GMS reforms risk workforce crisis amid wave of early retirements

GMS contract reforms could trigger a chronic workforce crisis in parts of England, GP leaders have warned.

Dr Buckman: Workforce warning
Dr Buckman: Workforce warning

One in eight GPs will quit the NHS if the contract changes go ahead, a poll published as part of the BMA response to a DH consultation found. The poll of nearly 8,000 GPs in England found that 13% planned to quit, with 63% of these saying they would simply bring forward their retirement date. Others planned to work abroad or switch careers.

Practices also believe they will be forced to lay off staff and freeze recruitment.

The DH consultation on GMS contract changes closed on 26 February and final details of how the contract will be altered are expected within weeks.

Details of any pay rise for GPs in 2013/14 are also imminent, after the Doctors’ and Dentists’ Review Body revealed it has now submitted its recommendations to the DH.

GPC chairman Dr Laurence Buckman said it was ‘quite plausible’ that the GP workforce would face losses on the scale suggested by the poll if the DH did not amend its plans.

‘It will be a number that resembles that,’ he said. ‘The government quite clearly doesn’t think it matters.’

Areas with a high proportion of GPs near retirement age could face ‘very significant’ workforce losses and those with a high proportion of single-handers could lose practices, he warned. A total of 18% of GPs in London and 13% in the West Midlands are aged over 60, NHS Information Centre data show.

Londonwide LMCs medical director Dr Tony Grewal said the capital would be hit hard because it also has a high proportion of single-handers. ‘If they retire we have a problem. Once a practice is gone, it’s gone,’ he said.

Many GPs over 50 were ‘crossing off the days’ until they claim their pension and had no intention of returning to work in any capacity, he added. Dr Grewal said the crisis of morale facing GPs was the worst he had known since qualifying from medical school in the 1970s.

‘My father was in practice in the 1960s, when morale was so low, it led to threats of mass resignation – it’s nearly as bad as that. It fills me with concern,’ he said. ‘This is not crying wolf or political posturing. The risk is the government will see it as that.’

Findings from the poll showed GPs fear patient services will be affected as workload rises and practices are forced to cut services and staff.

The BMA said plans to cut MPIG over seven years from 2014 ‘were not motivated by fairness’, and called for the changes to be modelled to avoid destabilising practices.

It warned plans to make GPs  offer new directed enhanced services to earn back cash cut from the QOF would lead to many opting out and losing thousands of pounds.

A letter from Dr Buckman that accompanies the BMA consultation response hits out at 'misleading' DH references to 'additional or maintained levels of investment'. It warns that plans to cut MPIG and force practices to work harder to maintain existing income would have meant that the 1.5% GMS funding increase initially offered by the DH would 'not have been realised in practice'.

Earlier this year the GPC warned that planned QOF changes could raise practice workload, harm practice finances, increase public scrutiny on GPs, risk ‘potentially dangerous’ polypharmacy and undermine the doctor/patient relationship.

Health minister Lord Howe said: ‘Our proposed changes to the GP contract are designed to improve the care offered to patients.’

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