedded in one practice to enable peer support and continuity. And there is no change to the duration of the scheme – GPs can participate for five years with the possibility of a two-year extension in some cases.

As before, practices can employ more than one retained GP.

Practices must be able to demonstrate that they can meet the educational needs of the retained GP.

They should provide a named educational supervisor who is either a GP trainer, F2 supervisor or has recently accessed a suitable training course in supervision.

The change to the National GP Retention Scheme is the latest effort by NHS England to boost GP numbers by retaining those already in the workforce and enticing leavers to return.

The GP Retention Scheme is open to doctors who:

  • are seriously considering leaving, or have left, general practice due to
    personal reasons – such as caring responsibilities or their own health
    approaching retirement; or
    requiring more flexibility to undertake other work, either within or outside general practice.
  • can’t get the flexibility they need from a regular part-time role; and
  • need additional educational supervision.