Interview: 'GMS changes will affect locums'

Dr Vicky Weeks says practices' funding struggles could force locum GPs to reduce their fees. Abi Rimmer reports.

Dr Vicky Weeks: if you start losing those GPs who have tremendous skills, how are you going to promote the shift of work from secondary to primary care?
Dr Vicky Weeks: if you start losing those GPs who have tremendous skills, how are you going to promote the shift of work from secondary to primary care?

Dr Vicky Weeks, chairwoman of the GPC's sessional GP subcommittee, was more than ready for the Christmas break when it arrived.

On top of her subcommittee role and working as a part-time salaried GP in west London, Dr Weeks has, since July last year, been representing salaried and locum GPs in GPC negotiator meetings.

She took on the extra role after Dr Beth McCarron-Nash - at that time also a salaried GP - was voted off the GPC negotiating team.

Before our interview at the BMA's Tavistock Square headquarters in central London, she admits with a smile that the holidays brought a welcome break from emails.

Dr Weeks won't be pressed into complaining about the workload created by her new responsibilities, but admits it is 'more time in front of the screen, more paperwork'.

She is more concerned with how much work the GPC as a whole faces this year. With proposed changes to the GMS contract threatening practice profits, CCGs going live, revalidation and CQC registration, the committee is likely to be busier than ever.

Dr Vicky Weeks
  • Salaried GP in west London
  • Chairwoman of the GPC sessional GP subcommittee since 2002. The subcommittee has 19 members and is the GPC's second largest.
  • GP tutor, London Deanery

GMS contract changes

Salaried and locum GPs may not hold GMS contracts, but they will not escape unaffected if the UK government's plans to alter the deal are imposed.

Dr Weeks, like many GPs, is finding it hard to reconcile the government's proposals with its stated desire to put GPs at the heart of the NHS.

'If the working environment comes to the point where there isn't a spare moment in the day, GPs will start to think: "Why am I doing this?". It's a no-win situation, if you start losing those GPs who have tremendous skills, how are you going to promote the shift of work from secondary to primary care?'

The financial pain practices will feel is likely to be shared by locum and salaried GPs.

Almost two thirds of GP practices have reduced their use of locums to help maintain profits in the past year and one in 12 have laid off salaried GPs, a recent GP magazine poll found (GP, 7 November 2012).

Dr Weeks says the findings are backed up by anecdotal evidence that she has heard. Plans to make practices pay locum GPs' superannuation from April could further limit their opportunities for work.

The question, Dr Weeks says, is 'whether or not (locums) are going to be put into a position where they would have to drop their fees'. She asks: 'How much money, how much practice income is there?'

Dr Weeks warns that the imposed contract changes may tempt some partners to throw in the towel and become locums or salaried GPs themselves, potentially further increasing competition for work and on the fees GPs can charge.

'It's a distinct possibility,' she says. 'It's destabilising the workforce.'

On top of threats to their income, this year will see many GPs facing revalidation. It has long been recognised that locum GPs in particular may struggle with the process.

Dr Weeks says this year the GPC will work with the RCGP to deal with areas likely to cause the most problems, such as clinical audits, significant event analyses and patient and colleague feedback.

Dr Weeks hopes a new model for feedback can be developed, to address the problems locums face in gathering such information. 'There is a hierarchy; partners in practices rate each other very nicely, then a little bit lower is the salaried GP and locums are down at the bottom. It's really important that we get suitable benchmarking, so you benchmark with your peer group.'

Involvement in CCGs

Difficulty gathering colleague feedback is just one result of professional isolation - a long-standing problem for sessional GPs. Despite the BMA and the RCGP repeatedly calling for locum and salaried GPs to be more involved in CCGs, Dr Weeks describes the current situation as 'still very woeful'. Representation of sessionals on LMCs is not much better and remains 'patchy', she says.

Dr Weeks says the GPC will work hard on reducing isolation this year, developing groups to help involve locums more in CCGs.

So will 2013 be harder than ever for salaried and locum GPs? Dr Weeks replies: 'I think it's hard to be a GP.'

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