LMC Conference 2016: Skill mix warning as LMCs debate workforce crisis

Increasing skill mix in general practice will not solve the growing workforce crisis facing the profession, GP leaders have warned at the LMC conference 2016.

In a 'themed debate' on the GP workforce on Thursday, LMC representatives hit out at factors forcing doctors out of the profession, citing soaring indemnity costs, heavy workload and growing levels of bureaucracy.

GPs said that the workforce crisis had forced practices to increase skill mix, but often without proper funding or support.

Dr Richard West, of Suffolk LMC, told the conference: 'We have heard about the problem with excess workload. It is unquestionable we need help. But we have to remember first that the best person to do a GP's job is a GP. Skill mix is not the answer to the real problems with have with a lack of GPs.'

Full coverage of LMC Conference 2016

Kent GP Dr Zishan Syed warned that skill mix was 'a euphemism for the deprofessionalisation of doctors'.

In a speech criticising the GPC, he warned: 'GPC, please stop your collusion in the GP backward view to replace doctors with other staff. It is unsafe for patients. What kind of society promotes a system that replaces doctors with other staff and blames GPs when things inevitably go wrong?'

Yorkshire and Humber GP Dr Zoe Norris added that general practice urgently needed to make its position clear on the adoption of wider skill mix in the primary care workforce.

'I am conflicted. While we debate the pros and cons of PAs and pharmacists - as far as the government is concerned it is a done deal. Are we on board? If so have to decide how it works in our practices. Or are we not, [in which case] we lay down the law. The thing that conflicts me is we have little choice at the moment as we are in such a dire position.'

East Midlands GP Dr Pete Medcalf said he was among the 'lost tribe' of GPs taking early retirement because growing pressure had made the job untenable.

'I am now one of the lost tribe,' he said. 'Three weeks ago at 58 I took early retirement. It was a difficult decision, but the easiest decision. I felt the work was unsafe for me and patients. Too much to do in increasingly little time with an increasing chance of mistakes.

GP workload

'What would bring me back? A sustainable workrate, 15-minute appointments, sensible appraisal...stop overregulation and treat us as professionals and acknowledge our expertise and value. Do this and I might be able to return to the GP workforce?'

Avon GP Dr Mark Corcoran warned: 'I see an inexorable decline in GP numbers. I wonder if the government sees GPs a bit like tonsils - they are nice to have but they can be a pain and you can get on perfectly well without them. I say you lose GPs at your peril. GPC - ask the government again - do you think you need GPs? Do you think you need a service that is run and staffed by GPs? I think you do. We need GPs.'

In an electronic vote at the end of the debate, GPs voted in support of existing GPC policy on the general practice workforce.

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