Challenge Fund provider drops bid to recruit non-specialist doctors for GP work

An out-of-hours provider is reviewing plans for doctors with no specialist training to deliver GP consultations as part of a Challenge Fund pilot after the RCGP raised questions.

Doctor: non-specialists could deliver GMS roles
Doctor: non-specialists could deliver GMS roles

Out-of-hours provider Shropdoc advertised for ‘community physicians’ to undertake 'the full spectrum of GMS consultations’ with a salary of between £30,002 and  £39,693.

But the advert has now been withdrawn, after GP leaders warned the positions were not training posts and could mislead doctors.

The job advert appealed for ‘fully registered medical practitioners, having completed at least Foundation Year 2’. On top of GMS consultations the trainees will carry out in-practice and community work with frail elderly patients, and urgent care sessions, the advert read.

GP consultations

The position, the job ad said, includes two educational sessions a week. A job description said: ‘Safe and effective patient care will be delivered by using clinical skills, incorporating history-taking, physical assessment, diagnosis and prescribing and liaising where appropriate with other healthcare professionals.’

RCGP chairwoman Dr Maureen Baker tweeted that she was asking Health Education England for clarification over the role: ‘Re 'community physician' role. Asking @NHS_HealthEdEng 4 urgent clarification. Training or not? Supervision? CCT 4 independent work.’

London GP blogger and advisory board member at the Centre for Health and the Public Interest thinktank, Dr Jonathon Tomlinson, first raised concerns on social media, saying the positions would mean ‘trainee doctors work[ing] like GPs without specialist training’.

Dr Matthew Piccaver, a GP in East Anglia, tweeted: ‘Feels like a kick in the teeth. Undervalues the years of training.’

Dr Michelle Sinclair from Resilient GP, added: ‘Seems anyone can "be a GP" nowadays.'

A statement released by Shropdoc chairman Dr Russell Muirhead said: 'We are sorry for any confusion that has been caused as a result of this job posting, which was unfortunately released prematurely before final sign off by the senior directors. The advert has now been taken down for editing and will be re-posted in due course.

'The community physician post is a new development and is aimed at doctors having completed FY2 posts who seek further experience in primary care before applying for specialist training in the normal way. The programme consists of supervised roles in several primary care facing services including dementia, frail elderly and urgent care. This is not a specialist training position but does include education and training in elderly care and dementia via a university diploma course.

'The aim of this initiative is to introduce and promote general practice and community care to newly qualified doctors at a time when doctors choosing to enter general practice is falling.'

Earlier on Monday, Dr Muirhead - a Challenge Fund board member - told GPonline that the qualified doctors were equivalent to trust or staff grade and would otherwise be working as locums or staff grades in hospitals. ‘We are offering them a primary care position very much with  a focus on the training element,' he said.

GP contract

Working with Health Education West Midlands and Keele University, Shropdoc planned to provide the doctors on a one-year contract with a training package and the opportunity to gain a diploma qualification with a focus on dementia and frail elderly patients, although the qualification will not count towards any GP speciality training.

Dr Muirhead denied the doctors would be used to staff out-of-hours work alone. ‘They will be given experience of out-of-hours care in a supervised fashion. They won't be working autonomously and won't be expected to prescribe. It's a bit like having an FT1 or medical student. It's a supervised training position giving exposure to general practice.’

Shropdoc as the employing organisation will also cover the doctors’ indemnity, he added.

Dr Muirhead said those who had expressed an interest so far included doctors who had ‘struggled’ to get a place on a specialist training scheme. ‘If they do this year and have the added qualification and experience that will improve their chances next time around.’

As well as the community physicians, Dr Muirhead said, the Challenge Fund scheme was looking to take on physician's associates, extended scope pharmacists and physios.

Dr Ian Greaves - the joint applicant for the Challenge Fund bid and a GP partner at one of the participating practices - said the doctors would not be expected to be GPs. 'We are expecting them to be urgent care practitioners working under the supervision of a registered medical practitioner.'

But GPC education, training and workforce subcommittee chairman Dr Krishna Kasaraneni said the posts were not training posts 'and could mislead doctors who may see this is a GMC accredited training programme, which requires trainees in general practice to be supervised and assessed to a high level of standards set by the GMC'.

'Only qualified GPs can provide certain types of care and we need to ensure the quality of patient care is protected and maintained,' he said.

'These posts cannot be seen as a sort of replacement for GPs. The only way to meet rising demand and alleviate pressure on services is to address the funding and recruitment crisis crippling general practice.'

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