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• General Practice Handbook

GPST contract

Who is my employer.

NES will be your employing organisation as the Lead Employer for all GP Trainees on the Grampian GP Specialty Training Programme. You will therefore be employed by NES as the Employing Board for the duration of your GP Training programme as you rotate through placements within hospital and general practice settings.

Which terms and conditions apply and when?

a. The contract of employment for your hospital placements (“the Hospital Contract”);

When in hospital placements, your employment will be subject to the Hospital Contract and the Terms and Conditions of Service of Hospital Medical and Dental Staff and Doctors in Public Health Medicine and the Community Health Service (Scotland) as amended from time to time (“the Terms and Conditions of Service”). You will be provided with a new Placement Details letter in advance of each hospital placement which will confirm your place of work, working pattern and the banding of the rota.

b.  A model contract of employment, used in Scotland for General Practice placements used in Scotland (“the BMA Model Contract”).

When rotating into General Practice your employment will be subject to the terms and conditions, or no less favourable terms and conditions set out in the BMA Model Contract for GP Specialty Registrars working in General Practice (COGPED) as amended from time to time.

In advance of each General Practice placement, you will be provided with a completed GP Placement Detail letter setting out the terms of your placement. You will also agree your working pattern with your Educational Supervisor, as at Appendix 2 of the enclosed BMA Model Contract.

Does my previous NHS service count towards continuous employment with my lead employer?

In accordance with the Employment Rights Act 1996, previous employment with the Employing Board immediately prior to taking up this appointment counts as part of your period of continuous employment. However, for the purpose of certain NHS conditions of service, previous NHS service not treated as "continuous” under the provisions of the above Act, may be reckonable for certain purposes under the Terms & Conditions of Service.

What is my job title?

You are employed as a GP Specialty Trainee. Your duties will depend on the nature of your rotational placements. The duties will differ between primary and secondary care settings.

What is my hospital during hospital placements?

When in hospital placements, you will receive a pay banding supplement in addition to your basic salary, assessed in line with paragraph 22 of the Terms and Conditions of Service. You have been provided with confirmation of your current pay banding supplement and this is confirmed at clause 1 of the attached Hospital Contract.

Pay band supplements may alter in light of changes in the working patterns in future rotational posts. Your total pay may therefore vary between placements. Further information about salary is contained at clauses 3 and 4 of the Hospital Contract.

You will be informed of your rota and pay banding supplement in advance of or on commencement of each subsequent hospital placement by the provision of a Placement Detail letter.

What is my salary during placements in general practice?

When in General Practice placements, you will be entitled to a 45% supplement on top of your basic salary (the GP Supplement), plus a motor vehicle allowance, as detailed in clause 6 of the BMA Model Contract.

If your base salary is incorrect, then it will be amended by NES on proof of previous service (e.g. recent payslip).

What is my working pattern during placements in General Practice?

You will agree your working pattern with your educational supervisor as at Appendix 2 of the enclosed BMA Model Contract.

Further information about working patterns in General Practice is set out at clause 8 of the BMA Model Contract.

What is my sick pay entitlement?

Your entitlement to sick leave and sick pay for hospital placements is detailed in paragraphs 225-244 of the Terms and Conditions of Service and is referred to in clause 15 of the Hospital Contract. Sickness absence will be managed by NES in accordance with NHS Grampian Attendance Management Policy.

For General Practice Placements, please refer to clause 20.4 of the BMA Model Contract. Sickness absence will be managed by NES in accordance with NES Management of Sickness Absence Policy .

Subject to you complying with the appropriate Policy reporting requirements and statutory notification requirements relating to Statutory Sick Pay and Medical Certificates, you will be entitled to receive remuneration, inclusive of Statutory Sick Pay for a limited period in line with your contractual rights outlined within your Terms and Conditions of Service and BMA Model Contract.

You have an obligation to inform your supervisor at each placement, at the earliest opportunity, and ideally before the start of your normal working day/shift, of any temporary absence due to sickness or otherwise so as to enable the placement within which you are based to arrange emergency cover.

You will be required to complete a self-certification form from the first day of sickness. If your absence continues beyond the seventh day, you will be required to submit a medical statement from your doctor to the placement Board Medical Staffing/ HR. Further statements are required if the sickness continues beyond the period stated on the initial medical certificate.

If you become aware that you or any member of your household is suffering from any infectious, contagious or notifiable disease, you should immediately notify your supervisor at the placement within which you are based.

What medical indemnity cover will I have?

Whilst undertaking training within both hospital and General Practice placements, you will be covered by Clinical Negligence and Other Risks Indemnity Scheme   (CNORIS) indemnity against claims of medical negligence. However, in certain circumstances, such as involvement in criminal proceedings and performance procedures including GMC hearings or where you are providing services for which you receive a separate fee, you will not be covered by this indemnity. In these circumstances, we would advise that you maintain membership of a medical defence organisation to support you with this element of cover.

Where can I find out more about travel expenses during placements in general practice?

You are expected to claim all expenses through the NES expenses processes. When in General Practice placements, you will be entitled to additional travel expenses, details of which are set out at section 18 of the BMA Model Contract.

How will grievances be dealt with during my employment?

If you have a grievance in connection with your employment, you should normally notify your supervisor who will take such steps as necessary and who will follow NES’ grievance procedure (as amended from time to time). The nature of the grievance will have a bearing on who leads the grievance. When the grievance pertains to pay or terms and conditions, NES will lead the grievance process. When a grievance relates to a local issue, the placement Board/ practice may lead the grievance process, feeding back information and outcomes to NES, with NES representation on the panel where appropriate.

Disputes relating to education and training will still be referred to the Director of Postgraduate General Practice Education as appropriate.

Banding appeals will be led by the placement Board.

What are my obligations in relation to confidentiality?

As a doctor in training the care you give to patients must:

• be responsive to their needs,
• be equitable,
• respect their human rights,
• challenge discrimination,
• promote equality, and
• maintain the dignity of patients and carers.

As part of your contract you must understand, accept and agree to be bound by the principle of confidentiality and safeguarding of patient records data as detailed in your contract (Hospital section 18; General Practice section 15). You are required to take all reasonable precautions to ensure that any personal data concerning patients, will be kept confidential. Patients must not be discussed with other professionals outside the clinical setting, except anonymously. When recording data or discussing cases outside the clinical setting patients should not be identifiable by others. All confidential data, including electronic, must be used in accordance with employer and placement Board Policies and Procedures ensuring data is created, used and managed securely.

How do I raise concerns?

Concerns should be raised at an early stage with the Employing Board or Placement Board as appropriate.

Further details on Whistleblowing including policies and processes, and confidential contacts of the Employing Board and the Placement Board can be found here . This does not affect your rights under the Public Interest Disclosure Act 1998.

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GP Trainee – Travel Expenses

In July 2019, NHS Employers, the British Medical Association and Department of Health and Social Care (DHSC) agreed to introduce provisions in the terms and conditions of service for NHS Doctors and Dentists in Training (England) for additional mileage/expenses for GP trainees.

GP trainees who use their personal vehicle for home visits during their placements can claim mileage expenses for all mileage incurred.

GP trainees can also claim mileage expenses for their normal home to base journey on days that they perform home visits or are expected to perform home visits.

GP trainees in England employed under the 2016 TCS (terms and conditions of service) have the below entitlement to home to base mileage:

• able to claim home to base mileage for any day on which the practice expected them to have their vehicle available to to do a home visit
• able to claim mileage expenses for one full return journey from their home to their place of work – minus any excess mileage expenses that the trainee is receiving for the same journey
• mileage will be reimbursed at the reserve rate, 28p per mile, as stated within the NHS staff handbook.

Read more about this in on the NHS Employers webpage  2016 TCS  and also on the  BMA  website.

Tax arrangements

Unless you are employed under a lead employer contract and therefore covered by a HMRC exemption, you will be required to pay tax on all home to base mileage expenses you receive, as this is considered to be ‘ordinary commuting’ costs.

Your employer should:

• complete a P11D form for the Inland Revenue detailing this, and that any tax owing will be taken out of the trainee’s tax and national insurance contributions the following year, or
• have payroll software that can do the tax calculations for them as they go along
• keep a record of any mileage claims for up to six years for tax purposes.

Further information on the  P11D form can be found here

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What can doctors claim tax back on?

• By Ed Cantelo
• on April 10, 2024
• | Most popular , Working tax efficiently

Junior doctors can claim tax back on GMC, BMA, MDU, MPS, Royal college and examination expenses amongst other professional expenses, reducing the costs by up to 45% (48% in Scotland). But many of us doctors aren’t sure what you can claim, how to claim and how many years previous you can claim for.

Medics’ Money is run by Dr Tommy Perkins, and Dr Ed Cantelo, who is not only a GP but also a Chartered Accountant and Chartered Tax Adviser.

You can download our free step by step guide for doctors here to claim yourself, online for free.

What can junior doctors claim tax rebates on.

The most important point is that what you can claim depends on your employment status. The information in this article is for junior doctors on a training contract or recently qualified GP or Consultants. If you have been a Consultant, GP, Salaried GP, GP locum or locum doctor for a while the rules on what can be claimed are different and we would strongly advise using a specialist medical accountant.

Is there a list of what doctors can claim tax rebates on?

We’re often asked if there’s a definitive list of what doctors can claim tax rebates on. There isn’t as such, but HMRC does have a list of professional bodies approved for tax relief (List 3). Our free tax rebate guide helps you search this list so you claim back as much as possible. You can download your free guide here .

However List 3 isn’t very intuitive to search. For example the GMC appears in the M section as “Medical Council General”. Similarly, the BMA appears in the M section as “Medical Association British”. This makes it tricky to use, but our free guides give you speciality specific guidance on what you can claim to make things easier.

It’s important to realise that what you can claim depends on your employment status and if you are Self-employed or working via a Limited company we would STRONGLY advise you to use an accountant.

Join 30,000 doctors and receive free, exclusive, financial CPD for doctors in your inbox.

Medics’ Money is run by doctors and finance experts, for doctors. Our free financial CPD gives you all the knowledge you need to take control of your finances.

How many years can I claim for?

HMRC impose strict time limits for claiming back tax – 4 previous tax years, listed below, plus the current tax year from 6th April 2024 to 5th April 2025.

Start your claim today by downloading our free step by step guide to claiming tax rebates for doctors .

Do i need receipts.

Not to make your claim, but in the event of any queries by HMRC you need to be able to produce receipts. However most of this information can easily be obtained. For example if you log onto your GMC account then click “My Account” and “Payment History” all your GMC fees receipts are there. Download our step by step guide to reclaiming tax here which shows you how to find receipts easily.

What cannot be claimed?

There are some expenses that you may have incurred which you cannot usually claim for. These include, among other things, the following:

• Fees incurred for continuing professional development such as courses; if you have a trainee contract which specifically states you are required to complete specific training this may be allowable. If you are unsure and have spent a significant amount it would be worth getting advice from a specialist medical accountant.
• Fees which your employer has paid for you, for example through your study budget
• Fees for revision courses for exams or any expenses in connection with studying
• Fees for any diplomas taken that are not a requirement of you completing training. Examples would include botox training etc

If you have a significant amount of expenses that you’re not sure you can claim, we would recommend using a Medics’ Money accountant to maximise the amount you claim.

Is it worth claiming? YES

Get an instant estimate of how much you could save using our free rebate calculator.

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• Doctors in training

Funding arrangements for the payment of relocation and expenses

New national arrangements for the payment of relocation and expenses for doctors in training have been agreed and are in force from 1 November 2020.

We have been working closely with the BMA and other stakeholders on a policy which aims to bring a single, consistent approach to relocation and expenses payments. This policy will replace the existing 13 individual funding arrangements that currently exist across the country. 

The new system aims to provide consistent approach to supporting to all trainees across the country who face the financial costs of moving house to take up training and who are disadvantaged as a result of training programmes which cover large geographical areas. There is however, recognition that each region has different geography and travel systems and so there is some flexibility within each region to address this in terms of toll charges and public transport costs.

Read more in the documents below.

FAQs - Relocation as at 24/05/2023

Q1. Can I backdate my travel and relocation claims to 5th August 2020, when I started?

A1. No, claims are eligible from the relevant implementation date, (please see paragraph 1 of the framework).

In this case, the implementation date for trainees who commenced training in August 2020, was 1st November 2020. Eligible claims could be made from that date onwards.

Implementation for all other (existing) trainees will be agreed on a region-by-region basis.  Please refer to your employer if you have a question about the implementation date that applies to you.

Q2. Where a training programme includes placements outside of the local office or region which relocation policy applies?

A2. HEE has agreed a framework for the arrangement of payment of relocation and associated travel expenses for doctors, dentists and public health trainees in accredited HEE training programmes.  However, it is the employer that is responsible for implementing the policy and administering claims and therefore trainees should liaise with their employer when making any claims.

Trainees should note that the framework only applies in England, if their training programme includes placements in the devolved nations they will need to follow the local policy.

Q3. I am training Less Than Full Time, meaning my programme will be longer than 8 years. How much can I claim?

A3: The maximum sum is based upon an assumption of 8 years reckonable service in any approved HEE training programme.   Trainees who exceed this period of training (for example trainees whose CCT is awarded after completion of ST7/8 and trainees working less than full time) and who have exhausted the £10,000 maximum allowance will be entitled to continue to claim for excess mileage and/or removal expenses (paragraph 14).

The amount available over the £10,000 limit will be assessed on an individual basis, subject to the requirements of placements and personal circumstances, at the discretion of the Postgraduate Dean.

Q4. I have previously made Relocation claims up to the limit of £8,000. Can I continue to claim now that the budget limit has increased to £10,000?

A4: Yes, if you believe you are eligible, you can now submit a request for claims up to the remaining £2,000 of your allowance. Applications must relate to new expenses incurred from the Framework implementation date onwards (this will vary in each region). No retrospective or previously-rejected claims will be approved.

Q5. During my training, I have moved from region to region, am I entitled to reset   the allowance and have a further GBP 10,000?

A5. No, the 10,000 is cumulative over entire period of PG Training from foundation to CCT.

Q6. Can a trainee who lives outside the HEE regional footprint claim excess mileage or temporary accommodation allowance?

A6. Yes, provided the majority of placements on their training programme are within reasonable commute from their home. This will be deducted from the maximum allowance.   Eligibility for temporary accommodation for placements not within a reasonable commute would need to agreed by the PG Dean on an individual basis, and will be taken from the trainee’s maximum allowance.

Q7. Can a trainee claim in their final year of training for relocation costs (house sale costs, removals) when they have chosen to move closer to the placement hospital, but this was not required e.g. the rota does not include on-calls? 

A7. There is no stipulation in the framework that negates relocation in the final year of training.  However, any relocation should be clarified for eligibility prior to submission and if the employer assesses there is no requirement to move to fulfil clinical commitments, then this would not be supported.  Trainees will not be expected to profit materially in relation to relocation and associated expenses.  The trainee would still be eligible to claim any applicable excess mileage.

Q8. Are trainees who move regions as a result of an inter-deanery transfer eligible to claim relocation and associated travel expenses?

A8. Yes.  Trainees who move as a result of an inter-deanery transfer are eligible for relocation and associated travel expenses, provided they have not exhausted their entitlement.

Q9. Are trainees on OOP eligible to claim and who pays?

A9. Trainees who are deemed to be out of programme (OOP) will not be eligible to claim relocation, temporary accommodation or excess mileage payments whilst they are out of programme but may claim expenses in order to support them returning to their training programme. The exception to this is trainees on approved OOPT (Out of Programme for Training) experience.

Trainees who are OOPT are eligible under this framework, providing they are working in an NHS setting within England.  Eligible trainees should make claims via their employer.

Arrangements in the devolved nations would need to be agreed with the relevant provider.

A trainee on an OOPT in any non-NHS setting is NOT eligible under this framework.

Q10. Where a trainee is on an academic programme, such as a Clinical Lectureship, and employed by a Higher Education Institution are they eligible for relocation and associated travel expenses?  If yes, how do they make a claim?

A10. As detailed in paragraph 9 of the framework, trainees on academic training programmes are eligible.  Where a trainee is employed by a Higher Education Institution they should liaise with their regional/local office regarding the process to submit claims.

Q11. Can I claim for rail fares or season tickets?

A11. No, if you are using public transport for journeys, you can claim expenses based on the equivalent mileage at the reserve rate (paragraph 35). For trainees not on the 2016 contract, the public transport rate applies.

Q12. Can I claim reimbursement of taxi fares, from public transport hubs (e.g., railway stations) to the Trust or other placement site?

A12.   No, if you are using taxis or public transport for journeys, you can claim expenses based on the equivalent mileage at the reserve rate (paragraph 35). For trainees not on the 2016 contract, the public transport rate applies.

Q13. Where a trainee travels to their place of work using public transport how do they claim expenses when receipts are not available? 

A13. If you are using taxis or public transport for journeys, you can claim expenses based on the equivalent mileage at the reserve rate (paragraph 35). For trainees not on the 2016 contract, the public transport rate applies.  Receipts are not required.

Q14. Can I claim reimbursement of any parking charges which have been incurred?

A14. No, under the Framework, (paragraph 34), trainees are not eligible to make a claim for the cost of parking.

Q15. Can a trainee who owns a property outside of the HEE regional footprint, with no intention of selling and the majority of their placements are not within a commutable distance, make a claim for temporary accommodation costs?

A15. No - the trainee is not entitled to claim in these circumstances, (please see paragraph 33). 

Exceptional personal circumstances referred to in paragraph 33 are subject to the agreement of the Postgraduate Dean or nominated deputy.

Q16. Can I claim excess mileage to my first placement?

A16. Yes, provided you are eligible and your home to place of work is more than 17 miles each way and you are not on a single site training programme.

Q17. Will I be taxed on reimbursement of removal or rotational travel expenses such as mileage?

A17. Expenses used for removal/relocation are exempt from income tax as per the relevant HMRC guidance, however excess mileage claims may be subject to tax. Trainees should clarify their personal position with their employer.  (Please see paragraph 15).

Further guidance is available on the HMRC website at https://www.gov.uk/expenses-and-benefits-relocation . 

If you have any queries regarding tax please speak directly to your employer and/or HMRC as none of the team at Health Education England, are qualified to provide advice on tax or national insurance contributions.

Q18. What constitutes ‘accommodation’ costs?

A18. Accommodation costs is rental costs only. It does not include any other related costs such as utility bills and council tax.

Q19. What is the current mileage rate? Is it still 28p/24p pre 2016 contract?

A19. All trainees are on NHS T & Cs now so the rate is standardised – for full details see link .  The exception is any trainee who is on pre-2016 T&Cs where different rates will apply.

Q20. Are trainees appointed to single-site training programmes eligible to claim excess mileage?

A20. No, trainees on single-site training programmes are not eligible to claim excess mileage.  They are expected to live within a reasonable commute (less than 20 miles) of the place of work.

Q21. Where a trainee works night shifts and is concerned about their health & wellbeing, are they eligible to claim temporary accommodation, where the travel from principal place of work to home is excessive.

A21. Yes, the cost of reimbursement for temporary accommodation is part of the maximum relocation allowance and will need to be agreed prospectively with the employer.

Please refer to paragraph 40 of the framework

The maximum allowable costs are outlined in Appendix 3: Temporary accommodation allowance rates.

Q22. If a trainee following a night on-call is not able to drive home as it is deemed unsafe, is the Trust responsible for providing appropriate rest facilities and covering related costs?

A22. This is the employer’s responsibility and is not part of the relocation framework.

Please refer to schedule 13, paragraph 10 of the Terms and Conditions of Service for NHS Doctors and Dentists in Training ( https://www.nhsemployers.org/system/files/media/NHS-doctors-and-dentists-in-training-eng-tcs-v9_0.pdf )

Q23. Where the employer requires a trainee to undertake work away from the principal placement, e.g. a community based clinic, are trainees entitled to claim for standard business rate from base to community clinic?

A23. This is the employer responsibility and is not part of the relocation framework. Please see Section 17: Reimbursement of travel costs in the NHSE Terms and Conditions of Service Handbook

Q24. Please could you clarify the statement that the maximum excess mileage claim of 53 miles each way per day but a total journey of 70 miles each way?

A24. The 53 miles maximum excess mileage claim is because there is a deemed reasonable daily commute of 17 miles each way before excess mileage can be claimed and an overall “safe” each way journey of 70 miles.  So, if you deduct the 17 miles from the 70 miles you get 53 miles maximum claim.  Travelling further than 70 miles each way needs to be agreed by the employer and the PG Dean.

Example: Home to trainees principal place of work is 70 miles each way.  The trainee is eligible to claim for 53 miles each way, because 70-17=53.

Q25. As an employer when approving applications referring to relocation, how would I know if the trainee’s post lasts a minimum of 2 years?

A25. Most training programmes are a minimum of 2 years.  You may be able to view the programme or curriculum end date on TIS.

Q26. I am a trainee who has been recruited to F2 Standalone Training programme and am relocating to England from overseas.  May I submit a claim under the framework for travel/relocation costs from point of entry to my training programme destination?

A26. The framework states:- Provided trainees meet the criteria to relocate to take up appointment of a training post which lasts a minimum of two years or who have to rotate to different geographical areas as part of their training programme they may make a claim.  So, if the training programme is less than 2 years and there is no requirement to relocate to different geographical areas then you are not eligible.  If your training programme is in a different region to the one where your UK port of entry is located and more than 70 miles from port of entry then you are eligible to claim.  You can claim these travel expenses based on the mileage at the reserve rate. 

Q27. I am a trainee relocating from Wales. Are my previous excess travel expenses and legal costs taken from the allocated £10k?

A27. Any reimbursements take effect from the border between England and Wales.  You would not be expected to take any costs, which were incurred in Wales, from your £10k, only costs that were incurred from your point of entry into England.

Q28. What financial assistance is available where a trainee is required to undertake a short placement out of region to gain a competence / capability that is not available locally. 

A28. There may be tax implications when undertaking a short placement out of region. Such placements may be undertaken as an honorary attachment / secondment in a Trust outside of the training programme’s geographical footprint and the trainee should discuss with their local office what the arrangements are to undertake such a placement, including the financial assistance available which is not covered by the relocation framework.

Q29. I am a trainee who has been recruited to F2 Standalone Training programme and am relocating to England from overseas.  May I submit a claim under the framework for travel/relocation costs from point of entry to my training programme destination?

A29. The policy states:- Provided trainees meet the criteria to relocate to take up appointment of a training post which lasts a minimum of two years or who have to rotate to different geographical areas as part of their training programme they may make a claim.  If your training programme is in a different region to the one where your UK port of entry is located then you are eligible to claim.  You can claim these travel expenses based on the mileage at the reserve rate (see paragraph 35).

Q30. Can a postgraduate doctor or dentist who has previously owned and sold a property, and then relocates, be considered as a first-time buyer?

A30. In line with the Government definition of a first-time buyer, a first-time buyer would not apply to a postgraduate doctor or dentist who has previously owned a property.

Q31. Can a trainee claim expenses for both relocation and excess travel?

A31. Yes, but please refer to paragraph 22 of the framework and the requirement to be within a ‘reasonable commute’ of the majority of the anticipated prospective hospitals / placements on the training programme to be eligible for relocation expenses. If your place of work then exceeds 17 miles each way you may claim excess mileage.  Both relocation and excess mileage claims will be subject to the maximum expenses limit of £10,000.

Q32. Can a trainee claim for travel expenses and temporary accommodation expenses?

A32. Please refer to paragraph 39 of the Framework. Travel expenses would not be paid on top of temporary accommodation expenses save for one journey to and from home each week.

Q33. When searching for new accommodation (appendix 2 of the framework) can I claim a total of four nights' accommodation and subsistence or four nights per preliminary visit

A33. It is a total of four nights whether consecutive or split

Q34.  What is the rate for overnight accommodation as part of the search for new accommodation

A34. HEE will make a contribution in line with appendix 2 of the framework and in accordance with the NHS terms and conditions of service handbook

Q35. Will travelling expenses for trainees and their dependents be reimbursed in full when incurred on removal from the old accommodation to the new property accommodation (appendix 2 of the framework) and does this also apply to hiring of vehicles?

A35. Travelling expenses will be reimbursed in full in this situation. The cost of a hire vehicle may be reimbursed provided it is for the purpose of relocating to the new property.

Q36. Are trainees only eligible to claim continuing commitments (appendix 2 of the framework) if they own the original property?

A36. Yes, they must own the original property

Q37. Is Dublin counted as an overseas location?

A37. The framework states all removal and associated expenses will be reimbursed from UK port of entry only, with the exception of the Isle of Man and Jersey for those trainees appointed to a training programme which includes one or more rotations to these locations. There is no exception for the Republic of Ireland

Q38. Is there a time limit between selling a property and purchasing a new one?

A38. There is a 12 month time limit

Q39. What financial assistance is available where a trainee is required to undertake a short placement out of region to gain a competence / capability that is not available locally. 

A39. Such placements may be undertaken as an honorary attachment / secondment in a Trust outside of the training programme’s geographical footprint and the trainee should discuss with their local office what the arrangements are to undertake such a placement, including the financial assistance available which is not covered by the relocation framework

Q40. How do I claim for one return visit to an old property to supervise the removals.

A40. Doctors in training are entitled to an additional day as paid leave, by their employer, to oversee the removal from their old property.  This is in addition to annual leave and special leave entitlement.   Subsistence will be reimbursed and mileage should be claimed at public transport rate/ standard rail fare.  Trusts may require proof of the request.

Q41. Is HEE looking at its excess travel policy following increase of fuel costs and travel?

A41. The rates of reimbursement for excess travel in the Terms and Conditions of Service for NHS Doctors and Dentists refers to Section 17 of the NHS terms and Conditions of Service Handbook which apply to all staff directly employed by NHS organisations and sets the rates of reimbursement. Individual Trusts may have taken an internal view to increase reimbursement costs, however this is not subject to any national agreement.

Q42. Can a doctor in training who is working less than full time claim temporary accommodation expenses in lieu of excess travel under para 14 of the framework?

A42. Eligibility for temporary accommodation expenses does not differ between full time and less than full time doctors in training.  Please refer to para 39 of the framework.  If a less than full time doctor has exhausted their maximum allowance they should refer to para 14 of the framework to consider if they are eligible for additional financial assistance.

Q43. Is there any guidance on how excess mileage calculations should be made?

A43. There are a variety of on line tools to calculate the distance. The NHS Terms and Conditions doesn’t specify a tool for calculating mileage however we would expect Doctors in Training to take the shortest and most cost effective approach when claiming, unless there are exceptional reasons.

Q44. Can a doctor in training claim for excess mileage when they are already living within the region?

A44. If they live in region and the commute to work is in excess of 17 miles they are able to claim excess mileage.  If they live OUT of region they are unable to claim excess mileage without Dean’s discretion, please refer to para 33 of the framework.

Q45. Can doctors in training who are moving from rented to rented accommodation claim for storage costs?

A45. No – they are not able to claim; the framework is clear and no other expenses will be reimbursed

Q46. Who does para 21 of the framework apply to?

A46. If a MOD doctor in training is relocated to a different part of the country it would not come out of the £10,000 allowance

Q47. Are GRID doctors in training expected to live in the region which manages their programme or is living within a reasonable distance of some of their placements sufficient for them to claim?

A47. GRID doctors in training are the exception to the rule in that management of the training programme transfers to the appointing region to allow them to undertake sub-specialty training. Where a programme rotates across regional boundaries the decision will be taken by the programme lead. Para 33 of the framework refers to Dean’s discretion to provide financial assistance on the grounds of exceptional personal circumstances.

Related Documents

• National Relocation Framework (.pdf) 377.72 KB
• Equality Impact Assessment (.pdf) 283.98 KB

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Huge rise in GP expenses could make some practices unviable within two years

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GP principals face a pay cut this year because inflation and recommended pay rises for practice staff are greater than the uplift to practice funding, meaning practice expenses will take up a larger slice of practice income.

Modelling of the impact of inflation levels on practice profits, prepared for the BMA by former GP committee negotiator Peter Holden, and shared with The BMJ , shows that this year profits will fall by 16%—and in terms of buying power GP principals will experience a pay cut of almost 23%.

Holden said, “The key matter here is not just at what point we stop earning a living, which at 10% inflation is after four years, but at what point do the banks get scared and withdraw our loans—which I think could be as early as the end of next year.

“This is urgent. This is not going to go away. I understand the government not reopening the multiyear deal negotiated with the BMA for pay, but they’ve got to reopen it for expenses.”

Soaring inflation

Funding for independent general practitioners is tied to a five year deal, which for 2022-23 provides for a 2.1% uplift for all GPs, practice staff, and practice expenses based on predicted inflation in 2019. 1 2 Actual inflation is running at 9.4%, 3 however, and predicted to go higher—past 10%—and official pay review bodies have recommended higher pay awards for practice staff—4.5% pay award for salaried GPs and a £1400 uplift for nurses (worth at least 4%). 4

The UK has not experienced such high inflation levels since the 1980s, at which time expenses were treated separately. At that time, independent practitioners received an increase to cover their rise in expenses (costs) plus an uplift to their income based on recommendations from the Review Body on Doctors’ and Dentists’ Remuneration.

This changed in 2004 when reforms were made to the general medical services (GMS) contract and how it is reimbursed. GPs gave up responsibility for patients out of hours, a new funding formula was introduced along with the quality and outcomes framework, and expenses were no longer treated separately.

Holden, one of the negotiators of the 2004 contract, said that pre-2004, even if the government did not give GPs a rise in income, at least any rise in expenses was covered.

Increase in expenses to earnings ratio

Since 2004 the expenses to earnings ratio has also increased. In 2004-05, the UK expenses to earnings ratio was 55% for UK GMS GPs, 5 but by 2019-20 it had reached 69.7% —a rise of 14.7 percentage points. 6

Holden has modelled how inflation will continue to increase the expenses to earnings ratio and cut GP principal pay. Using a baseline expenses to earnings ratio of 66.7%, and modelling inflation at 8% (based on predicted inflation at 11% minus 2.1% GP income uplift for 2022-23) the expenses to earnings ratio hits 72% this year. If high levels of inflation continue, the expenses to earnings ratio will pass 90% after 4 years—and even if inflation falls, it will likely surpass 80% within two or three years.

Holden estimated that GPs had around £5bn invested in premises including mortgages. “My concern is if the government doesn’t grip this, if the banks start to understand this fully, they’ll pull the bank loans long before we go bust,” he said.

Kieran Sharrock, deputy chair of the BMA general practitioners committee, said, “Like the rest of the country, GP practices are feeling the pressure of inflation. The costs of running a practice are increasing at the rate of inflation, but practices only received a 2.1% uplift to cover their expenses in 2022-23, while inflation this year is expected to reach more than five times that at 11%.

“On top of last week’s significant real terms pay cut for GP practice staff, with no extra funding to practices for staff pay, inflationary pressures will only exacerbate the increasing financial burdens. With the double pressure of massive workloads and increasing costs we fear that we will lose even more GP contractors on top of the nearly 5000 lost since 2015.”

How inflation will erode practice profits in 2022-23

A group practice with 3 or 4 GP partners and gross turnover of £1m with current net profit £333 000 and practice £667 000—and expenses ratio 66.7%

Modelling impact of inflation at 8%* a year

Revised expenses after inflation £720 360.00

Revised net profit after expenses £279 640.00

Percentage fall in profit 16.02%

Actual expenses ratio 72.04%

Real new profit (taking inflation into account) £257 268.80

Real pay cut (taking inflation into account) since start of year 22.742%

Revised expenses after inflation £777 988.80

Revised net profit after expenses £222 011.20

Percentage fall in profit from baseline 20.61%

Actual expenses ratio 77.80%

Real new profit (taking inflation into account) £204 250.30

Real pay cut (taking inflation into account) since start of year 1 38.66%

*Inflation predicted at 11% minus 2.1% uplift to GP income for 2022-23

• ↵ BMA. GP contract agreement England 2018-19. www.bma.org.uk/collective-voice/committees/general-practitioners-committee/gpc-england/gp-contract-agreement-england .
• ↵ NHS Digital. GP earnings and expenses—2004-05, November 2016. https://digital.nhs.uk/data-and-information/publications/statistical/gp-earnings-and-expenses-estimates/gp-earnings-and-expenses-2004-05 .
• ↵ NHS Digital. GP earnings and expenses estimates 2019-20, August 2021. https://digital.nhs.uk/data-and-information/publications/statistical/gp-earnings-and-expenses-estimates/2019-20/main-findings .

Relocation and Excess Travel

The new arrangements for the payment of relocation and excess mileage expenses came into effect for postgraduate medical and dental trainees on 1st November 2020. The framework has been developed through close coordination with the BMA.

Trainees should read the national framework:

HEE National Relocation Framework

Claims for relocation or excess mileage expenses are managed and processed by employing trusts. Trainees should contact their employing Trust with any questions about relocation and excess travel. Expenses claims must be submitted to the Trust within three months of the expenditure being incurred.

Relocation and mileage claim forms

We are still in the process of adding Trust claim forms to the website. If your employing Trust is not listed below, please contact the Medical HR or Medical Education Centre directly.

UHS Relocation expenses claim form

UHS Excess mileage claim form

DHUFT Relocation expenses claim form

DHUFT Excess mileage claim form

DCH Relocation expenses form

DCH Excess mileage form

Salisbury Relocation expenses form

Excess mileage expenses should be submitted using the ‘Easy Expenses’ online system

Solent Relocation expenses form

Solent Excess mileage claim form

UHD Relocation expenses claim form

UHD Excess mileage claim form

Excess Mileage – Excess mileage claims should be submitted using SEL expenses online system. Please contact Karen McCarthy, Medical Education Lead [email protected] for further information

Relocation Expenses Form

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Removal & Expenses Guidance

Guidance for doctors in training on travel and removal

NHS England is responsible for providing you with assistance for relocation expenses, including removal or excess mileage. Such claims are administered by your employer.  NHS England has introduced a new, national framework across England for all trainees commencing training programmes from 5 August 2020. The purpose of the national framework is to ensure equality of treatment for all trainees across the NHS England regions. At the request of the BMA, it has been agreed that this will not be implemented in August as sufficient consultation has not been able to take place given other priorities.

By accepting a place on the training programme, you agree that your entitlement to reclaim expenses and removal costs will be subject to the new framework once it is introduced.

The latest national framework was published in November 2020 when press statements were released by both the BMA and NHS England. The new guidance is available via the link on the right. Locally we have been working with employers and the BMA and the new guidance has been implemented as follows:

Please refer to the Travel/Relocation FAQs for further information on the Overall Framework and for Frequently Asked Questions.

If you have any queries about relocation and excess travel please always contact your employer first (Medical Staffing) and if you have any queries for NHS England, please contact my team on [email protected] .

Page Last Updated 11th March 2024

If you are a trainee employed by St Helen's & Knowsley (Lead Employer), please refer to the guidance on the STHK Shared Services website  here .

• " alt="bma gp travel expenses" target="_self"> Travel/Relocation FAQs
• " alt="bma gp travel expenses" target="_self"> Relocation and Travel Expenses Guidance (November 2020)
• " alt="bma gp travel expenses" target="_self"> Removal & Travelling Expenses Guidance (January 2020)
• " alt="bma gp travel expenses" target="_self"> Mileage Grid (2014)
• " alt="bma gp travel expenses" target="_self"> Travel & Relocation Expenses Claim Template (Trust Use Only)

Here at Health Education England Midlands we aim to offer our medical and dental trainees the highest quality training, supervision and support. This is because we believe excellence in education and training is at the heart of delivering excellent patient care. We hope you will spend many enjoyable and rewarding years with us developing your medical or dental career.

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Relocation and Excess Travel

Latest update: 22 September 2023:

This page has been updated to remove older updates.  The national framework for Relocation and Excess Travel published on 1 November 2020 was first applicable to all trainees recruited to programmes commencing August 2020,  It subsequently applied to all other trainees from 1 February 2021.  A small number of trainees in the East Midlands still follow the 2007 policy after a consultation exercise.  The 2007 policy for such trainees is available upon request from [email protected] . 

The national HEE website includes further information and FAQs related to Relocation and Excess Travel and is available here .

For all operational queries related to Relocation and Excess Travel, please contact your Medical Staffing Department in your Trust first.  If you are relocating to the region, please make contact with your Trust as soon as possible, before you relocate.

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