Vulnerable practices risk collapse if GPs are forced out of locum roles

Scapegoating locums for the GP workforce crisis and trying to force them away from locum careers risks undermining general practice and driving up closures in vulnerable practices, the GPC has warned.

GPC sessional subcommittee chair Dr Zoe Norris (Photo: JH Lancy)
GPC sessional subcommittee chair Dr Zoe Norris (Photo: JH Lancy)

NHS England must stop adopting a ‘destructive narrative’ to demonise locum GPs and set sessional and partner GPs against one another, Dr Zoe Norris, chair of the GPC sessional committee has warned.

She said NHS England was trying to scapegoat sessional GPs by suggesting that the ‘only’ problem in general practice is a growing sessional workforce – or that the pursuit of money is the sole reason GPs choose to work this way.

Many vulnerable practices and the out-of-hours service would collapse instantly if locums are pushed to work in partnership roles, she added.

Her comments follow publication of NHS England’s Next Steps on the NHS Five Year Forward View document, in which it was critical of the amount charged by locum doctors.

The report described locums as 'individuals who are actually available to work and are doing so – but in a way that is unfair to their permanent colleagues and is placing an unacceptable burden on the rest of the NHS.'

Locum GPs

The comments belied a lack of understanding of the locum workforce and deliberately attempted to increase division between colleagues, Dr Norris said.

She is scheduled to meet NHS England chief executive Simon Stevens, director of primary care Dr Arvind Madan and director of commissioning Ros Roughton next month to raise her concerns and discuss the locum GP workforce.

‘To have any national body reinforcing the destructive narrative that the "only" problem in general practice is a growing sessional workforce, or that the pursuit of money is the sole reason for GPs to wish to work this way is unhelpful and frankly misleading,’ she told GPonline.

‘I give the profession more credit than buying into this, and hope to see a united front from GPC and LMCs at the upcoming conference.

‘Improving the working lives of sessional GPs won't solve the collapse of primary care. Rather than seeking to impose a model on GPs, efforts should be made to address why the GP Forward View is failing to deliver.

‘Pushing sessional doctors into a preferred way of working without listening to them will result in the instant collapse of many vulnerable practices, and the entire out-of-hours service. Recognition, investment and reward for the hard work that GPs do, both from NHS England but also from the government is what is needed.

Part of the solution

‘Putting time and effort into delivering an accurate and updated performers list so we can be confidently assured that we have a way of contacting all sessional doctors would be the single biggest thing that would make a difference.’

A supply of sessional GPs offers many advantages to the NHS, and they are ‘part of the solution, not the problem’, she added.

Locum GPs help stabilise practices, staff urgent and out-of-hours care and increasingly have a range of expertise and experience ‘to help practices, CCGs and STPs deliver their plans’, Dr Norris argued.

She said: ‘With the pressures on general practice, partners are struggling to find any headspace between clinical work and the increasing demands on them of trying to fit into the working at scale vision. Sessional GPs can help, and partners should have central support to utilise their local sessional workforce.’

An NHS England spokesperson said: ‘The General Practice Forward View recognises the vital role locum GPs play. However, we must also acknowledge the challenge practices face in providing continuity of care for patients if they are struggling to recruit substantive GP roles.

‘This is why we are working with the BMA to develop positive opportunities for GPs wishing to retain greater flexibility, for example: the GP Career Plus pilots being rolled out in the first instance, and with other stakeholders to streamline the application process to join the medical performers list.’

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