This has resulted in GPs retiring early, leaving partnerships to work as locums or abroad. Recruitment to training schemes particularly away from centres with a medical school has become difficult.
In some places the situation is becoming acute. As GPs leave practices the remaining GPs struggle to replace them, often running on a variety of temporary staff. This results in increased stress on the remaining partners who committed to their patients’ care, find that practice administration begins to suffer often leading to a further reduction in income.
Further financial pressure has resulted from the proposed changes in MPIG and those on a PMS contract. Although in theory the total budget for primary care remains the same with some practices benefiting there are those that will lose out significantly. RCGP chairwoman Dr Maureen Baker has called for an increase in funding to general practice and if there is serious intent to move more work closer to patients then this has to happen as a matter of urgency.
There are a variety of options open to existing partners
With no real increases in NHS funding expected over the next few years it is going to be hard to shift money away from hospital trusts unless CCGs take a firm grip on it. This may eventually require them to take over the primary care budget from NHS England which will prove convoluted.
Existing GPs could elect to walk away from their practices but this is not attractive for the patients, the GP or the government. Many GPs are reluctant to leave a practice where they have become established. They have patients who they have bonded with, staff and colleagues who they enjoy working with and they are settled in an area. Added to this they may have equity tied in to premises that they could only easily sell onto another GP.
There are a variety of options open to existing partners who want to practice high quality medicine, develop personally and retain a varied degree of investment in their business. A number of organisations such as third sector and independent providers and groups of GPs who are in effect another commercial provider have been working to provide viable solutions.
Some GPs are seriously examining new solutions which allow them to focus on treating patients
I have been working for five years with One Medical Group, which works in partnership with GPs looking for a better work-life balance and is experienced in succession planning for GPs. It can also provide equity release for partners who wish to sell their premises. As the overall stress of being a partner continues to rise some GPs are seriously examining new solutions which allow them to focus on treating patients while others concentrate on areas such as human resources, IT, premises and CQC compliance. Working within a larger group also allows for peer support and development of clinical interests and leadership.
One Medical Group (OMG) is an example of an increasing number of independent providers which are committed to high quality patient care working within the NHS and are already investing heavily in the future with an established learning academy for staff. It provides opportunities for existing partners to work as a salaried GP within the group or as a GP continuing to hold a financial stake within their business.
Experience has shown that there is no single ‘one size fits all solution’ so it works with GPs to provide a bespoke blend of solutions to meet the needs of the partners and patients. One Medical Group is running a variety of educational seminars around the UK and details can be found on its websitewww.onemedicalgroup.co.uk or by calling 0113 284 3158.
* Dr Paul Charlson is an East Yorkshire GP, strategic medical director at One Medical Care and vice-chairman of Conservative Health.