Employment issues for primary care networks

This week’s article considers some of the workforce issues for primary care networks, in particular the employment of additional roles. Hill Dickinson’s Alison Oliver and Michael Wright provide their views.

Workforce issues preoccupy primary care networks (PCNs). Employment of additional roles in general practice is a key component of the network contract directed enhanced service (DES), but there are various potential risks and pitfalls associated with employing these additional roles. Common employment models include:

• Lead practice model – where one practice employs staff on behalf of the network;
• “Flat practice” model – where the practices jointly employ staff;
• PCN company employment model – where the practices form a limited company to employ staff on their behalf; and
• Third party employment model – where the PCN practices contract with a third party organisation (such as a hospital trust or local GP federation) to employ staff on their behalf.
• Regardless of which organisation employs the staff, it is important that the practices within the PCN agree on matters such as which roles are needed and how staff resources, risk and liabilities will be shared between them. They should also have robust contractual arrangements in place with any third-party employers to ensure that they can hold those organisations to account if they fail to deliver the required service and so that roles and responsibilities of the various parties are clear.

The staff themselves should have contracts of employment with their employing organisation and their contracts should reflect any requirement to work across multiple practices. Where this involves a change to existing contracts, the process should be approached carefully to avoid legal challenge. Line management responsibilities must be clear.

Practices should consider whether they wish to adopt common employment policies and procedures across the PCN or whether the employing organisation has freedom to adopt their own policies and procedures.

Other issues that need to be considered include:

• What happens to staff if particular roles are no longer required or if PCNs cease to exist in the future
• Whether PCN staff will have access to the NHS pension scheme and how to ensure this access where required
• Whether the employing organisation is acting as an employment business by supplying staff to PCN practices and what this means in practice
• Whether a third party employing organisation is doing more than simply employing staff and trespassing into the provision of regulated activities
• Whether the primary contracting and network contract DES subcontracting requirements apply to the employment arrangements and
• Whether payments to the employing organisation are subject to VAT.

PCC is running a training session on these topics and more.

Book event

Alison Oliver and Michael Wright
Hill Dickinson LLP