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The waiting game

Hospitals advertise £100k GP vacancies as they look to make inroads into primary care

Exclusive GPs are already being targeted for recruitment by hospitals bidding to receive funding to offer primary care services, Pulse has discovered.

Yeovil District Hospital Foundation Trust (YDHFT) has begun advertising for GPs in preparation for providing primary care services in line with NHS England’s vision for new models of care.

Another hospital - Salford Royal Foundation Trust – has said it is bidding for the £200m funding promised by the Government to pilot new organisations that will provide primary and secondary care, while Pulse understands that Northampton General Hospital NHS Trust will also bid.

LMC leaders in Cumbria, Devon and Lancashire said they were also expecting bids from hospitals to become primary acute care system (PACS), which will employ GPs.

The funding – which is separate from the £250m a year funding from Government to upgrade GP premises – is meant to help both GP practices and hospitals to offer integrated primary and secondary care.

NHS England has said in its Five Year Forward View that the majority of new care organisations will be led by GPs, as so-called ‘multi-specialty community providers’, while PACS will predominantly be established in areas of poor GP recruitment.

Pulse has learnt several hospitals are well advanced in their planning, including one already advertising for salaried GP vacancies.

YDHFT posted a job advert on for a ‘Consultant with an interest in Care of the Elderly’ role paying £75,249-£101,451.

However, despite the name, it said: ‘The GP orientated post is for a minimum of five sessions weekly, with designated sessions providing inpatient care at Crewkerne Community Hospital and sessions providing Care of the Elderly medical care at Yeovil District Hospital NHS Foundation Trust.’

The advert added: ‘As providers of NHS care in South Somerset we’re redesigning the way primary, community and acute care services work together.’

It said the trust is ‘creating new medical roles which will underpin this exciting collaborative approach’.

The advert added: ‘We are now looking for ambitious and enthusiastic doctors (including consultant or qualified GP grade) keen on portfolio working, who will form part of our team of GPs and/or elderly care consultants.’

Chief executive of YDHFT Paul Mears told Pulse that it had been working on a similar project since 2012, but NHS England’s plans provided ‘a helpful framework’.

It is looking at working with 19 local GP practices to care for the 4% most frail elderly patients, because these are currently taking up 50% of the local health and care costs.

He said: ‘We have been very clear that this isn’t about the hospital suddenly setting itself up to run GP surgeries. It is about how we work with the GPs to develop better services for the local population.’

But he added: ‘We know primary care services are also in a difficult place at the moment, with workload and recruitment challenges and things like that. So we are looking at how could these sorts of models potentially also provide some more attractive opportunities to recruit GPs to a different type of work locally.’

Somerset LMC chair Dr Harry Yoxall said it was ‘early days’ though and GPs were taking part in ‘initial discussions’ to see if it would be possible to set up an accountable care organisation based on the trust and local practices.

He said: ‘I think everybody is going to go at it with their eyes open. Looking at a 10 to 15 year future, we know that things are going to have to change and that practices are not necessarily going to be able to carry on in the way that they are, so this is just one option for the future. If it doesn’t look right then we will have to look at alternative possibilities.’

Elsewhere, a NHS Salford CCG spokesperson said that there were plans to create a PACS locally.

They added: ‘Salford health & social care commissioners and providers (NHS Salford CCG, Salford City Council, Salford Royal Foundation Trust and Greater Manchester West Mental Health Foundation Trust) are considering submitting a joint bid for transformation funding to trial a new model of care relating to Primary and Acute Systems (PACS).’

It is understood that Northampton General Hospital is also making a bid to run a PACS but a spokesperson said it was too early to comment.

Trusts in Cumbria, Devon and Lancashire were unable to respond by time of publication to LMC leaders’ claims that they were looking to set up PACS in their regions.

Readers' comments (21)

  • 'PACS will predominantly be established in areas of poor GP recruitment.'
    Wonderful. Where needy groups are- let's move their care into hospitals remote from their community. Will the PACS be responnsible for home visits? Will they have transport links for patients or will they set up satellite buildings (otherwise known as GP surgeries) to provide primary care. Hosptials and HMG still presume to think they know what we do and how we do it. A very rude shock will come to them. I can see GPs who are burnt out or do not want the responsibility to staff these jobs.
    EWTD, paid indemnity, study leave, T+Cs all apply and they will need 1.5GPs for every job

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  • How do the Salford GP's feel about this?

    Seems like they are going to be targeted for takeover.

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  • I welcome same. The local Gp`s will "advise" of their top 1% unhappy patients that they have a "choice" now and the hospitals will be for a rude shock when that happens.
    Interestingly CCG`s are memebership of local GP practices. I presume PACS will not have GMS/PMS/APMS contract and then if there are no GP`s left in GMS who will form the CCG!
    Also if PACS are competing with local GP`s who form the CGG , who pay the PACS wont there be a conflict of interest.
    This hasn`t been thought out fully!
    I am not against the idea but this will require lots more planning , change in laws etc before it can materialize .Also it has not been costed well.

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  • This is good news for newly qualified gp, in hospital they follow national rules of employment , which are often over looked in gp practices, if given choice i would work for hospital as salaried gp as compare to work under some other gp.

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  • T Roscoe

    Good luck to them getting full time GPs for £100k, I know of a practice that was offering £125 for 8 clinical and 1 admin and no one applied

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  • double it to 200k and you may start to get some interest

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  • A step in the right direction for young colleagues. Many of them would appreciate a stable starting position with a decent salary.
    However, the powers above need to make sure they don't slave drive them and chase them out as they have a large percentage of colleagues.

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  • A salary of £100K is a higher rate of pay than most GPs (salaried or partner). Its certainly more than my partners and I receive. And I assume the hospital would pay employers superannuation, indemnity, maternity, paternity, sickness and holiday cover (so no more locum insurance), and deal with the admin side of things. So all in all this would be a lot more pay for less work and therefore quite attractive. But what would worry me is that employment by a hospital would do nothing to ensure the thing that I think general practice needs most - to rediscover the value of continuity of care and providing health care over the long term to each generation and really knowing the social context of our patients (a cost effective model of care). Hospitals have never delivered this model of care - they have episodic care with "finished consultant episodes", specialisms which define their own barriers unlike the openendedness of GP care, and a need to measure everything - so the consultation which just helps a patient come to terms with their illness or just listens as someone talks about their pain, with no obvious easily measurable outcome, would risk being seen in a hospital setting as a waste of money. We need to move towards longer consultation time too - consultants get 45 minutes for new patients. GPs should have at least 20 minutes per patient. If hospitals could overcome those objections and provide the facilities for GPs to provide good long term person centred care then it would not bother me if I lost independent contractor status. But somehow I don't see it happening. The premises problem would still exist for one thing.

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  • no doubt the daily mailers will apply

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  • For Marie Loiuse,
    continuity of care is a thing of past so is the concept of "cradle to grave".
    After all OOH will do the rest, call 111.

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