All items marked “Τ” must, by law, be included in a single document – the ‘principal
statement’ to be given to an employee when he/she begins work. Items marked “ ”
must be included in the Written Statement of Main Terms and Conditions of
Employment. If there is no provision for any of the items which have to be included,
this must be made clear. For instance, if there is no overtime rate payable, then the
written statement should say so.
For items marked “ ”, the employee can be referred to other documents
accompanying either the principal statement or in instalments which must be given to
the employee within two months of the date of starting work.
Items marked are examples of good practice.
An example of a Written Statement of Main Terms and Conditions of Employment
appears on the next page. This incorporates all the items that must by law be
included into such a document and identifies or makes reference to other documents
the employee is entitled to access. It also gives examples of the wording that could
be used. The example aims to demonstrate good practice!
Throughout the examples given are a number of optional or alternative statements that
could be used, these are indicated within brackets. The inappropriate statements will
need to be deleted.
Using the template on the disk provided it will be a simple task to ‘customise’ the document
to meet the requirements of the practice.
Τ = Must appear in Principal Statement
= Must be included in Written Statement
= Example of ‘good practice’
Producing a Written Statement – Example 43
Written Statement of the Main Terms & Conditions of Employment
Part I of this document sets out the terms and conditions of this employment
Part II of this document sets out the Disciplinary and Grievance Policy and
Procedures of the Practice
Τ 1 Terms Agreed Between
Name of employer Dr(s)
Name of employee
Τ 2 Commencement of Employment
Your employment with this Practice began on:
Τ 3 Continuous Employment
Your previous employment with ( which
commenced on ) (does/does not) count as
part of your continuous period of employment.
No employment with a previous employer counts towards your period of continuous
employment with the practice.
Τ 4a Job Title
You are employed as a
Τ 4b Job Description
A Job Description is attached to this Statement, (if not already provided).
(4a or 4b to be included but it is advisable to include both!)
Producing a Written Statement - Example 44
Τ 5 Job Location
You will work at the premises detailed above. In the event that the practice is
located to different premises within a reasonable distance of the existing
premises, your place of work will change to new premises and there will be
reimbursement of any excess mileage. (From time to time you may be required to
work at the branch surgery at to cover for colleagues whilst on
leave). You may also be required to visit patients in their homes.
Τ 6 Pay
Your rate of pay is £ per annum which equates to £ per
(inclusive of Outer London Weighting or Inner London Weighting for A&C staff)
(inclusive of Outer London Allowance or Inner London Allowance for Nursing staff)
You will be paid by (cheque/credit transfer) on the (28th day / OR INSERT OTHER
DATE) of each month.
Your salary will be reviewed annually on (1 April or INSERT OTHER DATE) and any
cost of living (and/or incremental) rise will be in line with that approved by the
Τ 7 Hours of Work
Your hours of work are per week.
The distribution of these hours will be mutually agreed.
(No overtime rate is payable for Saturday morning surgeries which are worked in
rotation. This is an arrangement in which all staff are expected to participate).
On occasions you may be required to work additional hours to cover staff who are
absent due to sickness/holidays. (Time off in lieu will be given or overtime at the
standard rate will be paid).
Τ 8 Holidays
Your holiday year runs from 1 April to 31 March each annum.
Your paid holiday entitlement is ( weeks / days) per year
Producing a Written Statement - Example 45
In addition, you are entitled to 8 Public Holidays each year and any additional
proclaimed national holidays if these are days when you would normally work.
9 Education, Training and Development Opportunities
You will be encouraged to attend Study Days, Courses and other training
opportunities relevant to your area of work. This may occasionally involve
attendance during your own time. (Reasonable time off in lieu will be given).
10 Sickness Absence
If you meet the eligibility criteria you will be entitled to Statutory Sick Pay (and
after 6 months service you will also be entitled to receive payment in line with the
Practice Sick Pay Scheme). Full details of (this/these) scheme(s) can be obtained
from the (Practice Manager/GP) but in general the entitlement will be:
(Describe Practice Staff Sick Scheme here)
Any entitlement to SSP will be offset against the Practice Sick Pay Scheme
If for any reason you cannot come to work, you should telephone the practice
as soon as possible on the first day of absence, preferably before 9.00am
and speak to (the practice manager / GP).
You should indicate the probable duration of your absence in order that
arrangements can be made to cover the period you are away.
A self certification SC2 must be provided for absences of 4-7 days but can be
required from the start if the practice wishes. You must provide a medical
certificate for any absence of 8 days or more. Failure to comply with these
requirements may result in loss of pay and action through disciplinary procedures.
12 Maternity Leave and Pay
Female employees will be entitled to maternity leave and payment in line with the
provisions of the Employment Relations Act 1999. Any woman will be entitled to 18
weeks maternity leave and the right to return to her job irrespective of length of
service. After 6 months continuous service by the qualifying week (i.e 15th week
before the week in which the baby is due) women who meet the eligibility criteria
will be entitled to 18 weeks Statutory Maternity Pay. Women with at least 1 year’s
service on the 11th week before the week in which the baby is due will also be
entitled to extended maternity leave i.e up to 29 weeks after the baby is born.
During this extended leave, SMP will only be paid for 18 weeks. Full details of the
Producing a Written Statement - Example 46
arrangements for maternity leave and pay are available from the (practice manager
13 Parental Leave
After one year’s service all employees, male and female who have parental
responsibility for children born after 15 December 1999 and under 5 years*, will be
entitled to up to 13 weeks UNPAID Parental Leave and the right to return to work.
Full details of this provision under the Employment Relations Act 1999 are available
from the (practice manager / GP) but in general and with the appropriate notice, up
to 4 weeks unpaid leave may be taken each year, until the child’s 5th birthday. The
maximum leave entitlement is 13 weeks and this INCLUDES leave taken during a
*The time limits are different if a child is adopted or has a mental health problem but full
details are available from the (practice manager / GP).
14 Leave for Emergencies Involving a Dependant
You will be entitled to reasonable time off in the case of a domestic emergency
involving the care arrangements for a dependant. (See practice handbook for
definition of “dependant” and examples of emergencies in relation to dependants).
Payment for these days will be at the discretion of the doctors.
15 Pension Scheme
You are entitled to join the NHS Superannuation (Pension) Scheme. Full details of
this Scheme are available from the (practice manager/GP). Employees who do not
belong to the NHS Pension Scheme will be required to ‘opt out’ of the NHS Scheme
and will contribute to the State Earnings Related Pension Scheme (SERPS).
16 Retirement Age
The retirement age in this practice is (INSERT AGE) years for men and women.
17 Health and Safety
You will be required to follow the Health and Safety policy of this practice. A copy
of the policy can be obtained from the (Practice Manager / GP).
Producing a Written Statement - Example 47
18 Termination of Employment
Delete as appropriate:
You are required to give weeks notice of termination of your
employment. (If the notice period is dependent on the length of time an employee
has been in post, these details must be given).
Your contract is for an indefinite period but subject to the following notice.
Length of service Notice Period
More than 1 month but less than 2 years 1 week
2 years but less than 3 years 2 weeks
3 years but less than 4 years 3 weeks
and continuing with 1 week’s notice for every year
of continuous service up to a maximum of
12 years or more 12 weeks
(Your employment contract is for a fixed term and expires on: )
(Your employment contract is temporary and is expected to continue for: )
19 Signature of Employer Date
* I acknowledge receipt of my particulars of employment (or I accept the terms
and conditions of my employment specified above).
Signature of Employee Date
Producing a Written Statement - Example 48
20 Disciplinary Rules
A copy of the Practice’s Disciplinary rules and procedures is attached to this
statement. You will be expected to work within the code of practice laid down in
the Practice’s Disciplinary Policy document.
21 Disciplinary Procedures
The practice’s disciplinary procedure is described below.
Purpose and Scope
It is the Practice’s aim to promote good practice and encourage improvement in
individual conduct where this is deemed to have failed. This procedure sets out the
action which will be taken when disciplinary rules are breached.
(i) The procedure is designed to establish the facts quickly and to deal
consistently with disciplinary issues of a disciplinary nature. Disciplinary
action will only be taken following a full investigation and if there is a case to
(ii) At every stage you will have the opportunity to state your case and be
represented, if you wish, at the hearings by a work colleague or a trade union
(iii) You have the right to appeal against any disciplinary decision.
(iv) Records of disciplinary action will be removed from file after 1 year’s
satisfactory conduct / performance
Stage 1 – Oral Warning
If your conduct or performance is unsatisfactory, you will be given an ORAL
WARNING, which will be recorded on file. The warning will be removed from file
following months -
Producing a Written Statement - Example 49
Stage 2 - Written warning
If the offence is of a more serious nature, there is no improvement in your
standard of performance, or if a further offence occurs, you will be given a
WRITTEN WARNING which will include the reason for the warning and a note
that, if there is no improvement after months, a final written warning will
Stage 3 - Final written warning
If your conduct or performance is still unsatisfactory, a FINAL WRITTEN
WARNING will be given making it clear that any recurrence of the offence or
other serious misconduct within a period of weeks/months will result in
Stage 4 - Dismissal
If there is no satisfactory improvement or if further serious misconduct occurs,
you will be DISMISSED.
If, after investigation, it is confirmed that you have committed one of the
following offences (this list is not exhaustive), disciplinary action may be up to and
· serious breach of confidentiality
· damage to practice property
· incapacity for work due to being under the influence of alcohol or illegal
· physical assault
· gross insubordination
While alleged gross misconduct is being investigated, you may be suspended, during
which time the normal hourly rate will be paid. Any decision to dismiss will be taken
by your employer only after a full investigation.
Producing a Written Statement - Example 50
If you wish to appeal against any disciplinary decision, you must do so within two
working days. Your employer, not the same person who carried out the disciplinary
procedure will hear the appeal and decide the case as impartially as possible.
If you are dissatisfied about any disciplinary decision that affects you please
INSERT TITLE OF GP e.g. Senior Partner
23 Grievance Procedure
If you have a grievance concerning your employment, please raise this with the
(Practice Manager / GP or partner).
It is Practice policy to ensure that any employee with a grievance has access to a
procedure which can lead to a speedy resolution of the grievance in a fair manner.
If you have a grievance about your employment, you should first raise it orally with
the practice manager, who should give you a reply within two working days.
If the reply given at stage 1 does not satisfactorily resolve the grievance, you
should detail the grievance in writing. The written grievance will then be submitted
to the GP (or partner) with responsibility for practice staff).
If the matter is not resolved satisfactorily within five working days, you may elect
to appeal to (the senior partner or in the case of a single-handed GP to )
who will give a decision within five working days. This decision will be final. All staff
are required to read, the Practice Handbook and comply with the practice rules
Producing a Written Statement - Example 51