The Health Care Modernization Program, which began in 2011, had the goal, among other things, to increase the earnings of medical workers to 200% of the average for the corresponding region. For this purpose, the concept of “incentive payments to health workers” was introduced.

Who is entitled to incentive payments in 2020?

The above program fundamentally changed the payroll system for both doctors and nurses.

However, not all healthcare workers are covered by it.

1. Stimulants are not allowed:
   Enterprise administration. Managers may be an exception to the rule if they practice medicine.
2. For doctors covered by the Health program, and more specifically:
   those involved in providing assistance during childbirth, while caring for infants;
   pediatricians, local therapists, family doctors, junior staff working with them in tandem.
3. Specialists providing high-tech assistance.

Payment of incentives to doctors should help to intensify their activities and improve the level of service to the population. More money to those who help people better!

Incentive payments are awarded only to those employees who have a standard certificate for the main working specialty.

Documentary base of the Program

Federal legislation generally regulates the remuneration of public sector employees, including medical workers.

In Art. 129 of the Labor Code of the Russian Federation are indicated the following types accruals:

• basic, otherwise called basic;
• compensation depending on the specifics of the region;
• stimulating;
• social.

The first, main part is paid to everyone without exception. The second point indicates accruals depending on specific working conditions. They vary by region. Incentive payments to doctors that interest us are calculated based on an assessment of the performance of doctors and nurses.

Basic regulatory legal act, on which the administration of a medical institution relies, is the Regulation on the establishment of remuneration systems for employees of federal budgetary, autonomous and government institutions, approved by Decree of the Government of the Russian Federation of 05.08.2008 No. 583 (hereinafter referred to as the Regulation).

This paper states that all parts of income, except for incentives, for medical workers are strictly regulated by central and regional legislative acts. But incentives are given to the medical institution.

The administration of the enterprise is obliged to publish a document regulating incentive payments to healthcare workers, then familiarize workers with its contents!

Where are incentive criteria developed?

Based on clause 6 of the above-mentioned resolution of the Ministry of Health and Social Development, recommendations that are mandatory for implementation when developing internal documents have been developed and sent to all institutions. Guided by this paper, each organization approves its own Regulations on incentive payments medical workers. In addition, relevant acts are issued at the regional level.

Ask the administration of the medical institution about the contents of the above document in order to understand exactly how the accruals are made.

Union control

When developing and approving recommendations for medical institutions, the Government of the Russian Federation consults with trade unions.

This format is called a tripartite commission, in which employers also participate. It meets annually, therefore, it provides recommendations to the administration of medical institutions once a year.

This means that the Regulation on stimulating labor with money should also be approved locally only for a specified period.

It reflects the following points:

• sources of financing from which incentives will be paid (a special fund is created at the enterprise);
• categories of specialists subject to the Regulations;
• a specific accrual scheme divided into financing from: compulsory insurance and money received from business activities;
• criteria for the effectiveness of medical work.

Nuances of charges

Order of the Ministry of Health and Social Development dated December 29, 2007 No. 818 “On approval of the list of types of incentive payments...” contains a number of specific factors to be encouraged, namely:

• duration and continuity of experience;
• results of the work;
• achievements associated with intense activity;
• quality of work.

The first two criteria are usually understood unambiguously; they are quantitative indicators. But in order to assess the level of efficiency, quality, intensity and effectiveness, it was necessary to create a special methodology. The Ministry of Health, by order No. 421 dated June 28, 2013, proposed to regional departments a list of performance indicators that should be taken into account when addressing incentive issues described in the Methodological Recommendations.

According to this document, the factors characterizing the effectiveness of the work of doctors are:

• how many ailments according to his profile the doctor identified at an early and advanced stage;
• how many misdiagnoses he made;
• were there any cases of untimely hospitalization;
• how many complications were identified after operations (other manipulations with the body);
• customer complaints and complaints;
• errors and inaccuracies in document management;
• unsanitary conditions;
• other.

A specially created commission within the organization carries out performance assessments. Every month this body issues a special expert assessment Act, which is the basis for an order on incentives.

The above criteria must be described in the Regulations on remuneration of the enterprise. The regional Ministry of Health is obliged to establish in its document minimum value each of the listed factors.

If at the end of the year it turns out that the hospital has unused funds under the Program, they can be paid to doctors (annual bonus).

How does combination and substitution affect the amount of incentives?

Health workers often have to work for an absent or temporarily absent colleague. This does not always lead to higher salaries.

Part-time workers will receive incentives only if their additional responsibilities are properly documented, that is, in an employment contract. Doctors who replace their colleagues on vacation can also be paid extra. But this type of combination should be formalized by an additional agreement.

Combining positions within the framework of the main contract is not subject to additional incentives.

Deprivation of incentives

The head of the organization decides who to pay and when to refuse. The law does not provide for mandatory payment of incentives to doctors, which suggests a hypothetical probability of deprivation of this part of the salary.

This requires a serious reason, for example, disadvantages in all of the above criteria (the doctor did nothing) or a gross violation of labor discipline.

If you are faced with a refusal to accrue any part of your salary, ask for an order from management on the basis of which the accountant acted. Look for reasons in this paper. Only after studying them should you decide to file a complaint.

Last changes

In connection with the work to implement the so-called May Decrees of the President of the Russian Federation (from 2012), in 2017 there was a serious redistribution of funding for the parts that make up the salaries of doctors. There is a decrease in incentives for doctors throughout Russia.

Reducing the amount of incentive payments occurs in two ways.

In the first case, citing the need to comply with federal legislation, the base salary was increased. At the same time, some types of incentives were cut back or completely cancelled.

In the second case, payments were reduced, which are not regulated by government regulations. This mainly affected incentives for the quality and intensity of work.

Since the end of 2018, the calculation procedure and the amount of insurance premiums for compulsory medical insurance for the non-working population have changed, including in terms of the increase in the cost of medical services. An increase in such indicators should entail a corresponding increase in the remuneration of health workers, calculated based on the number of citizens served with this type of compulsory medical insurance. However, whether the remuneration of health workers will actually change or this is yet another reshuffle within the framework of the FFOMS budget - only practice will show.

In 2020, the redistribution of funds will continue in order to equalize wage indicators for public sector employees. The remuneration of health workers should be in accordance with the average salary in the region as a whole.

The increase planned for junior medical staff by 4.3% in 2019, by 3.8 in 2020 and by 3.4% in 2021 actually indexes wages to the inflation rate.

In recent years, doctors’ salaries and the entire system of remuneration for medical workers have changed significantly, which can be associated with the need to motivate employees to provide high-quality medical care. In turn, the salary level of healthcare workers should fully depend on how high-quality medical services they provide to the population.
Government Order No. 2190-r dated November 26, 2012 provides for a phased change in the wage system in the public sector, which involves improving the main components of wages - salary, tariff (hourly) rate, as well as additional incentive and compensation payments.

At the same time, the salary level of healthcare employees should fully depend on the quality of medical services they provide to the population.

Salaries of doctors and medical workers in 2016*

According to Rosstat, for the first half of 2016, the average salary of doctors and medical workers was 48,946 rubles.

The highest salaries of doctors are predictably recorded in the Nenets, Chukotka, Yamalo-Nenets, Khanty-Mansiysk - Yugra, autonomous okrugs; Kamchatka region; Magadan, Sakhalin, Tyumen regions; Moscow and the Republic of Sakha (Yakutia).

The lowest salaries of medical workers and doctors: Oryol region, Republic of Mari El, Ulyanovsk region, Republic of Ingushetia, Republic of Adygea, Republic of Dagestan, Kabardino-Balkarian Republic, Karachay-Cherkess Republic, Republic of North Ossetia-Alania, Republic of Kalmykia.

See the full salary tables for doctors in 2016 in Russia below.

Piecework wages for health workers

A doctor’s salary can be based on the principle of piecework, taking into account some features. In particular, it is necessary to take into account the recommendations of the Ministry of Health of the Russian Federation, as well as the Russian Tripartite Commission (RTC). Generally speaking, the current legislation contains provisions allowing the establishment of piecework in an organization wages, however, no exceptions are provided for employees of medical institutions. With piecework payment for health workers, the established price for the work performed is taken into account, while the tariff rate is set for the completed labor standard, and does not include incentive or compensation payments. The fact that these concepts are not equivalent follows from the conclusions of the courts based on the results of consideration of civil cases. In addition, Order No. 377 of the Ministry of Health of the Russian Federation, which contained a direct indication of the possibility of using piecework rates to set the salaries of health workers, has also lost force. Today, the Ministry of Health of the Russian Federation adheres to the position that the salary of doctors should include: salary, incentive and compensation payments and a tariff rate. However, if in a hospital there is still a need to establish a piece-rate form of remuneration for individual employees, then it is necessary to provide for such a form in a local act of the institution - in a collective agreement or other local act. This will not constitute a violation of current labor laws.

Brigade forms of remuneration

Some hospitals are considering the possibility of establishing team forms of remuneration in the institution, that is, when the salary of a particular doctor or other medical worker depends on the overall results of the unit, department or visiting team.

Today, the system of remuneration for medical workers in ordinary urban and district hospitals, provides for the calculation of the amount of additional incentive payments depending on the specific collective results of the work of hospital employees.

Formula for calculating the optimal average daily load on an emergency medical team:

According to the author’s methodology V.M. Shipova and A.N. Plutnitsky, the optimal load on the emergency medical team has not been determined, since the flow of calls is random and the frequency of calls is not regulated. But it is possible to calculate the optimal load on an emergency medical team. Based on planning and normative data on the provision of the population with ambulances and the number of calls, we derive the formula:

318 X 10: 365 = 8.7, where
318 - number of calls per 1000 population;
10.0 thousand - population;
365 - calendar days of the year;
The indicator of 8.7 (9.0) calls is the average daily load on the emergency medical team.

The wage system in such institutions is fixed in local acts(agreements, collective agreements, regulations, etc.), taking into account:

• approved classifiers of professions and positions;
• developed medical professional standards;
• opinions trade unions health workers;
• professional communities of employers;
• volumes of state guarantees in the field of wages;
• position of the Russian Trilateral Commission;
• position of the Ministry of Health of the Russian Federation.

Thus, the joint recommendations of the Ministry of Health of the Russian Federation and the RTK do not provide for the use of a team form of remuneration. Previously, the use of the form of team remuneration for medical workers was provided for in the order of the USSR Ministry of Health No. 1180 dated November 10, 1986, but since 2009 it has lost its legal force. However, current legislation does not prohibit taking into account the results of the team’s work to calculate incentive payments to a specific medical worker. Also, the Order of the Government of the Russian Federation No. 2190-r dated November 26, 2012 states that specific incentives should be established for medical workers for achieving collective work results.

Salary parts ratio

The Ministry of Health of the Russian Federation has established a maximum level for the ratio of the average salary of chief doctors of hospitals and medical workers in the system of healthcare institutions. Thus, in accordance with Order No. 170 of March 28, 2013, the maximum salary level for the chief physician of a hospital is a multiple of 8 salaries of hospital employees under the jurisdiction of the Ministry of Health of the Russian Federation. The regulations on remuneration of employees of the Medical Organization have been developed in accordance with the requirements Labor Code RF and other regulatory legal acts containing labor law norms.

Salary of medical workers

This section discusses all the legal features of establishing salaries for medical workers, including the rules for using professional qualification groups, accounting for length of service and the possibility of establishing an individual salary for a medical worker.

Setting a personal salary

Salary is a certain amount of remuneration for a health worker, which is set for him to perform his duties. professional responsibilities provided for by a specific position. The salary amount does not include other additional payments. We believe that establishing personal salaries for health workers in state and municipal hospitals labor legislation is not directly prohibited, although it is not recommended by other standards for the following reasons. In accordance with Art. 22 of the Labor Code of the Russian Federation, a medical institution, as an employer, must provide its employees with the same wages for performing similar work. At the same time, the establishment of different salaries for the same positions is not prohibited, but seems unjustified. The RTK adopted unified recommendations for establishing remuneration for employees of state and municipal institutions dated December 25, 2015, which do not recommend establishing different rates and salaries for employees who are included in the same qualification group. It is also not recommended to indicate the range of official salaries for health workers who perform work of the same complexity. However, as law enforcement practice shows, the decision to establish an individual salary is not recognized labor discrimination in the event that employees occupy the same position, but perform different amounts of work of varying complexity.

How to take into account experience

By general rule The length of service of a medical worker does not in any way affect the amount of his official salary. As we already said, official salary represents a fixed monthly payment to an employee who has fulfilled his job responsibilities in the proper amount. Since the remuneration of medical workers consists not only of official salary, their continuous medical experience should be reflected in other payments, for example, in compensation payments. Such recommendations were established by order of the Ministry of Health and Social Development of the Russian Federation No. 818 dated December 29, 2007.

Application of professional qualification groups

Professional qualification groups (PQG) can be used when establishing base rates and salaries by the Government of the Russian Federation; the salary of health workers in state and municipal hospitals cannot be lower than the salaries established by the PQG. According to the order of the Government of the Russian Federation No. 2190-r dated November 26, 2012, interested executive bodies, together with the Ministry of Labor of the Russian Federation, can develop and make their own specific proposals on the official salaries of PKG employees. The basis for the formation of the PKG are certain requirements for the level of qualifications of employees that they need to implement a specific professional activity, because In accordance with labor legislation, a doctor’s salary, like any other employee, depends on his qualifications. Therefore, before the establishment of base salaries for specific positions by the Government of the Russian Federation, in healthcare institutions, PCGs can be used in the development of remuneration systems for health workers. This is confirmed by the provisions of the Government of the Russian Federation No. 583 dated August 5, 2008, which states that employee salaries are established by the management of the institution based on the requirements for qualifications and work experience for a specific position (PC). This takes into account the volume of work performed by employees and its complexity.

Ratio of salaries of managers and medical workers

The salaries of medical workers do not in any way affect the salary of the hospital's chief physician and the salaries of his deputies. As stated in Art. 145 of the Labor Code of the Russian Federation, remuneration for heads of state and municipal institutions is established in accordance with labor legislation, constituent documents official, regional and municipal acts. Specific terms of remuneration for executive officers are reflected in their employment contracts. At the same time, a number of regulations have adopted recommendations for establishing the level of remuneration for heads of institutions: recommendations for 2016, approved by the RTK dated December 25, 2015, as well as in relation to federal institutions - Resolution of the Government of the Russian Federation No. 583 dated August 5, 2008. These documents recommend that the heads of the institution be set a salary that is a multiple of 8 average salaries of all employees of the institution; The decision of the RTK dated December 25, 2015 also recommended setting salaries for chief accountants and deputy chief physicians at the level of 70-90% of the salaries of hospital managers.

Salary: establishment control

Which bodies can verify the correctness of the choice of salary for employees of a medical institution:

Labour Inspectorate when conducting inspections as part of state supervision for compliance by medical institutions with labor legislation of the Russian Federation. In addition, the State Labor Inspectorate carries out inspections of the implementation of the program for improving the wage system in state and municipal institutions, which was approved by Decree of the Government of the Russian Federation No. 2190-r dated November 26, 2012;
The Ministry of Health of the Russian Federation, as the department that exercises the powers of the founder in relation to subordinate medical institutions; territorial compulsory medical insurance funds, which check salary levels as part of audits of labor costs, which are included in the structure of the tariff for payment of medical care in the compulsory medical insurance system;
other government bodies authorized to conduct audits of financial and economic activity hospitals.
The reporting form for wages of employees of medical organizations in the field of compulsory health insurance was approved by Order of the Federal Compulsory Medical Insurance Fund dated March 26, 2013 No. 65.

Calculation of the amount of funds allocated for remuneration of employees of the office (office) of general medical practice (family doctor)

1. Number of employees

2. Number of attached population, people.

3. Per capita funding standard, rub.

4. Amount of financing, rub.

5. Report on the expenditure of funds

Chief physician

Chief Accountant

Compensation payments to medical workers

Indication of compensation payments in the employment contract

Is it possible to stipulate in a health worker’s employment contract that the amount of his compensation payments is established by the legislation of the Russian Federation? If the legislator has established minimum amounts of compensation payments for health workers, the employer must indicate in the employee’s employment contract a specific amount or a percentage of the official salary. Compensation payments to medical workers can be provided on various grounds: for medical experience, for irregular working hours, for working in rural areas, for having a professional category, etc. Labor legislation, as a rule, establishes only the minimum amount of such payments. The specific amounts of compensation bonuses for medical workers must be established by the employer by setting out such sections in the hospital’s wage regulations. Additional guarantees for employees who work in conditions deviating from normal conditions must be specified in the employee’s employment contract, in accordance with Art. 57 Labor Code of the Russian Federation. In addition, the recommendations approved by Order of the Ministry of Health of the Russian Federation No. 167-n dated April 26, 2013, indicate that specific factors and conditions for receiving all compensation payments should be specified in the wage regulations, as well as in the employee’s employment contract.

Reduction in the amount of compensation payments based on the results of special assessment work

Let's consider the conditions under which a health worker may be reduced in compensation payments provided to him in connection with special assessment working conditions (SOUT). The amount of compensation for a health care worker may change as it improves. working conditions, which is confirmed by the conclusion of a specialist on special medical treatment carried out in a hospital (Article 74 of the Labor Code of the Russian Federation); As is known, guarantees and compensation for health workers who are employed in working conditions that deviate from normal are provided in accordance with the provisions of labor legislation, the hospital’s collective agreement, the employee’s employment contract, etc.

However, the employer must cancel the previously provided guarantees if safe working conditions are provided at the employee’s workplace, as confirmed by the conclusion of the state examination or SOUT. In connection with the adoption of the new law No. 426 “On SOUT”, there is a transition period to new system job evaluations. So, if the hospital carried out certification of workplaces before July 13, 2015, then it will continue to be valid for 5 years. SOUT is not necessary during this period. The medical institution has the right, but is not obligated, to initiate the implementation of special assessment procedures before the expiration of the certification results.

If the preservation of working conditions that gave the employer the right to establish compensation payments to its employees has been confirmed, then the amount of these additional guarantees cannot be changed in comparison with those payments. Which were in effect at the beginning of 2014. In accordance with the clarifications of the Ministry of Labor of the Russian Federation dated December 15, 2014 regarding the application of the new SOUT rules, an improvement in working conditions is a reduction in the final class or subclass of working conditions at a specific employee’s place of work. So, if the working conditions of a health worker have improved, which was confirmed in the conclusion of the Special Assessment of Labor and Safety, the hospital management may reconsider the amount of compensation provided to the employee during harmful conditions labor. In this case, it is necessary to remember the rules for changing the terms of the employment contract between the hospital and the employee, which are set out in detail in Art. 74 Labor Code of the Russian Federation.

Replacement additional leave for harm with monetary compensation

Many employees have a desire to replace part of their annual leave with monetary compensation. Is it possible, from a legal point of view, to replace leave granted to an employee for working in hazardous working conditions with monetary compensation?

Replacing vacation with compensation is possible, but it is important to meet a number of conditions:

• You can only compensate part of the vacation “for harmfulness” (2, 3, 4 degrees);
• All employees of the Labor Code of the Russian Federation guarantee a minimum of 7 calendar days for work in harmful and dangerous working conditions;
• if the collective agreement of a medical institution or industry regulations guarantee such employees more than 7 days of additional leave, then, at the request of the employee, the part exceeding the guaranteed one can be replaced by monetary compensation;
• the possibility of replacing parts of vacation days with monetary compensation should be directly stipulated in the hospital’s local regulations or industry agreement;
• the employee must express his desire to replace additional leave with money; his consent is formalized in an additional agreement to the employment contract.

Accounting for compensation payments when on duty at home

Remuneration for medical workers consists of salary, compensation and incentive payments. Taking into account all these payments, payment is also made for the doctor’s duty at home.

Home duty refers to the stay of a hospital doctor at home while awaiting a call to a medical facility or to a patient to provide urgent or emergency medical care. For such employees, special work and time recording regimes are usually established.

In accordance with the order of the Ministry of Health of the Russian Federation No. 148-n dated April 2, 2014, the time during which a health worker was on duty at home is considered working time, and it is taken into account when recording working time in total.

However, the legislation does not establish specific rules by which to calculate doctor's salary, who was on duty at home. This means that all payments to the employee are taken into account in general procedure, including compensation payments, regardless of whether the doctor was on duty at home or not.

Compensation payments: control of establishment

The following government agencies and officials can verify the accuracy of the establishment of compensation payments to medical workers:

territorial bodies of the labor and employment service, during the state examination of working conditions. It is during such an audit that inspectors assess the correctness of providing health workers with the required amount of compensation for working in harmful or dangerous working conditions;

the state labor inspectorate, which assesses the safety of working conditions, verifies the provision and protection of the labor rights of health workers during special inspections;

labor protection specialists and inspectors of trade union bodies of medical workers who carry out an independent examination of working conditions and employee safety in the workplace;

territorial bodies of compulsory medical insurance, during inspections, the purpose of which is to check the costs of wages, which are part of the tariff for payment of medical care.

Incentive payments to medical workers

Using scoring

Medical institutions of municipal or state system healthcare providers are not required to use scores to evaluate the performance of their employees labor activity Incentive payments to medical workers must be established in local regulations of the hospital, in a collective agreement, industry agreement or other regulations that contain labor standards.

Approved by Order of the Ministry of Health of the Russian Federation No. 421 dated June 28, 2013 guidelines, which states that there are different mechanisms for distributing the fund of incentive payments among employees of a particular institution. Including the introduction of a scoring system and bonuses. This means that a specific medical institution can develop and implement its own mechanisms for calculating incentive additional payments to medical workers, including the right to introduce point system distribution of payments. To do this, it is necessary to develop appropriate criteria and indicators.

Payments to PNP “Health”

Payments to medical workers within the framework of the national project “Health” are established in the regions in accordance with tariff agreements and the terms of the territorial program. Let us remind you that one of the objectives of the program is financial incentives medical workers. Should the management of a medical institution maintain payments to local doctors and paramedical staff that were previously provided to them under this program? Labor legislation in Art. 135 of the Labor Code of the Russian Federation identifies sources in which additional incentive payments to employees can be established, including the conditions for paying bonuses.

In accordance with the program of state guarantees for 2016, which was approved by Decree of the Government of the Russian Federation No. 1382 of December 19, 2015, the structure of the tariff provided for payment for assistance provided to the population in the compulsory medical insurance system includes incentive payments for local doctors, nurses, and paramedic-obstetric employees points, ambulance staff, etc.

In tariff agreements between the regional executive body, the territorial compulsory medical insurance fund, trade unions of medical workers, as well as medical non-profit organizations, specific tariffs are established for payment for medical care provided by hospitals.

Today, when setting these tariffs, the commission authorized by the participants takes into account the amount of incentive additional payments to health workers, which were previously established by the national Health program.

In this regard, we believe that a medical institution should provide that all such payments should be made in the amount that is already taken into account in the tariff for the provision of medical care under the territorial compulsory medical insurance program approved at the regional level.

Conditions under which incentive payments are not made

The medical institution must initially register in the regulatory documentation special conditions, upon the occurrence of which incentive additional payments to specific health workers will not be made. The current system of remuneration for health workers is established in the hospital’s collective agreement, in the regulations on remuneration, as well as in the employment contracts of specific employees. From legal essence Incentive payments mean that their accrual to specific medical workers is not the responsibility of the medical institution - it is its right. At the same time, the order of the Government of the Russian Federation No. 2190-r dated November 26, 2012 directly states that the remuneration system, as well as the conditions for receiving certain payments and rewards, should not be interpreted ambiguously by the parties, they should be equally understandable to both the health worker , and to the employer.

• if during inspections the fact of providing citizens with medical services paid, while the state guarantee program provides for the provision of such services for free of charge;
• overlay disciplinary action for a medical worker.

At the same time, the remuneration system of a particular medical institution may provide for other conditions for depriving a medical worker of incentive payments in a specific period.

Deprivation of bonuses to medical workers

The issue of applying such a sanction as deprivation of bonuses to medical workers is controversial. Let us note that, according to departmental recommendations, as well as the provisions of the Labor Code of the Russian Federation, it is recommended that medical institutions provide conditions for the use of incentive additional payments, but not conditions for depriving an employee of a bonus due. In accordance with Government Order No. 2190-r, measures to improve the system of incentive additional payments to health workers are carried out with the aim of connecting the size of doctors’ salaries with the specific results of their work. First of all, the quality of medical services provided is taken into account, based on which incentive payments are applied. The bonus itself is one of the types of incentive payments for medical workers, therefore the medical institution must establish specific conditions for receiving it. A specific list of disciplinary penalties is contained in Art. 192 of the Labor Code of the Russian Federation, however, such a measure as deprivation of bonuses (deprivation of bonuses) is not contained in the current version of the code. Judicial practice also speaks about this. The courts clearly interpret the application of a reduction in bonuses in relation to any employee of the employer as an unreasonable and not subject to application sanction, which current legislation is declared illegal. In this regard, we recommend that chief doctors of hospitals avoid applying such sanctions in relation to medical workers; local hospital regulations, moreover, should not contain any conditions for deprivation of bonuses.

Labor standards for incentive payments

When establishing incentive payments for health workers, certain labor standards are used, however, not all of them are advisable to use as criteria for additional payments. In particular, labor standards that are not directly provided for the purpose of assigning incentive payments and do not in any way reflect the results of the professional activity of a health worker and the quality of medical services provided to him are not applicable. This is due to the provisions of the Order of the Government of the Russian Federation No. 2190-r dated November 26, 2012, which states that all incentive additional payments to employees depend on the quality of their work and the professional results achieved, and specific indicators and criteria of their activities must be reflected in labor contract employee based on the developed remuneration system. In accordance with Order of the Ministry of Labor of the Russian Federation No. 504 dated September 30, 2013, specific labor standards of an institution are established by the labor standardization system in the organization. At the same time, different norms and standards may be established in a medical institution: by number of personnel, by time, by volume, output, etc.

It is inappropriate to use the following standards to determine incentive payments:

1. Norm number of health workers. In accordance with Order of the Ministry of Labor of the Russian Federation No. 504 dated September 30, 2013, this norm is needed, first of all, to determine the number of employees in certain positions that are necessary to perform a certain amount of work or production and other functions. For example, such a norm can be expressed in one medical position per area in accordance with the number of the attached population.

2. Time standards. In accordance with Order of the Ministry of Labor No. 504, they express the specific time spent by a health worker, which he needs to provide one service (perform work). This indicator is primarily used to calculate employee headcount standards.

Service standards, in accordance with Order of the Ministry of Labor of the Russian Federation No. 504, are indicators of the number of jobs, equipment, production space, etc., with which an employee works during a certain unit of working time. This indicator can be used to evaluate an employee’s work performance when calculating incentive payments.

An approximate list of indicators for assigning incentive payments for the intensity and effectiveness of work, as well as bonus payments for certain categories of employees, is recommended expert group information center"MCFER-Medicine".

Salary fund for medical workers

In medical institutions, there are several sources for the formation of the salary fund for medical staff:

• cash from budgets of different levels;
• funds from extra-budgetary sources (from compulsory medical insurance funds);
• cash received from income-generating activities.

In healthcare institutions that are under the jurisdiction of a region or municipality, the wage fund is formed in accordance with the relevant regulations of the constituent entity of the Russian Federation or municipality. In accordance with the Decree of the Government of the Russian Federation No. 2190-r dated November 26, 212, a system of differentiated remuneration for personnel is currently provided; the final salary of a doctor depends on the complexity of the work he performs, its volume, as well as the qualifications of the employee. The procedure for determining the wage fund of medical workers in a particular unit must be approved in the local acts of the medical institution, which establish the organization’s remuneration system. At the same time, the wage fund is calculated in different ways. So, in some hospitals the basis is taken staffing table, in others, the amount of annual funding is taken into account.

In any case, remuneration for medical workers is based on - official salary, which was indicated in the employment contracts. It is in relation to the amount of salary that other mandatory payments are applied - compensatory. The procedure for their calculation must be specified in the local regulations of the hospital.

Accrual incentive payments depends on the quality indicators established in the hospital and the volume of work performed, as well as on other conditions described in the remuneration regulations. It is these components that make up the modern differentiated wage system. Thus, the final salary of a doctor directly depends on the quality, complexity and volume of his work, i.e. on the quality of medical services provided to the population.

In order to calculate the incentive part of earnings using such a system, you must follow the following procedure:

• determine how many points each doctor earned during the reporting period;
• summarize all points earned by department employees;
• determine the part of the wage fund that falls on incentive payments to department employees;
• calculate the cost of one point;
• calculate the incentive part of the employee’s salary based on the cost and the amount of points scored.

Based on this, the wage fund of a medical worker is the sum of all payments due to the employee for the month worked, including incentive payments, bonuses, and other regular payments. A doctor’s salary is calculated based on the hospital’s tariff lists, as well as its approved staffing schedule.

*) includes doctors and employees of medical organizations with higher medical (pharmaceutical) or other higher education, providing medical services (ensuring the provision of medical services) in educational, scientific, cultural, healthcare, and social service institutions.

The Faculty of Medical Law returns to the discussion of the issue of guarantees and compensation provided by the state to medical workers. As is known, medical workers when moving to countryside A one-time compensation payment is provided. Today we will talk about the procedure for providing this compensation as part of the changes for 2017.

About a one-time compensation payment

So, according to part 12.1. Article 51 Federal Law dated November 29, 2010 No. 326-FZ “On compulsory health insurance in Russian Federation"(hereinafter - Federal Law No. 326) a one-time compensation payment to medical workers is provided to medical workers who meet certain criteria, who come to work in a rural locality, or a working village, or an urban shooting range village, or who move to work in a rural locality, or a working village, or an urban-type settlement from another locality.

You should know that the amount of a one-time compensation payment to medical workers is 1,000,000 rubles.

Financing of one-time compensation payments to medical workers in 2017 is carried out through other interbudgetary transfers provided to the budget of the territorial compulsory medical insurance fund from the budget of the Federal Compulsory Medical Insurance Fund in accordance with Federal Law dated December 19, 2016 No. 418-FZ “On the budget of the Federal Compulsory Medical Insurance Fund for 2017” and for the planning period of 2018 and 2019,” and funds from the budgets of the constituent entities of the Russian Federation in the ratio of 60 and 40 percent, respectively.

Please note that in accordance with clause 37.2 of Article 217 of the Tax Code of the Russian Federation, a one-time compensation payment is not subject to taxation.

The purpose of this payment is to attract medical workers to rural settlements and compensate for costs associated with relocation and arrangement, as well as inconveniences caused by less comfortable living conditions compared to other (non-rural) settlements.

At the same time, the legislator does not at all limit medical workers who come to work in a rural locality in what the provided amount will be spent on.

The medical worker, in turn, upon receiving a one-time compensation payment, must work for a certain period of time in a medical organization in a rural locality of the constituent entity of the Russian Federation with which the specified agreement was concluded. As a rule, this period is 5 years.

It should be noted that Federal Law No. 326 does not provide any explanation as to which particular settlement can be considered rural.

A similar explanation is contained in the FFOMS Letter No. 801/21-i dated 02/05/2013 “On making one-time compensation payments in 2013” ​​(hereinafter referred to as the FFOMS Letter No. 801/21-i). On the issue of classifying settlements as rural settlements and workers' settlements, it is necessary to be guided by Part 1.1 of Article 10 of the Federal Law of October 6, 2003 No. 131-FZ “On general principles organizations local government in the Russian Federation" (hereinafter referred to as Federal Law No. 131). Since FFOMS Letter No. 801/21-i refers to the old version of Federal Law No. 131, we will present the current provision of Federal Law No. 131 on this issue.

Thus, according to Part 1.1 of Article 10 of Federal Law No. 131, the allocation municipalities the status of an urban, rural settlement, municipal district, urban district, urban district with intracity division, intracity district, intracity territory of cities of federal significance is carried out by the laws of the constituent entities of the Russian Federation.

It is worth noting that the criteria that apply to medical workers applying for a one-time compensation payment change from year to year.

Thus, in 2017, a one-time compensation payment will be paid only to those medical workers who meet the following criteria in total:

• age - up to 50 years (by the way, in 2012-2014 the age limit was up to 35 years, in 2015 - 45 years);
• presence of higher education;
• arriving at work in a rural locality in 2016 and 2017;
• existence of a concluded agreement with the authorized executive body of the constituent entity of the Russian Federation.

In practice, the authorities that are provided with such a package of documents also require the medical worker to employment contract between a medical worker and a state healthcare institution of a constituent entity of the Russian Federation or municipal institution healthcare.

By the way, oh given condition say the FFOMS and the Ministry of Health of Russia in the FFOMS Letter dated 07/08/2013 No. 5124/80-1/i “About judicial practice on the consideration of disputes regarding the payment of one-time compensation to medical workers who moved to work in a rural locality" (FFOMS Letter No. 5124/80-1/i) and Letter of the Ministry of Health of Russia dated August 10, 2012 No. 11-11/3089 "On the issue of implementing one-time compensation payments to medical workers" (Letter of the Ministry of Health No. 11-11/3089).

However, it is worth remembering that letters from the Federal Compulsory Medical Insurance Fund, the Ministry of Health of Russia and other authorities do not have any signs of normativity and can only be of an explanatory and recommendatory nature.

The publication of such explanatory letters by the relevant authorized bodies suggests that there is currently no uniform procedure for providing a one-time compensation payment.

In the absence legal regulation(procedure) for providing a one-time compensation payment, the FFOMS and the Ministry of Health of Russia allows the authorized executive bodies of the constituent entities of the Russian Federation to resolve this issue independently, as indicated, for example, in the letter of the FFOMS No. 801/21-i, according to which the specified bodies must submit regulatory legal documents to the FFOMS acts providing for measures of social support for medical workers, as well as the procedure for concluding an agreement between a medical worker and an authorized executive body.

Thus, the Procedure for concluding an agreement with a medical worker on the provision of a one-time compensation payment in 2017 in the Moscow Region was approved by Decree of the Moscow Region Government dated March 14, 2017 No. 145/8 (hereinafter referred to as the MO Procedure).

In accordance with this Procedure for Moscow Region, an agreement on the provision of a one-time compensation payment must provide for:

• the obligation of a medical worker to work for five years at the main place of work under the terms of normal working hours established by labor legislation for this category of workers, in accordance with the employment contract concluded by the medical worker with a state health care institution of the Moscow region located in a rural locality or workplace a village in the Moscow region, or an urban-type settlement in the Moscow region (hereinafter referred to as a health care institution);
• procedure for providing a medical worker with a one-time compensation payment in the amount of one million rubles during thirty working days days from the date of conclusion of the agreement with the Ministry of Health of the Moscow Region (hereinafter referred to as the Ministry);
• the obligation of a medical worker to return to the budget of the Moscow region part of a one-time compensation payment in the event of termination of an employment contract concluded by a medical worker with a healthcare institution before the expiration of a five-year period, calculated from the date of termination of the employment contract, in proportion to the period not worked by the medical worker;
• liability of a medical worker for failure to perform duties, provided for by the agreement, including the return of a one-time compensation payment;
• provision on the consent of a medical worker to the processing of his personal data.

The procedure for the Ministry of Defense explains that an agreement with a medical worker is concluded by the Ministry after the medical worker concludes an employment contract with a healthcare institution.

At the same time, a healthcare institution that has entered into an employment contract with a medical worker:

• checks the availability and accuracy of documents submitted by the medical worker;
• submits to the Ministry an application from a medical worker for a one-time compensation payment (please note that there is no deadline for submitting such an application to the Ministry. Note that previously the health care institution had to send an application to the Ministry within three working days from the date of concluding an employment contract with a medical worker).

Also, the Procedure for the Moscow Region states that a one-time compensation payment is established and paid to medical workers only at their main place of work.

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On approval of the Procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities...

GOVERNMENT OF THE MOSCOW REGION

RESOLUTION

On approval of the Procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people *

Document with changes made:
(Official website of the Government of the Moscow Region www.mosreg.ru, 06.26.2019);
(Official website of the Government of the Moscow Region www.mosreg.ru, 03/25/2020).
____________________________________________________________________

______________
* Name as amended, put into effect on July 7, 2019 by Decree of the Government of the Moscow Region dated June 25, 2019 N 375/19 by Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7 ..

In accordance with Appendix No. 8 “Rules for the provision and distribution of subsidies from the federal budget to the budgets of constituent entities of the Russian Federation for one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers’ settlements, or urban-type settlements , or cities with a population of up to 50 thousand people" to the state program of the Russian Federation "Healthcare Development", approved by Decree of the Government of the Russian Federation dated December 26, 2017 N 1640 "On approval of the state program of the Russian Federation "Healthcare Development", Government of the Moscow Region
(Preamble as amended, entered into force on July 7, 2019 by Decree of the Government of the Moscow Region dated June 25, 2019 N 375/19; as amended, entered into force on March 26, 2020 by Decree of the Government of the Moscow Region dated March 25, 2020 N 140/ 7.

decides:

1. Approve the attached Procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people.

2. Establish an expenditure obligation of the Moscow region related to the implementation of measures to financially provide one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers’ settlements, or urban-type settlements, or cities with a population up to 50 thousand people.
Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7.

3. Designate the Ministry of Health of the Moscow Region as the authorized central executive body state authorities of the Moscow region to provide one-time compensation payments to medical workers.

4. Financial support for one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers’ settlements, or urban-type settlements, or cities with a population of up to 50 thousand people, is carried out on the basis of co-financing at the expense of subsidy funds provided within the budgetary allocations provided for by the Law of the Moscow Region for the next financial year and planning period.
(Clause as amended, put into effect on March 26, 2020 by Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7.

5. The Main Directorate for Information Policy of the Moscow Region shall ensure the official publication of this resolution in the newspaper "Daily News. Moscow Region", "Information Bulletin of the Government of the Moscow Region", placement (publication) on the website of the Government of the Moscow Region in the Internet portal of the Government of the Moscow Region and on " Official Internet portal of legal information" (www.pravo.gov.ru).

6. Entrust control over the implementation of this resolution to the First Vice-Governor of the Moscow Region I.N. Gabdrakhmanov.
(Clause as amended, put into effect on July 7, 2019 by Decree of the Government of the Moscow Region dated June 25, 2019 N 375/19.

Governor

Moscow region

A.Yu.Vorobiev

The procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to...

APPROVED

Government resolution

Moscow region

dated April 3, 2018 N 204/13
(As amended as put into effect
from July 7, 2019 by decree
Government of the Moscow region
dated June 25, 2019 N 375/19. -
See previous edition)

The procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people *

______________
* Name as amended, put into effect on March 26, 2020 by Decree of the Moscow Region Government dated March 25, 2020 N 140/7..

1. This Procedure regulates the provision of one-time compensation payments to medical workers (doctors, paramedics) who are citizens of the Russian Federation who do not have outstanding obligations under an agreement on targeted training (with the exception of medical organizations with a staffing level of less than 60 percent) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people and who have entered into an employment contract with a medical organization subordinate to the Ministry of Health of the Moscow Region, on a full-time basis with working hours established in accordance with with Article 350 of the Labor Code of the Russian Federation, with the implementation labor function for a position included in the list vacant positions medical workers in medical organizations and their structural divisions, upon replacement of which one-time compensation payments are made for the next financial year (hereinafter referred to as a one-time compensation payment, medical workers), as well as medical workers who have fulfilled obligations related to targeted training (targeted training), provided that they continue to work in the same medical organization located in a rural settlement, or a workers' settlement, or an urban-type settlement, or a city with a population of up to 50 thousand people.
(Clause as amended, put into effect on March 26, 2020 by Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7.

2. The size of the one-time compensation payment is 1 million rubles. for doctors and 0.5 million rubles. for paramedics.

3. A one-time compensation payment is provided to a medical worker once.

4. The Ministry of Health of the Moscow Region (hereinafter - the Ministry) has the right to decide to provide a medical worker with a one-time compensation payment if he has obligations related to targeted training (targeted training), subject to the conclusion of an employment contract with a medical organization subordinate to the Ministry (hereinafter - a medical organization) whose staffing level is less than 60 percent.

5. The Ministry annually, before November 1 of the year preceding the next financial year, approves the List of vacant positions of medical workers in medical organizations and their structural divisions, upon replacement of which one-time compensation payments are made for the next financial year (hereinafter referred to as the program register of positions).

6. A one-time compensation payment is provided on the basis of an agreement on the provision of a one-time compensation payment (hereinafter referred to as the agreement), concluded between a medical worker, a medical organization and the Ministry.

7. The form of the agreement is approved by the Ministry.

8. Copies of the following documents are attached to the agreement:

passports of a citizen of the Russian Federation;

insurance certificate of state pension insurance;

certificates of registration individual at the tax authority;

completion document educational institution higher education (doctors) or professional educational organization(paramedics);
Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7.

document confirming completion of internship or residency (for doctors of specialties for which training in internship or residency is mandatory for employment in accordance with Order of the Ministry of Health of the Russian Federation dated October 8, 2015 N 707n “On approval of qualification requirements for medical and pharmaceutical workers with higher education in the field of study "Healthcare and Medical Sciences");
(Paragraph as amended, put into effect on March 26, 2020 by Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7.

document on professional retraining(in the presence of);

specialist certificate (or specialist accreditation certificate);

certificates of recognition of foreign education and (or) foreign qualifications;

specialist certificate issued Federal service for supervision in the field of healthcare of Roszdravnadzor, or its territorial authorities(for persons who received medical training in universities of foreign countries who are citizens of the Russian Federation);

employment contract;

work book or information about work activity received in multifunctional center provision of state and municipal services on paper;
(Paragraph as amended, put into effect on March 26, 2020 by Decree of the Government of the Moscow Region dated March 25, 2020 N 140/7.

order of appointment to a position;

document from credit organization, containing the name of the bank, BIC of the bank, TIN of the bank, KPP of the bank, personal account of the medical worker;

licenses for a healthcare institution to carry out medical activities.

9. The contract is concluded on the basis of an appeal from a medical worker to the head of a medical organization, received after the conclusion of an employment contract providing for work in a position included in the program register of positions, and completion probationary period, if such a period is established for a medical worker upon hiring.

10. An agreement signed by a medical worker and the head of a medical organization is sent by the medical organization to the Ministry.

11. The Ministry, within no more than 30 working days from the date of receipt of the agreement on the provision of a one-time compensation payment, signed by the medical worker and the head of the medical organization, signs the said agreement and sends two copies of the agreement on the provision of a one-time compensation payment to the medical organization.

12. If there are grounds for refusal to conclude an agreement, provided for in paragraph 13 of this Procedure, the Ministry, within the period specified in paragraph 11 of this Procedure, sends to the medical worker a reasoned refusal to conclude an agreement to provide a one-time compensation payment.

13. The grounds for refusal to conclude an agreement are:

non-compliance of the medical worker who signed the contract with the requirements provided for in paragraph 1 of this Procedure;

sending to the Ministry an agreement that does not correspond to the form of the agreement approved by the Ministry;

absence of copies of documents provided for in paragraph 8 of this Procedure.

14. If the reasons that served as grounds for refusal to conclude an agreement are eliminated, the medical worker has the right to re-apply for a one-time compensation payment in accordance with paragraphs 9 and 10 of this Procedure.

15. Ministry:

keeps records of concluded and executed contracts;

transfers a one-time compensation payment to the account of the recipient of the one-time compensation payment.

16. A medical worker who has entered into an agreement with a medical organization and the Ministry assumes the following obligations:

1) perform labor duties for 5 years from the date of conclusion of the contract for positions in accordance with the employment contract, subject to the extension of the contract for the period of non-fulfillment of the labor function in full (except for the rest period provided for in 107 of the Labor Code of the Russian Federation);

2) return to the budget of the Moscow region part of the one-time compensation payment, calculated in proportion to the unworked period from the date of termination of the employment contract until the expiration of the 5-year period (except for cases of termination of the employment contract on the grounds provided for in paragraph 8 of part one of Article 77 and paragraphs 5-7 of part first article 83 of the Labor Code of the Russian Federation), as well as in case of transfer to another position or enrollment in additional professional programs;

3) return to the budget of the Moscow region part of the one-time compensation payment, calculated in proportion to the unworked period from the date of termination of the employment contract, in the event of dismissal due to conscription military service(in accordance with paragraph 1 of part one of Article 83 of the Labor Code of the Russian Federation) or extend the validity of the contract for the period of non-fulfillment functional responsibilities(at the choice of a medical professional).

Revision of the document taking into account
changes and additions prepared
JSC "Kodeks"

On approval of the Procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people (as amended as of March 25, 2020 of the year)

Not long ago, the federal government introduced incentive payments to health workers in 2020. The purpose of such government assistance is to encourage health care workers to be interested in their work. What are the conditions and procedure for receiving financial support?

Regulatory acts governing the provision of benefits

Regulation of incentive payments to medical workers in 2020 is carried out on the basis of several regulations. The first of them is, namely Article 129. It specifies the concept of wages and types of payments to employees of organizations.

Another regulatory legal act is the Decree of the Government of the Russian Federation dated August 5, 2008 N 583 (as amended on January 19, 2019) “On the introduction of new remuneration systems for employees of federal budgetary, autonomous and government institutions and federal government agencies, as well as civilian personnel of military units, institutions and divisions of federal executive authorities, in which the law provides for military and equivalent service, whose remuneration is carried out on the basis of the Unified tariff schedule on remuneration of federal employees government agencies"(together with the "Regulations on the establishment of remuneration systems for employees of federal budgetary, autonomous and state-owned institutions"), which establishes remuneration systems for people working in budgetary, autonomous and state-owned enterprises. There is also an Order of the Ministry of Health and social development RF dated December 29, 2007 N 818 “On approval of the List of types of incentive payments in federal budgetary, autonomous, government institutions and clarification on the procedure for establishing incentive payments in these institutions” (with amendments and additions), fixing the list of incentives, factors , which determine the possibility of providing a salary supplement.

A list of performance indicators that are necessary to resolve the issue of stimulating workers is listed.

Local document on payments for stimulation

Each hospital must develop its own document that governs employee benefits. It is called “Regulations on the payment of incentive bonuses to medical workers” and is considered an addition to the team agreement, which is drawn up for one year.

IN this document must contain the following data:

• the source from which funds are allocated to pay incentives to health workers;
• a list of employees eligible to apply for additional payments;
• procedure for charging money;
• the amount of the monthly supplement;
• a list of criteria that are used to check the quality of work of medical institution personnel.

The sample Regulations on incentive payments to medical workers in each hospital are almost the same.

Who has the right to apply for financial incentives?

To receive incentive payments to medical workers, a specialist must be certified in his specialty. The employee also needs to show Good work. After all, when deciding on rewards, the performance of each employee of a medical institution is taken into account.

The regional authorities themselves establish a list of positions that are entitled to receive cash benefits. The following healthcare workers do not fall into the preferential category:

• administration of the institution. Count on financial incentive managers can, but only if they directly provide medical services;
• health workers who take part in the “Health” program, namely, provide assistance during childbirth, caring for infants, as well as other doctors working with them;
• employees of medical institutions providing assistance using high technologies.

Criteria by which the work of medical personnel is assessed

Incentive payments to doctors are assigned after assessing the quality of their work. The following factors are taken into account during the audit:

1. Quality of work completed per month.
2. Volume of provided honey. services.
3. Duration of work in the institution.
4. Amount of continuous work experience.
5. Skill level.
6. Part-time work.
7. Individual increasing coefficient.

In connection with the presence of these factors, it becomes clear that the implementation of material incentives for hospital employees depends entirely on how the work is performed. This is the optimal motivation for healthcare workers.

Accrual procedure

The procedure for calculating incentive payments to health workers is regulated by a local document, which sets out the rules of remuneration in the hospital. At the end of each month, the boss prepares an order, according to which financial incentives are paid to medical workers.

Management should also create a list of employees at the end of the month indicating information about the work they have done. If the doctor failed to cope with his job responsibilities, then the bonus may not be given. The decision to award an incentive is made by a special commission, which includes:

1. Chairman of the trade union.
2. Head nurse.
3. Head of the department.

Medical staff are notified of the grades they received for their work. The commission evaluates activities using a point system. To refuse to provide presidential payments to medical workers in 2020, serious reasons are needed. For example, the doctor did not fulfill his duties or grossly violated labor discipline.

If the accounting department did not give the employee a bonus, then you need to request the provision of an order on the basis of which the accountant acts. It must indicate the reasons for the negative decision. If an employee does not agree with management’s decision, he has the right to appeal it.

In addition to incentive payments, doctors and all other workers in the medical field are entitled to a number of other government preferences. These include:

• years and others;
• preferential consumer .

Approximate calculation of the amount of the allowance

Calculation of incentive payments to health workers is made depending on the work done. Eg, wage doctor is equal to 20 thousand rubles. The increasing coefficient after evaluating the work according to the established criteria is 0.2. As a result, the financial incentive will be equal to 4 thousand rubles. This example calculation is approximate and depends on many factors.

Do they receive payments upon combination and replacement?

According to the Regulations on incentive payments to medical workers, people who replace other employees are also provided with additional monetary compensation. But at the same time, the documentary procedure for registering a part-time job must be observed.

That is, an employment contract is concluded with the employee on combining positions. If it is agreed upon within the framework of the main employment agreement, then no allowances are made.

There are no changes regarding incentive payments to healthcare workers in 2020 yet. This program is a really good motivation for doctors. The state is trying to do everything to make the salaries of medical personnel worthy of this profession.