GP Recruitment & Retention Strategy
The total number of practicing GPs has increased nationally by a mean 2.3% annually since 2001. However, the ability of practices to recruit new GPs, particularly partners and those recently qualified is becoming increasingly difficult. For example, a recent Pulse survey found a national vacancy rate of 8% which was double the figure of 2011.
In 2012/13 the Fed, funded from the Transformation Fund, undertook a review to identify and understand the reasons that affect newly qualified GPs choose to move elsewhere rather than East Suffolk and to develop a sustainable strategy, post 2012 that will reverse this trend and attract newly qualified and qualified GPs to East Suffolk. The outcome from this work has now been updated and is set-out in this strategy.
Key Themes
§ There are plenty of opportunities available at all levels in Suffolk, including all styles of working from partner to locum. Candidates are able to pick and choose based on choice of practice and better opportunities. They can negotiate salaries or ask for partnerships sooner than practices wish to offer them.
§ Feedback from practice managers suggests partners lack realistic expectations of who they can attract, and on what basis, to their practice. Many are seeking to replace personalities or skill sets with those similar to those they had already. However, the recruitment criteria are difficult to match with candidates coming forward.
§ Local surgeries are offering ‘dull’, ‘unattractive posts’ in a buyer’s market with formulaic adverts which talk about sailing, schools, proximity to London, high QoF scores which are of limited interest to potential candidates.
§ Salaried doctors are seen by practices simply as workhorses and there is little effort by practices to offer what young doctors are looking for.
§ Therefore there appears to be a mismatch between what young doctors are looking for and what practices are offering. Younger doctors seek:
§ Salaried roles with flexibility and variety – typically more than partnerships.
§ A practice environment that is friendly with sociability and ‘atmosphere’.
§ The opportunity to offer a range of areas of expertise and to learn new skills. Career development is a critical issue when deciding where to live and which practice to choose.
§ Practices which make positive first impressions, for example their own reception at the practice, the quality of the practice websites and the use of IT to manage the partnership and practice.
§ Work/life balance, after a long term training period is a consideration in selecting where to work.
§ Practices which are forward thinking, dynamic and have a modern outlook.
§ Those who lack good premises struggle most but having a welcoming team atmosphere and well maintained space can compensate.
§ Practices often do not represent themselves well at interviews. For example, recruitment is not always conducted professionally or with a structured plan for the interview. Often the reception areas are not welcoming which is off-putting to potential recruits.
§ Attracting recruits from outside the County is a challenge:
§ There are perceptions around the quality of our local hospitals, although this is largely outside our control. There are real issues with education quality in the County.
§ Suffolk is perceived as a ‘back water’ but many outside the County, for example that it lacks innovation. However, feedback from Philip Leech, a national management consultant, suggests this is not the case but that we do not promote the innovation that takes place here.
§ Rarely is Suffolk a conscious choice and for students it can be a ‘distress’ decision, based on need to apply to medical school where they think they have a better chance of gaining a place. However, feedback from Visit Suffolk suggests that once people visit, they like the County and are more likely to come back or even move here. Attracting the initial visit is the key challenge.
§ If a GP is considering Suffolk, particularly from overseas, the process is not made easy for them. For example, they need to email the LMC for a list of vacancies and there is no information on what to expect both as a GP and for spouses if they move to Suffolk.
§ There is little to differentiate Suffolk from other Counties. For example, we do not offer development programmes for salaried GPs wanting to become partners, involvement with commissioning or other projects, ongoing support for a local sessional GPs or mentoring/coaching schemes.
§ There is a lack of support networks for newly qualified GPs that exist in other areas such as the RCGP led First 5 programme
§ There is no structured County wide approach to retention of the existing workforce. For example:
o Retiring GPs are not approached with a package of support to maintain them in the workforce. The lack of a locum chambers means being a locum is burdensome and onerous.
o We do not have the RCGP Intensive First 10 for GPs having breaks for children to keep them engaged in the workforce.
Recruitment and retention strategy
1. Improve the marketing of vacancies
Raise the profile of Suffolk
§ Mount a publicity campaign with local partners to sell the benefits of Suffolk and the positive aspects of the area. Publish on the Fed’s website a video on ‘working in Suffolk’ and a PDF brochure.
§ Submit regular articles in Pulse etc featuring innovation in Suffolk e.g. the formation of the Suffolk Federation.
§ Enter competitions for awards e.g. Health Service Journal
§ Develop a publicity campaign with local partners to encourage UK and overseas based doctors to visit Suffolk during long weekends. During the visit GPs can be shown practices during the Friday whilst their spouses are shown schools, housing etc. In the evening a dinner would be held with representatives of recruiting practices.
§ Develop a comprehensive stakeholder engagement strategy with SCC, Ipswich Borough Council, East of England Deanery, Local Education & Training Board (LETB), LMC & UCS. Particular attention should be paid to local flagship businesses and groups such as ‘Future 50’ as partners of prospective GPs may be employed by these organisations
Support for recruitment
§ Suffolk Fed to have a permanent advert in the BMJ title ‘Working in Suffolk’ with a brief summary of the practice vacancy and a link through to the Fed website. Practices subscribe say £500 per annum.
§ The Fed now advertises vacancies on its website.
o The quality of adverts is variable and the offering would be improved by having consistency.
o The website needs a video and PDF style brochure on ‘working in Suffolk’.
o A clear Fed ‘offering’ needs to be on the website for interested potential recruits covering weekend visits, the First Five program and salaried development programme (see below)
§ Practices need support with how to present themselves to candidates and interview/assessment techniques.
Final year UEA student post qualification but pre GMC reg internal (UK) elective for six weeks
§ The Fed offers 4 integrated electives: practice time, management time, board observation, project work and CCG contact time
2. The offer for newly qualified doctors
§ The Fed needs to offer an exciting and attractive suite of posts for newly qualified GPs or those wanting a fresh start. This itself would raise the profile of Suffolk and demonstrate innovation. The offer should include:
o Monthly half day release, to run alongside the Trinity Park sessions, for a group VTS style education program with a dedicated facilitator covering:
o So you want to become a partner?
o Developing education skills - FY1&2, medical student, GP trainees etc.
o In practice skills - QoF, practice finance, LTC, meetings skills.
o A structured offer of a variety of opportunities:
o To develop a clinical speciality in conjunction with Fed clinical services – cardiology, diabetes.
o To work across different practices – inner urban, market town, rural etc.
o Non-clinical e.g. research, Federation and CCG commissioning.
o Offer of Antipodean sabbatical with a guaranteed post on return.
o Nationally top quartile salary.
o Monthly evening facilitated peer support group.
o Group discussion of clinical cases.
o Group support for soft issues in the workplace.
o Each post assigned a mentor from outside the practice.
3. GP retention – retiring doctors, returning after family commitments
§ Develop the locum chambers to have more members and an established profile.
§ Develop a ‘light’ chambers’ offering for retired GPs who want to do only a limited number of sessions.
§ Develop a package of marketing materials for retiring GPs and those interested in becoming full-time locums.
§ Identify in advance doctors planning to leave the workforce and offer a standardised offer of support for continued participation via the chambers.
Cost estimates
Note – we may be able to attract contributions to some of this work from the Economic Development team at SCC, Area Team and Deanery.
£Improving the marketing of vacancies
Short film on ‘working in Suffolk’ suitable for CCG, SCC and Fed websites / 3,000
PDF style brochure on working in Suffolk / 5,000
Develop a training package for practices who are recruiting e.g. interview techniques / 2,000
Pilot hosted weekend for GP and spouses interested in Suffolk / 5,000
Support for newly qualified doctors
Monthly half-day release scheme with a VTS style programme / 25,000
Develop a ‘package’ of opportunities for salaried GPs in the form of a career development programme brochure / 5,000
Monthly evening peer support groups / 5,000
GP retention
Package of marketing materials for retiring doctors. / 2,000
Identify and meet retiring doctors to market the locum chambers – one year pilot / 5,000
57,000 excl VAT
David Pannell – May 2014