NHS England proposes setting a maximum rate for Locum doctors pay, based on a set of rates which may have some regional variation.
The bid to cap GP locum rates follows government announcements that fees will be capped for all agency staff, not just doctors, working in hospitals.
If NHS England succeeds in setting a rate they will likely also amend the electronic declaration system to include recording on the number of instances where a practice pays a locum doctor more than the maximum indicative rate.
GPC deputy chairman Dr Richard Vautrey suggested that implementing caps would potentially be against competition law. He argues that efforts should instead be directed towards increasing capacity within practices.
It has been reported that GP Locum rates have increased by over 5% nationally in the last year, while GP partner income has fallen by 25% over the last 10 years.
Is this a move to push the ever increasing wave of newly qualified GPs choosing to Locum as a career back towards being Partners? Shouldn’t they be trying to make Partnership more appealing instead?
This is a view agreed by Dr Peter Swinyard, chairman of the Family Doctor Association who said, “There is no incentive whatsoever to be a partner in general practice right now because you carry all the risk and all the blame and none of the money. Until partnership incomes rise well above the level we pay our salaried doctors, we will never recruit people into partnership and we will always be struggling to find salaried doctors and locums to fill the gaps.”
The proposals for now do not prevent locums and practices agreeing the appropriate rate for work undertaken.
Figures released by Pulse reveal the proportion of doctors applying for GP specialty training starting in August 2016 has reached a record low.
Applications for 2016 GP training have declined by 5% on last year indicating disaster for the Government target of delivering 5,000 more GPs by 2020.
Pulse reports in its exclusive figures, “Last year, the first application round of GP training received 5,112 applications for 3,609 places but this only delivered 2,769 trainees in 2015 despite three application rounds and changes to allow failed applicants to reapply.”
Health Education England has the Government-mandated target to recruit 3,250 GP trainees a year by August 2016, a major part of the effort to get 5,000 more GPs by 2020.
This is a major setback as this year HEE and the RCGP launched a major publicity drive to encourage candidates to choose GP training. The RCGP released a video stating there ‘was never a better time to become a GP’ and HEE produced a series of videos showing GPs doing exciting things like signing forms for sky-diving and helping patients run marathons while managing their asthma.
Deputy GPC chair Dr Richard Vautrey was quoted as saying “There are fundamental issues that the whole system has to address in terms of reaching out to medical students and young doctors around general practice. The only way to really tackle that is to address the root cause, which is the workload pressures and lack of funding in general practice itself.”
Dr Maureen Baker, chair of the RCGP, is reported to respond to the figures stating, ”If these figures are correct, it is important not to be discouraged or write off efforts to increase recruitment as unsuccessful. By the end of recruitment last year, the number of places filled had risen overall by nearly 100, so these should very much be seen as interim figures.”
GPs will be asked to consider handing in undated contract resignation letters after a motion to canvas opinion was backed last weekend.
At the Special LMC Conference, delegates voted overwhelmingly to carry a motion proposing that ‘the GPC should canvass GPs on their willingness to submit undated resignations’ unless ’negotiations with government for a rescue package for general practice’ are ’concluded successfully within six months’.
Dr Chaand Nagpaul, BMA GP Committee Chair, said he was ‘very happy for this motion to be supported’.
‘It’s not safe for GPs to be examining patients while simultaneously having to take urgent calls from hospitals, district nurses and social workers, and also be called for an emergency home visit at the same time,’ he said.
He added, ‘To put it simply, it is not safe to carry on the way we are, and which is why this conference is highlighting that general practice is quite literally in a state of emergency.’
Dr Maureen Baker, Chair of the Royal College of GPs, was in agreement and referred to the current situation as ‘unsustainable’.
‘GPs and our teams are making in excess of 370m patient consultations a year to keep up with the demand of our growing and ageing population.
‘That’s 60m more consultations than five years ago, yet funding for general practice has declined dramatically in real terms over the last ten years, and our workforce has remained stagnant.
‘That just isn’t sustainable – we just can’t work any harder than we already are.’
Dr Anthony O’Brien from Devon LMC said: ‘There is no point canvassing unless you think it is likely you are going to get a consensus.’
The motion in full
The conference instructed GPC that, should negotiations with government for a rescue package for general practice not be concluded successfully within 6 months of the end of the conference:
1- Actions that GPs can undertake without breaching their contracts must be identified to the profession
2- A ballot of GPs should be considered regarding what work/services must cease to reduce the workload to ensure safe and sustainable care for patients
3- The GPC should canvass GPs on their willingness to submit undated resignations