Sharing staff across a network

The concept behind primary care networks is to bring practices together and work in an integrated way across Directed Enhanced Services (DES). The payments for DES include staff, so they will be working across the practices and different employers.

Published in Practice Management 12 Jun 2019

The Mandatory Network Agreement, published by NHS England and the British Medical Association, available here, does have a section on sharing of staff. It states in clause 27: ‘We will each have individual responsibility for our own staff.’ There is then reference to Schedule 5, in which each network can set out its own arrangements, which is left blank.

Anyone who has run a practice will know that there are plenty of traps for the unwary in employment law. These are accentuated when sharing staff with others.

To begin with, you are going to have to consider who will be the employer of the network staff. Will it be one of the practices, or a company or partnership you have formed for the network, or it will be your GP federation or the NHS Trust or someone else?

Having agreed that, who will decide whom to employ? Your network governance arrangements should cover how decisions are reached and, therefore, the type of person to be recruited, and also the procedure to interview candidates and make the appointment. The agreement will also have to cover procedures for:

  • Performance reviews
  • Disciplinary procedures
  • Grievances
  • Leave arrangements, including annual leave, family-friendly leave without prejudicing other network members Varying the terms of employment, but will this require the consent of the other members?
  • Dealing with redundancies and meeting any payments
  • Dealing with any claims, and what if those claims arise when the employee is at the practice of another network member?

The above illustrates that you will also need to consider indemnities from the other network members.

To limit the risk of employment issues arising you will need to consider the parameters of the actions of the other network members; for example, stating that they will not deal with any employment issues or reprimand the employees but report any such matters to the HR person of the employer. If there is a disagreement as to liability, you will want to have a dispute resolution procedure to avoid having to make a claim in court.

In addition, the employer needs to consider the overall risks and, if it is not a practice, ensuring eligibility for NHS pension provision, Care Quality Commission (CQC) registration, and medical negligence indemnity insurance and that there will not be VAT issues.

The Mandatory Network Agreement does not cover arrangements for sharing of staff and the detail needs to be worked through and terms agreed before 1 July when the networks go live.