Helping Gps Back to Work

26 March 2015

Helping GPs back to work

Dear Colleague

Today sees the launch of a new, funded, national GP induction and refresher scheme in England, building upon the BMA agreement with the Government to improve GP workforce numbers.

It is a positive first step as part of a wider 10-point workforce plan developed jointly between NHS Employers, Health Education England, the BMA GPs committee and the Royal College of GPs.

This scheme aims specifically to redress the current obstinate, bureaucratic road blocks that have prevented perfectly well-qualified GPs from returning to work after career breaks.

This applies to GPs taking time off to raise their families or to go abroad to gain wider experience and skills. It makes no sense that, at a time of desperate GP shortages, there has been a complicated series of hoops that GPs have to jump through to get back on to the national performers list.

Furthermore, there has been no ringfenced funding for local education and training boards to provide local induction and refresher schemes.

It is therefore encouraging that the GP induction and refresher scheme will provide a structured programme simplifying the process for getting back into the workforce, including clear pathways for candidates and a central application portal on the GP National Recruitment Office website containing all the relevant information and key guidance.

Individual returner GPs will receive a bursary of £2,300 on a monthly pro rata basis for GP practice placements. In addition, supervising practices will receive an annual fee of £8,000, again on a pro rata basis, for each scheme entrant, eg for those in the scheme for three months, practices will receive £2,000.

While we hope that this initiative, alongside others to follow, will begin to turn the tide on GP workforce numbers, I have, however, been clear that the only sustainable way to improve recruitment and retention is to make the job of being a GP manageable and rewarding.

This requires sustained and increased resources so that GPs are working in fit-for-purpose premises, with adequate staff and support.

Visit the BMA website for full information

Our escalating workload — the figures speak for themselves

One of the greatest limitations in assessing GP workload is the relative dearth of itemised data regarding what we do, partly because we provide holistic care — not piecemeal treatments.

This is in sharp contrast to hospitals, where there is an abundance of statistics on emergency care attendances, outpatient and inpatient episodes, the coding of almost every intervention and treatment, and with funding designed to pay for volumes of activity.

The absence of detailed data in general practice has resulted in the unfairness of much of our escalating workload, which has been neither being recognised nor funded.

I am pleased to say, however, that when I attended the Northern Ireland annual local medical committees conference in Belfast last weekend, we were presented with results of a large-scale study on GP workload, commissioned by BMA Northern Ireland GPs committee, with its health department and the Health and Social Care Board.

This seminal study draws upon robust analysis of data extracted from the clinical IT systems of 45 GP practices over an 11-year period, and covered in excess of 250,000 patients.

The results expose the staggering increase in our workload from 2003/4 to 2013/14 in which the:

•Total numbers of consultations in GP surgeries increased by 63 per cent

•Number of acute prescriptions increased by 28 per cent highlighting the greater management of acute illness in general practice

•Number of repeat prescriptions issued increased by 42 per cent, in keeping with the escalating management of long-term conditions

•Number of test results dealt with by practices increased by 217 per cent, representing the increased management of patients out of hospital

•Administrative tasks increased by 115 per cent per cent, adding to the bureaucratic burden on GPs and staff.

It is scandalous that this dramatic rise in workload — unmatched in any other sector in the NHS — has been met with relative disinvestment in general practice in recent years, and has led to the crippling reality of demand grossly outstripping our capacity.

Furthermore, these figures do not even represent the full extent of rising workload, since the study did not measure the huge increase in complexity and intensity of consultations, with GPs now having to deal with multiple problems within a single appointment, and nor does it capture much of the work that we don’t record on our computer systems.

This report provides immensely valuable data to support and step up GPC’s arguments for safe levels of workload management, fair funding and an end to the exploitation of our goodwill.

It should be coupled with local pressure on commissioners and clinical commissioning groups in England to achieve this.

Uplift to contract value

You will be aware that following the Doctors and Dentists Review Body recommendation of a 1 per cent pay increase for GPs, the Government has awarded a 1.16 per cent uplift to the GP contract value.

It will be invested in global sum and, in addition to the transfer of enhanced service payments and MPIG redistribution, will result in the global sum value increasing from £73.56 (2014/15) to £75.77 in 2015/16.

The pound-per-point value of the quality and outcomes framework will increase from £156.92 (2014/15) to £160.15 in 2015/16. This reflects population growth and relative changes in practice list size.

Full details are in our focus on GP contract payments 2015/16.

For the latest news, please visit bma.org.uk/gpc

With best wishes,

Chaand Nagpaul

BMA GPs committee chair