Orange route: You are employed in the NHS transferring to a GP practice or primary medical care contract holder

This guide focuses on NHS staff transferring to a GP practice or primary medical care contract holder.

3 September 2021

Examples of this type of transfer

This type of transfer would generally be to a GP practice or group of practices providing primary and/or community services under a General Medical Services contract (GMS), Personal Medical Services contract (PMS), Alternative Provider Medical Services contract (APMS) or NHS Standard Contract.

Following the new models of care proposed by NHS England in its Five Year Forward View, there is an increasing interest for GP practices to federate or form provider alliances. In these circumstances, it is likely the contract under which services are delivered would be one of those referred to above. Some APMS may be provided under a sub contract to a NHS Standard Contract. While most arrangements under this route are applicable for staff transferred to provide services under APMS, if it is a sub contract, they would only retain entitlement to membership of the NHS Pension Scheme if the main NHS Standard Contract (from which the sub-contract flows) is held by an NHS Pension Scheme employing authority.

If the arrangement is a GP Federation, network or alliance, it is likely that the contract would be an NHS Standard Contract. If this is the only contract held by the employer, then the blue route should be followed. If it is a sub contract arrangement, and the transferee will work solely on that sub contract, then eligibility for membership of the NHS Pension Scheme could only be retained if the main NHS Standard Contract (from which the sub-contract flows) is held by an NHS Pension Scheme employing authority.

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For the purposes of this guide it is assumed that compulsory transfers will fall within the Transfer of Undertakings Protection of Employment regulations 2006 (TUPE) definition of a 'relevant transfer'. This means that TUPE would apply and employment contracts would transfer from one employer to the other without any change to terms and conditions, and without a break in continuity of service. In addition, Cabinet Office Statement of Practice (COSOP) applies across the NHS, as it does in other parts of the public sector. As well as giving guidance on the application of TUPE in the public sector, COSOP provides some guidance on what is expected to happen when TUPE does not apply. The current version of COSOP states that the principles of TUPE should be followed and that legislation should be used where possible to effect the transfer so that the staff are treated no less favourably than if TUPE applied.

It is expected that there should be all appropriate engagement and consultation with staff/staff representatives before any potential transfer takes place, regardless of which body you move to or from.

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Pay and terms and conditions

The vast majority of staff employed by NHS organisations receive NHS or equivalent pay and are on NHS terms and conditions of service. Terms and conditions of service include such details as holiday and sick leave entitlement and contractual redundancy benefits. For staff directly employed by NHS organisations these, in most cases, are set out in the NHS terms and conditions of service handbook and for NHS employed medical and dental staff in their relevant terms and conditions of service

These documents may cover more than contractual terms and conditions issues and therefore they may not all automatically transfer under the Transfer of Undertakings (Protection of Employment) Regulations 2006 (TUPE). Please contact your HR department or staff representative for further advice.

How will my pay and terms and conditions be affected if I transfer?

If you are transferred to a GP practice or primary medical care contract holder under TUPE your contractual pay and terms and conditions of service are protected. TUPE protects your existing NHS pay and terms and conditions of service at the point of transfer, and this can include any pre-agreed contractual future entitlements (e.g. a three year pay deal negotiated pre-transfer). This, however, does not cover any future changes in NHS terms and conditions of service (e.g. annual pay increases) negotiated after the transfer date, unless there is a specific agreement with your new employer that they will apply.

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Generally, staff employed in the NHS and in GP practices, where the GP practice holds a GMS or PMS contract or in the case of a GP Federation holding an NHS Standard Contract, have the ability to retain membership of the NHS Pension Scheme. However, for those practices on an APMS contract or in sub-contracting situations, it will be necessary to check with the pension scheme regulations, lawyers or the NHS Business Services Authority to clarify the situation. You should speak to your trade union or HR representative for more information.

Pensions under the NHS Pension Scheme includes the retirement pension and early payment of pension on grounds of ill health.

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Injury allowance

What is Injury Allowance?

Injury Allowance was introduced on 31 March 2013 for new claims and replaced the NHS Injury Benefit Scheme. The function of Injury Allowance is to recompense employees who have temporarily lost income due to injury or illness as a result of work.

The details of Injury Allowance provisions are set out in Section 22 of the NHS Terms and Conditions of Service Handbook.

How will the transfer affect my access to the Injury Allowance?

If you are compulsorily transferred from an NHS organisation to a GP practice or a primary medical care contract holder under TUPE and remain on your NHS terms and conditions of service without amendment, you should retain full access to Injury Allowance. Where TUPE doesn’t apply, COSOP should (see legal details as set out above).

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Staff engagement and partnership working

All staff delivering NHS services should be engaged by their employer in decisions affecting them and the services they provide. This is in line with the commitments in the NHS staff pledges in the NHS Constitution which apply to all providers of NHS services.

What do we mean by staff engagement and partnership working?

Good staff engagement encompasses a range of activities from sharing information with and gathering views from staff on issues that affect them to, for staff who are members of trade unions, working in partnership with their representatives on local workplace issues, adhering to legal requirements in respect of trade union membership and representation. The best performing organisations have staff that are engaged with their employer and empowered to put forward ways of improving how things are done. This applies equally to both NHS and non-NHS providers of healthcare to NHS patients. Research has shown that high levels of staff engagement have a positive impact on organisational effectiveness, patient satisfaction and contribute to the delivery of high quality patient care. This includes research from Aston University Business School in 2011, research from NHSE in February 2018, and research from NHSE in March 2018.

All organisations should develop an approach to how they will foster staff engagement. Key components of effective staff engagement in the NHS include: 

  • good leadership and good communication
  • valuing staff contribution
  • involvement of staff in decision making
  • seeking and responding to feedback from staff
  • partnership working with staff representatives

How will staff engagement and partnership working change when I transfer?

All providers of NHS services are expected to work closely with their staff, on issues that affect them, whether they are members of a trade union or not, in line with the NHS staff pledges in the NHS Constitution. If you are a member of a trade union, union recognition will transfer under TUPE from your existing NHS employer to your new employer if, following the transfer, the transferring organised grouping of resources or employees retains a distinct identity from the remainder of the new employer’s undertaking. If you are unsure how this will apply in the case of your transfer you should speak to your line manager, your HR adviser or trade union representative.

Regardless of who your new employer is following transfer, you can expect:

  • Joint working - Your new employer is committed to the principles of effective joint working as set out in the NHS Constitution. This means that your employer should talk to you, your trade union, your professional representative body and other stakeholders, as appropriate, about decisions that affect you and the services you provide.
  • Your right to become and/or remain a member of a trade union - Your employer will respect your right to either remain a member of a trade union or to join one if you wish (regardless of whether the union is recognised by your new employer or not); to be represented by a recognised trade union; and be entitled to other rights set out in employment law concerning information and consultation. The website includes information about trade unions and legal rights concerning union membership.
  • Your right of access to trade unions - If you are a member of a trade union you have a right to access and make use of the services offered by your union, such as advice (including legal advice), support and assistance, at an appropriate time, regardless of whether your trade union is recognised by your employer.
  • Staff experience survey - Your new employer may undertake a staff experience survey at reasonable intervals and you may be invited to take part. A summary of the survey results and actions in response to the results should be available to staff.
  • Openness - Your new employer will commit to achieving a climate of openness where you feel able to raise concerns, in a reasonable and responsible manner, on any aspect of service delivery without fear of recrimination. Your new employer should have an appropriate speaking up procedure in place.
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Education and training

Education and training opportunities such as on the job training, in-house courses, external courses, National Vocational Qualifications, higher level courses, secondment opportunities etc usually come from staff appraisals, personal development plans and/or regulatory requirements. GP practice staff can access support for education, training and development through local NHS leadership academies and through their local Health Education England offices.

How will my transfer affect my education and training?

If you are compulsorily transferred to a GP practice or primary medical care contract holder that is providing NHS services under a contract, it is made clear in the NHS Standard Contract that all providers of NHS funded clinical services are expected to provide adequate training and development for their staff, to ensure that staff are up to date with their skills so that they are safe to carry out their day-to-day practice. Such requirements reinforce wider duties to have regard to the NHS Constitution, including a pledge 'To provide all staff with personal development, access to appropriate education and training for their jobs and line management support to enable them to fulfil their potential.'

Additional training to ensure succession planning of their workforce would be for individual employers to develop in line with their own organisational business objectives and service delivery requirements to meet staff requirements and needs. Some providers of NHS services receive additional funding to provide student placement opportunities. These organisations should provide the necessary supervisory support for students, as required by the universities and colleges.

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HR policies and practices

Staff delivering NHS services can expect to work for an employer of choice. That is, an employer who provides a high quality working environment for their staff, an employer people choose to work for and stay with.

What do we mean by HR policies and practices? 

One way of ensuring a high quality workplace is by having good HR policies and practices. These may include policies and practices developed by your employer in partnership with local trade union representatives, which have an effect on your employment. Although developed locally, they are often based on national initiatives and guidance such as those provided by the Advisory, Conciliation and Arbitration Service (ACAS). Areas covered by such policies include equality and diversity, health, wellbeing and safety, work life balance and flexible working, discipline and grievance, speaking up/raising concerns and whistleblowing, and recruitment and promotion.

In the NHS there are a number of good employer initiatives that have been developed nationally in partnership with NHS Employers, the government, arm's length bodies and trade unions. Such initiatives include the Health and Wellbeing framework (2021)Workplace Health and Safety Standards, and part 5 of the NHS Terms and Conditions of Service Handbook – Equal Opportunities.

The SPF's speaking up page signposts resources available to employers to help them put in place policies and practices to enable staff to raise concerns. This includes a national policy produced to help standardise speaking up procedures across the NHS. The web page also links to speak up, which offers free independent confidential advice on the speaking up process for employers and employees in the NHS and adult social care.

The good practice guidance contained within these key national resources is accessible to both NHS and non-NHS employers to help develop local policies and practices in partnership with staff and trade union representatives.

How will my transfer affect me?

If you leave direct NHS employment to join another organisation providing health care services to the NHS, you will not necessarily continue with exactly the same HR policies and practices you had with your former employer, unless they form part of your existing contractual terms and conditions of employment. You may wish to discuss with your HR or trade union representative in advance of your transfer to confirm which policies and practices will be transferring.

Your new employer may take some or all of your former employer’s policies and practices and amend these to reflect the structure and size of the new organisation. Alternatively, they may decide to develop a new set of policies and practices or, they may already have a set of existing policies and practices. These decisions should be subject to discussion with the trade union representatives.

Contractual terms and conditions of employment are protected in a TUPE transfer except in very exceptional circumstances. They should also be protected in a transfer where TUPE does not apply, but the principles of TUPE are followed in accordance with the COSOP. If you are unsure what is included as part of your contract of employment you should speak to your HR department and/or trade union representative.

Regardless of who your new employer is following transfer, you can expect the HR policies and practices of your new employing organisation to not only meet the requirements of employment and discrimination law but also, to reflect a commitment to the provision of a high quality workplace and to being a good employer, as stated in the NHS Constitution. Your existing employer should work closely with you, your trade union representatives and your new employer to achieve this.


Visit our frequently asked questions web page for more information.

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Useful resources and information

  • In 2011, the Aston University Business School conducted research on behalf of the Department of Health, which provided evidence of the link between good staff experience and good patient experience. More recent research has identified links between engagement and absence levels, employee engagement, sickness absence and agency spend in NHS trusts (March 2018) and has highlighted the links between NHS staff experience and patient satisfaction: analysis of surveys from 2014 and 2015 (February 2018).

  • TUPE applies when there is a relevant transfer. A relevant transfer may include:

    • a transfer of an undertaking, business or part of an undertaking or business where there is a transfer of an economic entity that retains its identity; or
    • a service provision change, where a contractor takes on a contract to provide a service for a client from another contractor.

    However, the law relating to transfers is complex; TUPE may not necessarily apply so you should contact your HR department, trade union or staff representative to get further advice.

    For more information on TUPE see the website.

  • On 13 December 2010, the Government announced the withdrawal of the 2005 ‘Code of Practice on Workforce Matters in Public Sector Service Contracts’ (commonly referred to as the Two-Tier Code). The withdrawal of the Code brought into question the agreement ‘Agenda for Change and NHS Contractors Staff – A Joint Statement’ - which was based on the principle enshrined in the wider code of practice. The Department of Health has withdrawn the Joint Statement with immediate effect.

    The Joint Statement was agreed in 2005 and extended Agenda for Change (AfC) terms and conditions to staff that had transferred outside the NHS before the introduction of AfC in 2004. There was an expectation on all sides that the terms of the joint statement would be observed and implemented. These protections went beyond those afforded by the Transfer of Undertaking (Protection of Employment) Regulations (TUPE), as well as the Cabinet Office Statement of Practice.

    Where the Joint Statement has already been implemented there should be no need for any action as the pay improvements are now part of employee’s terms and conditions and protected by employment law and private contractor company contracts with NHS trusts will have been varied to reflect this ongoing obligation for the life of each contract.

    The NHS Standard Contract has been amended to reflect the withdrawal of the joint statement and the two-tier code. NHS contractors are, however, encouraged to adhere to the Principles of Good Employment Practice that have replaced the two-tier code.

    Where a contract was signed prior to the introduction of the current revised standard contract, the parties to that contract – the NHS trust and the NHS contractor - will, as part of their contractual commitments, continue to be covered by the obligation to conform with the standards and principles within the Joint Statement and the two-tier code.  

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