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RCGP pushes for overseas GPs to remain on UK performers list to combat recruitment crisis

Exclusive: GPs who emigrate to practise abroad could be allowed to remain on the performers list under plans to tackle the GP recruitment crisis being discussed by the RCGP and NHS England, Pulse can reveal.

The College is proposing allowing GPs to have their annual appraisal whilst in another country, possibly via Skype, in a bid to remove barriers for GPs wanting to return to practise in the UK, RCGP chair Dr Maureen Baker told Pulse.

It is also seeking funding and developing plans with Health Education England for creating in-practice, back to work schemes to help those returning after time abroad or a career break, as part of a set of principles for returners agreed on Saturday with NHS England and the GPC.

Dr Baker said that the NHS was ‘desperate’ to increase the GP workforce, so it was ‘ludicrous’ that there were so many barriers for GPs wishing to return to work. Meanwhile Dr Mike Bewick, NHS England’s deputy medical director, told Pulse Live in Manchester last week that the Government was looking to work with overseas regulators to help GPs return from abroad.

Pulse revealed last week that Government ambitions to get 50% of medical trainees into general practice had taken a serious blow, as annual training figures show 40% of training places in some areas are unfilled.

And the RCGP’s ‘Put patients first: support your GP’ campaign has been calling on politicians to redress the funding imbalance for general practice in order to recruit GPs and to alleviate some of the workload which is seeing medical students opt for careers in hospitals instead.

Dr Baker said: ‘I think it’s fair to say, that I have very much promoted the issue of returners, and how ludicrous it is that at a time when we are desperate for general practice workforce, that there are really very significant barriers to allow people to return to pick up their careers in general practice and the NHS.’

‘We’re exploring the possibility that these doctors could have their appraisal while they’re overseas. Then they would be eligible to be on the performers list, while overseas. And that would then let them be able to apply from abroad.’

‘There’s nothing stopping these doctors being able to collect their evidence and their e-portfolio of their learning, and skills that they have. Some may get good experience abroad that would be incredibly useful in the NHS, so there’s nothing to stop them collecting that information into their portfolio.’

‘If they were then able to have an appraisal by Skype, and then accept the PGP, then it seems to me, that they could then be eligible for the NHS performers list.’

‘But not all returners are the same, you can’t say that someone who’s been working out in general practice in Sydney is in the same position as someone who’s had a career break for five years and has done no clinical work in that time. They’re two very different situations.’

And Dr Baker said the College was looking at ways to streamline any retraining for GPs returning to work after a career break. More than 1,100 GPs under the age of 50 (representing 3.5% of the total) left the GP workforce between 2011 and 2012, according to the NHS Information Centre, the majority of whom were women. 

She said: ‘Not all returners are the same, you can’t say that someone who’s been working out in general practice in Sydney is in the same position as someone who’s had a career break for five years and has done no clinical work in that time. They’re two very different situations.’

‘It’s entirely possible, and may be desirable, for doctors to have time out, and they may be very keen to have a period of attachment to a practice and then undertake an assessment that seems appropriate for them.’

‘But we are looking for funded schemes to support doctors in that situation, so that they can have a safe, protected route back to practice. ‘

Dr Bewick said: ‘I would like to do a bit of work with some of the other countries’ regulators – the Australian equivalent of the GMC for instance – to try and see if we can get some cooperative agreement so that people, if they do come back it is a shorter training programme.’

HEE’s director of strategy and planning, Jo Lenaghan, said HEE had been working on getting nurses back into work which it would be applying to GPs.

She said: ‘We want to see what is it we can do while working with the RCGP that can address[ recruitment] quicker. It takes five or six years to train a GP so if we can get people back to work much quicker, it will be much better value for the tax payer, and better for staff.’

Related images

  • Dr Maureen baker - online

Readers' comments (30)

  • RCGP/GMC/CCG should simplify the procedures to get into performance list locally first as a starting point.
    The forms ask details of 20yrs ago. Doctors have to climb the loft and get the VTS sign off papers to check what all they did.
    GP shortage is a created shortage.

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  • @ 7.44 I totally disagree ! EU medical universities are at least at the level of UK, but many of them are better.

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  • ...and I fully support the comment @ 2:02 pm 20 June, dear Dr Ahmet Nana

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  • @1018am. I am sure there are many EU colleagues who are excellent doctors. However health care systems in different countries work differently. There are language and communication barriers to address. There are difference in prescribing and health care management. These areas need to be considered. I would not expect myself to be able to immediately take on a post in say France or Germany without trying to address these issues without some sort of orientation or training. Non EU doctors do and I don't see why it should be any different for EU doctors.

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  • I totally agree with Dr. Ahmed Nana.
    Every doctor who is willing to practise medicine in this country MUST prove that they meet the clinical and language competences to practise medicine in this country. Maintaining double standards when come to EU doctors may put patients at risk. Refuge provided by EU laws will not guarantee patient safety but the individual’s Clinical and language competency will.
    GMC turn the blind eye on this issue but they seem to focus on the doctors who jumped all the hurdles they set out as “British standards”. If their mantra is “patient safety” why double standards? IS IT ALL ABOUT PATIENT SAFETY?

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  • I will be interested to see what HEE says and I will be surprised if they agree to working abroad with annual appraisals as a means to stay on the performers list. . Their position -- when they were COGPED -- has always been that unless you are working in the NHS then you are not NHS competent. They appear to think there is some incredibly complex secret sauce in NHS work, the knowledge of which fades rapidly even if you are working clinically overseas. It's a very precious, smug attitude and one which totally refuses to acknowledge the benefits of working overseas in bringing new experiences and attitudes.

    I'm in Australia now and the attractions of coming back are not great, to say the least, so it probably doesn't matter for me now. I just find the current arrangements insulting and patronising to those of us doing jobs overseas which require far greater clinical expertise than the increasingly deskilled chronic disease manager role of the British GP, whose skills, through no fault of their own, are being atrophied by the burgeoning clinical governance prohibition on doing anything beyond the most mundane.

    It's a shame, because British GPs are bloody good and they are certainly loved here in Australia.

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  • I'm surprised the EU tolerates the existence of the performers list system. It looks and smells like protectionism and is ripe for challenge.

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  • I left UK General Practice partly because of negative attitudes of partners/trainers at work and partly because of the tedious work of revalidation. I think some of the older ones in the profession have a serious attitude problem with their juniors. I would have probably stuck around in spite of revalidation if the work environment were positive. It's such a shame that these pathetic individuals became doctors in the first place. It was all about hierarchy and power, not about knowledge and wisdom. They were too ready to claim they had 15 years of experience in General practice but they didn't act in a manner that reflected it. For ex: one of the partners at the training practice told me off because "she was stressed that day with a patient collapsing in her room". I was sat there thinking, "Well! where did your experience go then? You are supposed to be the one guiding me in such situations. I am the junior, so I would stress out. Where is the excuse for you? Surely, your 15 years hasn't served you well then?"

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  • I'm British, a UK graduate, MRCGP trained & 9yrs in UK as GP. I left UK 8yrs & work 10hr days,5-6 days a week in a busy Sydney City practice.
    My parents back in UK are getting older & I'd be keen to come back. Yet revalidation , trying to get onto a performers list ,being told I may be assessed as if I'd not been practicing is disheartening.

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  • I am a GP partner and have decided to relocate to Australia soon, i am so fed up with the bureaucracy around gp, working hours, less pay and the system.
    It is really sad that any single gp has to leave the country. Cant take it any more.
    Good luck NHS

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