NHS England unveiled the £150m 'GP COVID capacity expansion fund' - worth around £22,000 per practice - earlier this month alongside plans for the profession to roll out a COVID-19 vaccination campaign. It said the ring-fenced, non-recurrent fund was aimed at 'expanding general practice capacity up until the end of March 2021'.
However, an NHS England letter launching the scheme said local NHS organisations 'are encouraged to use the fund to stimulate the creation of additional salaried GP roles' that would be 'attractive to practices and locums alike'.
The letter left practices concerned that they would face significant red tape to set up new fixed-term salaried posts if they wanted to bring in additional GP support during the second wave of the pandemic - while locum leaders said the fund appeared to be a bid to 'corral' them into permanent roles.
Locum GP workforce
However, the BMA has confirmed to GPonline that although the 'hope would be' that practices use the money to bring doctors into 'substantive' posts, they are free to use the funding to hire locum GPs.
BMA GP committee chair Dr Richard Vautrey said: 'The whole intent of the £150m is to provide support direct to practices with minimum bureaucracy in a high-trust manner to support them through the tough winter ahead.
'There should not be bureaucratic hurdles. I think we should trust practices to use it as best they can to expand their workforce - it can be GPs or practice staff, and they can use it for locums.
'We are in an acute situation, we need all hands to the pump and we need to support practices - that is the top priority.'
Fixed-term contract
BMA sessional GP committee chair Dr Ben Molyneux told GPonline it was 'disappointing' that the NHS England letter failed to mention locum GPs explicitly.
He said: 'Practices are able to use this funding to engage locums to boost capacity during the second wave. Short timescales mean fixed-term contracts may be too difficult to enact and so it is disappointing that traditional locum usage hasn’t been more explicitly referenced at this stage.
‘Locum GPs are a vital part of the primary care workforce, while such working arrangements provide flexibility and options for talented and experienced doctors for whom partnership or a salaried position are not viable or desirable. There needs to be wider recognition of this valuable group of doctors, and practices need to be enabled to bring in their expertise and use them to their full potential.'
National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse said it made 'perfect sense' for practices to be able to use the funding to bring in locums. He said: 'It would have been silly to try and constrain the way practices can use funding that they so desperately need to boost capacity. So thinking to be open minded about [engaging locums] is really helpful.'
COVID capacity fund
Dr Fieldhouse said there was a lack of understanding of locums among NHS leaders and a failure to 'appreciate the benefits they can bring to a system - providing appointments for patients when others can’t'.
The capacity fund comes after plans proposed by NHS England in July to set up local banks of GPs working flexibly, to avoid practices employing 'more expensive agency and locum options'.
GP leaders have also repeatedly called for flexibility to use unspent funding from the additional roles reimbursement scheme (ARRS) - worth more than £400m in 2020/21 - to bring in locum support. Calls for greater flexibility on how this funding can be spent come amid concerns that many primary care networks have simply been unable to recruit staff in roles allowed by the scheme this year during the pandemic.
Locum GPs were hit hard financially during the first wave of coronavirus as work dried up initially as practices cancelled shifts while they completed the transition to total triage. An estimated 1,000 locum GPs are thought to have taken on private sector roles in recent months - while a recent GPonline poll found a third of locums were considering moving into permanent roles.
Concerns that retired doctors returning to support the NHS during the pandemic have been prioritised for some available roles while locums struggled to find work and inequality over death-in-service benefits have been blamed for undermining locums.
NHS England has said the COVID support fund can also be used 'for the employment of staff returning to help with COVID, or to increase the time commitment of existing salaried staff'. It added: 'And in line with commitments already made in the GP contract, support will be available to establish flexible pools of employed GPs (including returners) and other staff to deploy across local communities.'
NHS England's letter introducing the fund said: 'The fund is ringfenced exclusively for use in general practice. It will be for integrated care systems and CCGs to determine how best it is spent within general practice, with a focus on simplicity and speed of deployment...CCGs should not introduce overly burdensome administrative processes for PCNs and practices to secure support.'
