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Primary Care Networks - What You Need to Know About Joint Employment Contracts

on Wednesday, 01 May 2019.

The introduction of the primary care networks (PCNs) is an exciting challenge for the sector and a way for different service providers to come together and offer the public an integrated service of varied healthcare support.

This aims to improve the overall health of the public while alleviating some of the pressure on GPs and hopefully easing strains on the secondary care sector too.

Applications must be received by 15 May 2019 and for those choosing to join a PCN, there are many decisions to be made. A key consideration will be deciding who will be the employer of additional, new, and possibly the existing workforce.

We consider some of the preliminary issues with using joint employment contracts below. With VAT implications in mind, many PCNs will also be aiming to structure their practices as a Cost Sharing Group with VAT exemptions.

3 Issues with Joint Employment Contracts

The contracts of employment for shared staff will need to be carefully drafted, setting out clearly how the role and responsibilities will be divided between the practices.

  • Payroll
    Consideration  will need to be given for paying the additional staff, as well as a  practice needing to  take responsibility for HR and performance management, and staff will also need to have a point of contact and a set of policies to follow.

  • Liability
    If the risk of potential employment claims is to be shared, there needs to be a robust agreement in place between the practices to outline how any staff issues will be overseen across the PCN and all matters communicated. Cross indemnities should be considered between the practices  and appropriate employer liability insurance put in place.

    Otherwise, were an employee to be discriminated against while working in another practice, would the group of practices be comfortable being jointly and severally liable to each other for any resulting claims?
  • Vatable Supply of Staff
    You should ensure that the supply of  staff between various practices does not give rise to a chargeable supply which would be vatable. Whilst the provision of healthcare services is exempt from VAT the provision of healthcare and back office staff is not.

PCNs will need to ensure that where there is to be joint employment that such working arrangements are robust and set out the sharing terms and obligations between the various practices and the individual.

The contract of employment will need to reflect the reality of the situation and withstand scrutiny if investigated by HMRC since if they deem the joint employment contracts a sham, any unpaid VAT could become payable in full.

What Are the Alternatives?

  • Staff could be employed by the lead practice, and then seconded out to the work in the other practices. This may also cause VAT problems if deemed to amount to a supply of staff.

  • Staff could also be employed through the PCN as a separate entity. As matters currently stand, this may cause pensions issues as the PCN may not be eligible to access the NHS pension scheme for new staff.

Consulting with Existing Staff

We strongly recommend that you consult with your current workforce on upcoming changes and how they will impact on the day to day work, and that you review your employment practices as far as sharing staff are concerned.

If you have any questions regarding the employment implications of joining a Primary Care Network or would like assistance in drafting new employment contracts, please contact Michael Delaney on 01923 919 316.


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