Many reasons pushing to retire early and pensions tax is only one. Of the others, most would be summarised buy 'workload': A bigger and unrelated issue.
A more enduring question: Who that has got used to 4 day a week (48 hour) working, really wants to go back to 6 day (72hour) work patterns?
So only LTA to worry about: Early retirements will continue and extra shifts still push LTA arrival date forward. Work force needed: 30% pay (more if you count pension) cuts in 10 years is not a great motivator. Viscious regulators, expensive cowboy inspectors/ ombudsmen and rising overheads not a good thing. Hostile spin from leaders might have impact too?
Can the CMO (big academic rep from lots of experience doing thorough analyses) think of other bigger underlying causes? Pension, tax, regulation, inspection, rising standards, rising expectations, rising demand, rising costs, declining revenues, hostile GMC, hostile political climate, dissociation of academic and BMA and management from grassroots, stakeholders without a say, radical top down diktat, frequent (and accelerating) change after change, loss of goodwill, extended hours (often in empty clinics).... ring any bells? I could go on; these are just a few of the many issues.
If you do not talk about the elephant(s) in the room and nit pick, you loose credibility. Do it long enough people just stop engaging altogether. Shame as GP is a powerhouse of innovation and efficiency and it is being eroded back to basics, just as the call for its particular skill set is increasing.
Some of the CMO, NHSE, DOH and even Royal College/ Academy positions are frankly, bizzarely destructive, or at least unhelpful.
Just heard a nearby 'Flagship' Practice is closing at Ramsgate. Being taken over by a big CiC. Dominoes anyone? Ooops!
I'd advertise GP(WTE): patient ratio more. And remind people that Government has given up responsibility for the NHS since 2012. Perhaps some may see a link?
CCG says no other practices are closed. More accurately 2017-18 all Folkestone Practices had closed lists, 'full to safe capacity'. No CCG permission was required for that type of closure. Unhappily forced allocations can still be made under that status, only walk-ins can't register. And local CCG pre-mega-merger (to old-PCT size and role) means current CCG is running on a skeleton staff, so not likely to come up with intelligent dynamic coping strategies?
Surprise: Fix workforce, workload, capital investment problems and services improve! But try and tell any regulatory body that or get then to take it into account...
Anything that ignores the big reasons for problems to focus in the tiny or insignificant ones will struggle to seem justified to the coal face.
Workforce crisis? Workload crisis? Capital under-investment? Regulatory inflation? Real terms underfunding (not by RPI but Health cost index)?
They have to be constructive and competent before anything else. Yet to be that!
I though NHSE wanted autonomy and local priorities? Can't micromanage then!
I thought NHSE wanted service integration? So where are the contracts for all those other services: Integration is not going to work left to only 1 party!
I though PCN were to make GP sustainable? If so can't use them as a vehicle for unfunded work dump!
These are the basics that NHSE need to answer first.
Good comment: I hope it reaches policy level ears.
This is not a response that uses language that convinces me NHSE have insight into GP reaction. I do not believe it truly reflects the responses they received. 'Significant GP concerns' is not the same as overwhelming opposition. 'A level of in-principal support' suggests there is some support, which would surprise me. NHSE's integrity is in doubt.
All the PCN moneys can do is stabilise GP within existing workload. The proposed extra work has no GPs to do it. Social prescribers and pharmacists are not freeing up GPs. Trouble recruiting nurses, paramedics and GPs. Only excess is pharmacists. And they seem to have trouble with basic dispensing.
If this stays as is PCNs will mostly close.
Difficult for NHSE to simply withdraw without egg on their face, as they elected to go to public consultation: not a great option for complex technical negotations such as this.
NHSE will have to withdraw this or many PCNs will simply close. Awkward to have gone for a public negotiation before any GPC negotiation. I wonder how they will save face?
Who still believes the change from Criminal to to Civil standard of proof in GMC hearings had no effect? Or was sensible?
Don't worry there aren't any out there to recruit. (except pharmacists, whose useful roles are pretty saturated already).
There are ideas, we all have some, that would be constructive. And for each there are ways of sabotaging them. e.g. MDT: In-house small MDTs can be focussed and productive. MDTs for 50,000 town populations tend to be a monumental waste of time!
If it is to work we need to be allowed to focus on productive work. And it will be hard, given all the reforms, workload and workforce issues already on our plate. Any distraction, adjustment, new 'initiative', additional requirement and each change will waste energy and damage trust.