Thousands of GPs were given temporary registration by the GMC at the start of the pandemic, but GP leaders are doubtful of the regulator’s claims they will stay on, finds Nicola Merrifield
Plans are afoot to bolster the GP workforce by targeting GPs who came back during the coronavirus pandemic.
At the start of the virus outbreak the GMC granted temporary registration to GPs who had recently retired, under emergency legislation. This summer, it contacted them to advise them on next steps if they wish to continue practising.
The legislation that allows their temporary return can be revoked at any point by the health secretary, but the GMC said it is ‘in ongoing discussions’ with the Department of Health and Social Care to ensure it is given ‘several months’ notice’ before it must remove registrations from this cohort of doctors.
The regulator has been informing GPs about how to apply to restore their routine registration and licence, or retain or relinquish their temporary one. As of the summer, 8,224 GPs held a temporary licence, down from 8,306 in October 2020.
The potential boost to the workforce appears to be vast – but a GMC survey of around 4,000 of those returners at the end of 2020 shows only one in six would ‘possibly’, or be ‘highly likely’ to, restore their routine registration.
And GP leaders point out that since the survey took place many months ago, retired GPs who came back to help with the pandemic are even less likely to stay in the workforce permanently.
Policymakers are acting under a ‘false assumption’ if they believe a wave of returner GPs will stay on permanently, says Dr John Hughes, chair of grassroots campaign group GP Survival.
Working conditions in general practice have worsened in that time as demand has increased and GPs have been blamed for lack of access. And the return to more face-to-face care as society opens up poses a higher risk of catching Covid, especially for older GPs, he says.
Dr Hughes adds: ‘The GMC’s re-registration [to a temporary licence] was done without consulting people who were re-registered… they were informed they were put on it. Quite a number of them didn’t feel able to work again.’
Pulse obtained the exclusive figures following a freedom of information request to the GMC.
The findings reveal that when the survey took place – in October and November of 2020 – just a quarter of the 3,745 GPs taking part in the survey had actually returned to work, or received an offer of employment by that point.
Around 3% of all those surveyed – including those who had worked, plus those who had not – said they would be ‘highly likely’ to return, while 14% said they would ‘possibly’ do so.
The Government has a long-held ambition to bring thousands more GPs into the workforce – with the most recent target, set at the end of 2019, being 6,000 extra (including trainees) by 2024/25.
But Dr Hughes casts doubt on the idea that 17% of temporarily registered GPs would return permanently, noting that NHS England’s process for regaining GPs during the pandemic was ‘exceedingly challenging and impenetrable’.
‘There were a lot of complaints about that – and then somepeople who did go through the process were told work couldn’t be found for them.’
He adds: ‘Most people are retiring because they’ve had enough. Most of those who have gone would not be keen to come back, particularly since the working conditions and circumstances are worse now, [partly] because of the pandemic but also due to the general attitude of blaming GPs for everything.’
READERS' COMMENTS [13]
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Those who were restored were not subject to appraisal and revalidation. For those of us who had not retired and continue this is a big issue. I don’t expect that those who were restored will wish to go back to the annual charade. It has to be the same for everyone
Regarding Appraisal and Revalidation, good comments by Dr Crow. Really pleasingly the new Appraisal 2020 has been reset with much less effort required for preparation by GPs, who have often spent a great deal of effort and timer to prepare, and have had to fulfil their own and other peoples’ expectations – the reset has helped a great number of my appraisees. and Appraisal should be an appraising process, not a performance management tool – this is what is happening as part of the reset. I remember a GP Appraiser from Cornwall who said to our local NHSE Appraisers meeting ‘ I start all my appraisals by saying Thankyou for all you have done in looking after your patients over the last year’. What a nice way to commence a professional developmental conversation! I see it as my role to appraise and support in this style, as well as ensure that relevant boxes are ticked (but NOT make the appraisee jump too high – sometimes a challenge for those doctors amongst us who like to please others – and who drive ourselves hard with a level of perfectionism). I welcome the reset in Appraisals. Dr Andrew Tresidder, GP Appraiser, Practitioner Health Clinician, Somerset CCG Clinical Lead for Evidence Based Interventions and Medicines Management, and Staff Pastoral Support, past LMC member
Yep, that’s the consequences of micromanagement! Not forgetting the pension fiasco either! They have lost the best and most efficient part of the NHS workforce, suspect due to widespread incompetency rather than a cynical masterplan to destroy. No-one with 30years experience is going to come back to jump through the nonsense of appraisal for a start, but the other tick box stuff doesn’t help either! Javid …good luck! ..the blame lies firmly at your departments door!
@Andrew Tresidder.
“NOT make the appraisee jump too high ”
Wow ! That’s just SO magnanimous of you. You are NOT the appraisee’s boss, supervisor or trainer.
Remember that.
While you’re at it, please DO share with us all the evidence base that clearly shows that appraisal makes any of us better doctors.
I’m not holding my breath while you collate it.
@Andrew Tresidder.
I just love being patronised?
I am in total agreement with Michael crow.
One in six GP Covid returners ‘would consider staying on’…consider is like, a grey, unenthusiastic, potential maybe. There is no will, throughout this old-new NHS. It is a lost indefinable juggernaut. And “1 in 6 GPs might reduce their sessions or leave”.
Good luck with that one. I was granted emergency registration and gave up trying to jump through the hoops, I received a second hand laptop that didn’t work and the modules to complete were quite frankly ridiculous. I cannot imagine what would need completing to fully reregister.
The whole appraisal fiasco was put in place because of shipman.
However, the irony is that there was never any suggestion that shipman was a bad doctor – far from it, he was actually very up to date and perfectly competent.
The whole fiasco is based on a false premise – same as an awful lot of drivel from “those at the top”.
If they could simply invest their time and energy into trying to improve the system, rather than devising scams to avoid proper work, we could all get on with the proper job and deal with “those who are ill, or perceive themselves to be ill”
So, er… five in six definitely AREN’T staying on, and the remaining one in six is going to “consider it”. Not going to solve the workforce issue any time soon then!
BTW- I get better pay rises as a retiree than I did when working. There’s a lesson in that somewhere.
There have been major improvements in recent years regarding indemnity, lighter touch CQC.
Next we should make appraisal optional, and find a fix to the tax and pension ceiling where you could earn an extra £5000 but lose an extra £6000.
Referral management seems to be the biggest deterioration, exacerbated by whole system pressure and covid.
I’m struggling to see the benefits for the PCN effort, just another beaurocratic layer. Why didn’t they just allow practices to recruit ARSS roles?