Two-thirds of GPSIs set to fail new standards
As few as a third of GPSIs will be considered adequate for their jobs under a tough accreditation system due to be released in the next month.
Consultant leaders are insisting GPSIs who do not make the grade must be forced to retrain or be stripped of their titles.
The demands came as the rift between specialists and GPSIs widened further as one trust decided to put its entire specialist dermatology and rheumatology services out to tender with a view to shifting work to GPs.
Minutes of a recent Newham University Hospital NHS Trust board meeting reveal it has issued 'notice to quit' to the specialist services because of reduced commissioning levels.
Dr Colin Holden, president-elect of the British Association of Dermatologists, said consultants in Newham had entered last-gasp talks to save the services, and warned: 'PCTs have been allowed to flagrantly ignore current guidance.'
He said it was essential new guidance on GPSIs was made mandatory and had 'teeth',
and urged all GPs to check that their local GPSIs complied
with the new standards.
Dermatology criteria are set to outline the need for a diploma, between 25 and 50 supervised clinics, continuing training and on-the-job assessment.
Dr Holden said it was likely that a third of dermatology GPSIs at most would meet the new standards. A December 2005 survey found only a third had met the previous, less robust standards, and there was 'no evidence' of any improvement since.
Dr Andrew Bamji, president of the British Society for Rheumatology, made clear the concerns extended beyond dermatology: 'We're very aware of this situation. The whole issue of GPSIs working as stand-alone practitioners is fraught with problems. We've got no objection to GPs with an interest in rheumatology doing it, but we're very concerned about them going off and doing it on their own.'
Dr Alan Russell, deputy chair of the BMA consultants committee, joined calls for the accreditation system to be compulsory. 'The idea anybody can say they have a special interest is wrong. We need formalised training, formalised validation and continuous professional development.'
Dr Paul Roblin, chief executive Berkshire, Buckinghamshire and Oxfordshire LMCs, said GPs were currently unaware of the standard of GPSIs locally. 'We don't know the level of service we might be getting, so that's difficult medically and legally.'
Key criticisms of GPSIs
• GPSIs do not have to undertake formal training
• Only one in 20 undergoing continuing education
• Services have been set up without adequate support from hospital colleagues
• PCTs are not adequately assessing standards in services they commission