A GMC report published last week revealed that 'with advances and developments in technology and telemedicine, we are exploring how to maximise the longer-term potential for internationally based doctors to treat UK patients’.
The report shows the extraordinary steps the NHS could be forced to take to remain viable amid a workforce crisis that the GMC says has left the medical profession ‘at the brink of a breaking point’.
GP leaders warned that allowing doctors based overseas to treat NHS patients in the UK remotely could open the door to an international version of the controversial GP at Hand service.
GPC chair Dr Richard Vautrey told GPonline: ‘The reality is that with the internet there are no geographical boundaries in the way that was the case 10 years ago.’
NHS standards
He warned that all doctors treating NHS patients ‘wherever they happen to be geographically’ must be subject to the same standards - highlighting qualifications, language ability and access to patient records as key issues.
It was the ‘GMC’s responsibility to ensure that whenever a doctor is providing care to a patient in the UK they are competent to do so’, he added.
The GPC chair added: ‘This is an issue that is going to challenge all regulators.’
Dr Nigel Watson, the GP leading a major review to revitalise the GP partnership model, said: ‘My view is that we need to look at how to address the workforce in this country, not look to outsource services to other countries.’
Indemnity
He warned that allowing doctors based overseas to offer medical advice to NHS patients would raise ‘major complexities’, particularly around indemnity and training. Dr Watson pointed out that outsourcing services to call centres overseas ‘has not always gone well’.
Londonwide LMCs chief executive Dr Michelle Drage said: ‘The GMC is aware of the severe time and resource pressures facing doctors making clinical decisions. It would do better to focus its efforts on retaining the existing workforce and supporting those returning to practice, by promoting the safe levels of medical care that our patients need here and now.’
A GMC spokesperson confirmed the move was being explored and said the regulator was working to shape how it could be done safely before the plans were developed further.
The proposals to allow doctors based overseas to treat NHS patients in the UK remotely were set out in the GMC’s State of Medical Education and Practice (SoMEP) report.
Workforce crisis
GP numbers have slumped since the government announced in 2015 that it would recruit an extra 5,000 by 2020/21 - forcing health and social care minister Matt Hancock to scrap the deadline earlier this year.
The SoMEP report warned that heavy workload and understaffing has forced GPs to refer more and has undermined their ability to guarantee accurate diagnosis.
The NHS has launched a recruitment drive to bring overseas GPs to the UK, with 1,200 EU GPs applying to work in the NHS, and plans to streamline the process for Australian GPs to qualify for NHS work.
Meanwhile, the government has said the GP funding model could be overhauled to accommodate services such as GP at Hand that do not fit with the traditional geographically-based service.
GP at Hand - now formally known as Babylon GP at Hand after the private company behind the service - has used out-of-area patient registration rules to sign up tens of thousands of predominantly young NHS patients across a broad geographical area for a service delivered mainly via video consultations.
