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At the heart of general practice since 1960

Can former GPs be tempted back?

The Department of Health

is launching a new scheme to bring back into the fold

GPs who have left general practice. Doctors will be offered tailored refresher training for periods of between three and 12 months, as part of the department's strategy to boost GP recruitment and retention. But will it work?

Local refresher schemes have been run by some health authorities and postgraduate centres for several years now. For Birmingham GP Dr Jo Waddell such a course gave her the confidence she needed to become a principal in general practice ­ working in the sort of deprived urban area where GP recruitment can be most difficult.

Dr Waddell had been doing Benefits Agency work and a one day a week GP assistantship while bringing up a family, but when her assistant's post was axed she applied for the GP refresher course.

'It really changed the way I felt about myself,' she said. 'We started with a two-day residential course, setting the agenda based on what we felt we needed to learn. Then we met monthly as a group, with speakers, homework and presentations to our colleagues, and journal clubs discussing latest research. We learned so much, but it was the phenomenal support within the group which was most valuable.'

She added: 'It's essential that these courses are flexible. We had a very diverse group, some had being doing a little general practice, others worked in completely different areas of medicine.

A rigid course structure wouldn't work.'

Dr Bitty Muller, an associate regional adviser who helped organise the scheme, said: 'We set up the course after a research project revealed many doctors who had been out of practice lacked confidence, especially about clinical issues such as new protocols for asthma and diabetes. It was important that we planned individual needs assessments and targeted specific training. Regular workshops offering mutual support are also essential.'

Co-organiser Professor Ruth Chambers, of the University of Staffordshire, warned that providing proper support and training was very resource intensive and required adequate funding. 'We needed three facilitators for 12 people a year, offering sophisticated teaching to deal with problems of under-confidence and low self-esteem,' she said.

Dr Stewart Bailey is director of postgraduate medical education in the North West deanery, where returners can be attached to a training programme for up to six months. 'Doctors mostly have concerns about catching up with developments such as national service frameworks, computerisation and just the day-to-day running of a practice,' he explained. 'The scheme gives doctors confidence in their own abilities, and, importantly, a reference.'

But Dr Helen Liley, who organised her own refresher training after a six-year spell out of medicine, believes flexible working options are more important than refresher courses if doctors are to be encouraged back to general practice. She now works as a GP retainer for four sessions a week.

'I'm doing what I wanted to do, seeing patients. I don't have the admin or staff problems to deal with,' she said.

With four children to bring up and uncertainty over the GP contract, she has no plans to become a principal.

For further information on the DoH flexible careers scheme, contact NHS Professionals on 0845 60 60 345

As the Government launches a scheme to attract GPs back into practice, Steve Toon

asks 'Will it work?'

Many doctors who had been out of practice lacked confidence ~

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