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GPs opt for special interests to exploit PBC opportunity...

GPs are applying in droves to take on a specialism in

order to exploit the shift in work from secondary to primary care.

Deaneries, medical schools and other specialist course providers are reporting a huge increase in inquiries from GPs and predicting that interest will rocket in the coming year.

The rush to get 'GP with a special interest' (GPSI) status is being driven by practices' desire to take advantage of practice-based commissioning and maximise potential earnings now core income has been frozen.

But some GPs have warned the rush to specialise could harm the profession by undermining generalist skills.

The University of Bradford said it had seen a five-fold increase in interest in GPSI courses since January, leading it to double capacity for an upcoming cardiology course.

The Peninsula Medical School in Exeter said it already has 20 GPs interested in 15 places for a course starting in October and the University of Wales has already filled 72 places for its September courses.

Trent deanery expected an 'upsurge' in GPs looking to take courses after PCT reconfiguration was completed.

Rila, a company running GPSI courses in London, said it had seen a significant upturn in interest since February.

Professor Ram Dhillon, a consultant in ENT at the Northwick Park Hospital, London, who runs the courses, said: 'The thrust of the White Paper will mean there will be a vast increase in the numbers wanting to specialise.'

PCTs have also shown a strong desire to use more GPSIs to take on secondary care work.

Dr Tom Coffey, a GP in south London and professional executive committee chair for Wandsworth PCT, said the trust had just appointed 13 GPSIs at £250 per 3.5-hour session.

He said: 'We are going to need to expand numbers hugely. Not only will that generate income for them, but it will also make savings through practice-based commissioning.'

Dr Mayur Lakhani, RCGP chair, said he hoped the move would be 'transient'. He said: 'With the White Paper good GPs are at a premium ­ not just someone with a special interest but a good generalist who can use their skills to cut referrals.'

Dr James Kingsland, chair of the National Association of Primary Care and a GP in Wallasey, Wirral, said: 'We have to be careful not to be deskilled by this [move to specialise].'

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