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Ludicrous hoop-jumping is putting GPs off returning to work in UK

Arbitrary and overly restrictive policies are putting UK trained GPs off returning to practise in the NHS after a spell abroad, warns Dr Mohsin Ditta

Mohsin Ditta 3 x 2

Dr Mohsin Ditta

Dr Mohsin Ditta

Earlier this year, around nine months after I qualified as a GP, I made a move to Australia. I felt at home immediately, as 40% of my new practice population also hails from the UK – Little England they call it here!

I am finding most of the work is very similar to the UK in terms of management of chronic disease and mental health, with some extra acute minor injuries work and minor surgical work. GPs working in rural locations develop additional, wide ranging skills in the absence of nearby specialist colleagues and secondary care.

GPs working in Australia also take part in CPD and Quality Improvement projects mandated by the Royal Australian College of GPs, while seeing a host of undifferentiated primary care presentations.

Although relishing the experience here, my long term plan has always been to return to the UK to work in general practice. Already, though, I am learning how obstructive the system is for returning GPs.

For one thing, GPs have to do a minimum number of sessions to stay on the performers list each year – with this magic number being one session according to some appraisal teams and 50 according to others.

It is ludicrous that UK trained GPs with CCT and MRCGP via examination have to return to England on a yearly basis when they have chosen to take a break from the NHS, simply to maintain their performers list membership.

On the other hand, GPs like myself are reluctant to resign from the performers list because we are aware of the bureaucracy of the induction and refreshers scheme. GPs with many years of experience and qualifications don’t particularly like the idea of being treated like a medical student, or GP Registrar, on a six-month GP rotation. Nor do they wish to sit ‘situational judgement MCQ tests’ or drop their income to a £3,500 a month bursary for re-enrolment on the performers list.

Another issue facing GPs planning to return in the future is the lack of clarity around the permissibility of appraisals over Skype. Only under ‘extreme circumstances’ is a skype appraisal allowed, my local appraisers claim. But surely video conferencing technology should be encouraged, if GPs are returning to the UK to do the required number of sessions?

At a time when the NHS is on a foreign shopping spree to obtain GPs from anywhere and everywhere to meet the honourable health secretary’s ‘5,000 extra GPs’ targets it seems absolutely absurd that UK trained GPs with MRCGP by examination have to face excessive hurdles returning to UK general practice. I recently became aware of a GP with 20 years’ experience, who took a break from the NHS to work in UAE, resigning from the induction and refresher scheme owing to his frustrations with the bureaucracy, to work in a hospital setting where performers list membership is not needed.

UK trained GPs working in similar clinical environments abroad such as Australia, New Zealand and Canada should have their work abroad recognised and allowed to return to UK clinical practice with ease. There is no need for re-testing candidates with OSCES and MCQs and placements, when these candidates have already demonstrated competencies by way of obtaining a CCT.

The hassle of spending your holiday returning to the UK to do an arbitrary number of sessions means most GPs will resign from the performers list, while the requirement to undergo extensive assessment and placements via the induction and refresher scheme puts many UK GPs working and gaining valuable experience abroad off returning to UK clinical practice. This is far from an ideal situation given the current GP shortage in the UK.

Dr Mohsin Ditta is a UK trained GP practising in Western Australia

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Readers' comments (15)

  • I agree the whole situation is currently ludicrous.....I speak as a appraiser also....confusion abounds because of lack of clear uniform guidelines....a metaphor for the NHS in general. Perhaps better to stay in Australia?

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  • Stay down under and get me a job at your place ! Don’t come back !

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  • On one the biggest issues here is lack of accountability of the people who brought these processes in. There is obvious unrelenting evidence of harm because practices are closing all over the place with some towns seriously short of GPs. It's intolerable to insist on something that none of the rest of the world does in pursuit of 'quality' when the cost of this is quantity, or in many cases no care at all. There are some very powerful people who brought this about. The need to be questioned.

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  • I was told that you could return within two years without much hassle. Better to resign from performers list and then turn everything back on.
    Does anyone know different?

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  • .. just stay there , you got a little england in your practice so not missing much i guess, earning more& developing skills. why loose money on paying fees for bureaucracy just to maintain this 'performers list'.ongoing trainees are being locked out and overseas being fished in- £100m available to facilitate this.. cannot make the sense here

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  • I'm looking to go to Australia for a year but need to return for family commitment reasons. Any advice on how keep the bureauricy / cost to a minimum regarding performers list / appraisal?

    Can I stay on the performers list and just defer my appraisal?

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  • We don't want good, highly-qualified and experienced, British-trained GPs back in Britain after they have been abroad, especially not in a 'Commonwealth Country', we only want doctors with european qualifications and NO experience of the NHS - so that they do not know what they are letting themselves in for, of course!

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  • Azeem Majeed

    Good points Mohsin.

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  • You could consider doing online private consultations and then having your appraisal done through the independent doctors federation. Do a couple of Surgery sessions once per year on your way over to catch up with family and bob's your uncle!

    I also suggest speaking to an accountant as there may be a tax implications of this as well.


    Anonymous salaried!

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  • Jmd

    I agree with well explained barriers. Apart from returners from abroad, there are GPs who have retired but wants to return to GP with much reduced workload, are having difficulties in doing so.
    With all the clammer on increased workload and 'underpaid' , GP partners are unlikely to employ retired GPs( a vast resource untapped) who wants return but at a reduced workload --- I propose that the government subsides these post or even the CCG could look into a scheme locally with help from the centre.

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