Lead Employer Giovanna Edwards

1. Lead EmployerGiovanna Edwards

2. The Background • Proposal • Benefits • Risks • Recommendations

3. Background and Current Position • Currently approximately 264 GP specialty trainees supported by South West Peninsula Post Graduate Medical Education • From August 2014 there will be approximately 322 in the South West Peninsula footprint • Each trainee is currently employed by one of the 5 acute NHS trusts in the region or Partnership trusts or a general practice to which they are attached.

4. Difficulties with the current employment system; • there are differences in employment terms and conditions between practices and trusts; • due to the number of acute NHS Trusts and general practices involved, a difficulty in supporting close working relationships with the added difficulty of establishing continuity of service for the trainees; • differing policies on the management of sick leave, maternity/paternity leave, with breaks in service that can cause uncertainty about application of such policies;

5. Difficulties continued • problems associated with transfer and monitoring of information; • lack of continuity in cost and cover provided by medical indemnity due to a variety of medical indemnity suppliers used.

6. Proposal and Action • general practice specialty trainees are employed through a single lead employer for the duration of their 3 year programme; • Agreement in principal for initiation of tendering process

7. Benefits • mitigate any potential employment difficulties and problems; • provide a consistent approach for all trainees and eliminate the anomalies concerning continuous NHS employment; • to meet with the approval of COGPED; • to streamline the process for occupational health provision, enhanced criminal records bureau checks and tier two work permits which will then last throughout the length of the training programme.

8. Benefits continued: • consistent application of standardised policies and human resource practices; • a standardised and consistent induction programme; • one contract to cover the whole three-year training programme and no break in NHS service throughout their training programme mitigating problems around pensions, maternity/paternity leave, sickness benefits and cost savings around medical indemnity cover; • standardised occupational health support; • improved management of study leave and absence.

9. Benefits continued: • General Practices can concentrate on training and supporting the GP trainees rather than dealing with employment issues; • improved continuity and management of trainees who need Sponsorship for Tier 2 applications; • less employment checks for trainees as they move between rotations with resultant reduction in costs; • earlier interventions in potential employment issues.

10. Risks • the intention is for lead employer arrangements to be cost neutral, funded through bulk purchase of Medical Indemnity, however, at this moment in time this risk has not been mitigated; • there may be geographical restrictions to consider before awarding the Lead Employer Organisation in order to ensure that Lead Employer Organisation can effectively deal with all trainees’ needs irrespective of where a trainee is based;

11. Risks Continued: • all current employment organisations may not be agreeable to the plan; • there may be some trainees who wish to arrange their own individual cover; • there may be possible staffing implications for our current external payment organisation, as the Lead Employer Organisation would carry out that role.

12. Recommendations • To tender for the Lead Employer role with continuous updates on progress and viability

13. Any Questions ?