Indemnity rule for locum GPs threatens workforce crisis in Wales

GPC Wales has warned that the Welsh government's requirement for locums to sign up to a new register to access state-backed indemnity could leave practices without adequate cover next month.

GPC Wales chair Dr Charlotte Jones
GPC Wales chair Dr Charlotte Jones

In her final speech to the UK LMCs conference as chair of GPC Wales, Dr Charlotte Jones said that there was still no clarity about how locums should register for the list, despite it being less than 12 days until it was implemented.

This may leave practices without locum cover as many may be unwilling to work if they do not have clarity about their indemnity status, she said.

Dr Jones added that GPC Wales would be watching the proposal ‘with extreme care’ because there was the potential for ‘a critical part of our workforce to end up having unacceptable punitive conditions placed on them’.

Dr Jones also used her speech to the conference in Belfast today to hit out at health boards in Wales, which she said had blocked progress that could have been made since the country introduced cluster working in 2014.

Health boards

‘The clear strategy was for the cluster to drive transformation of services, assisted with new monies according to the needs of populations,' Dr Jones said. 'However, in Wales health boards have been extremely reluctant to lose their command and control over practices and clusters and thus not released the monies in a timely fashion.

‘This has demoralised practices from engaging, which is not surprising given the workload challenges and pressures they face on a day to day basis. It is also fair to say some of the allied health professionals also feel disengaged from the process, which means an excellent opportunity to integrate health and social care is at risk.’

She urged other UK countries to look at what had happened in Wales as they developed their own at-scale models, including primary care networks in England.

‘It would be wise to look at what happens in Wales where the interference of health boards has largely paralysed the potential that could be seen if clusters were allowed to flourish autonomously,’ Dr Jones said.

‘Over last few years significant sums of money have been awarded to enable different ways of working across multidisciplinary teams. Where the pathway was shown to be of benefit then the service should have been mainstreamed and ongoing funding provided from health board budgets. The reality - successful projects were often not mainstreamed quickly enough and project funding disappeared.’

She added that while the strategic direction for primary care may be agreed at all levels, implementation is often undermined because the government has too few levers to insist that health boards effect the change it wants.

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