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GPs go forth

GPs may be offered one year post-training roles that will include out-of-hours work

GPs in Scotland could soon be offered one-year salaried posts after their three years of training – including out-of-hours work with ‘enhanced support’ and training in out-of-hours care.

The recommendation was made by Professor Sir Lewis Ritchie in a Government-commissioned review of out-of-hours services in Scotland, and the Scottish health secretary has indicated that she would like to implement recommendations from the report.

The review argued that out-of-hours services are not sustainable unless more GPs are recruited, and called for professionals such as GPs, nurses, physios and pharmacists to work together at urgent care ‘resource hubs’ to provide out-of-hours care. 

This model will ease GPs’ workload in out-of-hours care because other health professionals would share out-of-hours calls, Professor Ritchie argues.

Existing four-year training posts in Scotland should also be reviewed to ensure that the experience ‘maximises educational opportunities for the future GP workforce,’ he said.

Professor Ritchie also wants to see a national GP performers’ list in Scotland so that GPs do not have to apply separately for each NHS board they wish to work for.

The Scottish Government initiated the review to tackle the challenges of providing out-of-hours (OOH) care for an ageing population.

Professor Ritchie, a GP in Peterhead and former director of public health for NHS Grampian, said: ‘We have asked for new one year posts to be created for GPs after completion of three-year training, and for four-year training to be better configured for urgent GP care.’

He said that GPs ’may feel insufficiently experienced’ in urgent care after their training.

Professor Ritchie added: ’This may be contributing to a reluctance to undertake OOH work. Existing four-year training posts should be reviewed, and in the meantime newly qualified GPs should be offered a salaried one-year post, which will include OOH work with enhanced support and continuing professional development in OOH medical care.’

The review also calls for the introduction of national standards for out-of-hours care, improving records systems and technology.

And GPs should have ‘rapid access to phone advice’ from paediatric specialist staff during daytime and OOH periods.

Professor Ritchie added: ‘The present situation for OOH services is fragile, not sustainable and will worsen unless immediate and robust measures are taken to promote the recruitment and retention of sufficient numbers of GPs and other multidisciplinary team members working in both daytime and OOH services.’

The Scottish Government will publish its response to the review early next year, alongside a detailed implementation plan. Health secretary Shona Robison has suggested that the Government will implement many of Professor Ritchie’s recommendations.

She said: ‘I believe that in the report we have the clear authoritative advice we were looking for.’

Dr Miles Mack, chair of the RCGP in Scotland, said: ‘The RCGP warmly welcomes the inclusive approach and support shown by Professor Sir Lewis Ritchie and his review. We hope this report can provide a lasting, meaningful solution to patients looking for urgent, out-of-hours medical care.’

Readers' comments (11)

  • R O T A F O D D E R

    They weren't born yesterday.

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  • Typical.....another British con job

    Pay suitable ooh rates and the local GP's will provide it. Also reigning in on the huge costs of indemnity which makes such risky work prohibitive will also have a positive effect.

    its only in Britain, that when something works well it is destroyed to make way for "lowest common denominator" policies such as cost cutting and subcontracting ooh to for profit organisations who will invariably

    - hire less doctors and more nurse practitioners to man telephone triage and base station visits, leading to more home visits, ambulance calls, hospital admissions and invariably more workload for the doctors on the shift who can actually make decisions;

    - Try to lobby for more cheap labour such as GP registrars and newly qualified doctors to plug gaps in their rotas caused mainly due to the ill conceived policies above;

    i am sure newly qualified doctors will be flocking to fill these lucrative posts while turning up their noses at the HUGE salaries on offer down under and around the world!!!!

    if you're a newbie......... your skills are worth far more than the pennies on offer in ooh and the hassle associated with the work in the first place.

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  • How are physios going to provide much OOH care ? Their role is surely fairly limited.

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  • Indemnity,indemnity,indemnity what the hell will this cost who will be paying it,Who will be supervising these inexperienced souls.

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  • Having had 4 or 5 years being used as filler from crappy hospital rotas, newly qualified GPs are not going to sign up for the same immediately after qualifying.

    Most will just locum - and I would do the same if I were just finishing now.

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  • Don't trick are a muppet.

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  • Why would anyone think that GPs are that stupid??!! Are we not doctors any more because we chose general practice? Is the daily mail that effective in highlighting our mistakes and turning people against us?? Or are the majority of GP really stupid and I was not aware of that??
    What the hell is going on here peeps?

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  • Does Professor Ritchie currently do OOH? If he doesn't when did he last do OOH?

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  • posts will be rota and terrible pay you can guarantee. until they start paying proper rates for OOH or reducing indemnity rates then GPs will vote with their feet.

    at present due to my indemnity payments (which will only rise in future years) it's not even worth me doing OOH for less than £120 an hour.

    per hour - £35 indemnity. £50 tax = £85 an hour! gone just for the pleasure of working!

    add pension on to this also and can see why it's not just worth bothering with. you can make more babysitting!

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  • It won't be long before it is compulsory to do OOH for a year for free as part of 'GP training'.
    This government is doing all it can to make us work as much as possible for nothing.
    Shame on GP leaders who time and time again have bent over and let whatever health secretary happens to be in power do whatever they want to us.

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