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LMCs reject proposals to allow SAS doctors to work in general practice

LMCs reject proposals to allow SAS doctors to work in general practice

LMC leaders have called on the BMA to reject proposals which would allow SAS doctors to work in general practice as primary care doctors. 

The vote, part of the annual UK LMC conference, asked the BMA’s GP Committee to reject any changes to the Performers’ List which enable non-CCT holders to work in general practice. 

The motion proposed by Norfolk and Waveney LMC and was overwhelmingly passed, following a lengthy debate.

Starting the debate, GPC policy lead for education, training and workforce Dr Sarah Matthews said the committee now understands NHS England’s proposed pilots of SAS doctors working in general practice for 2023/24 have been ‘pulled’.

Dr Matthews said the potential of moving forward with regulatory change without these pilots was a ‘wild west’ situation.

Chair of the BMA’s Staff and Associate Specialist (SAS) Committee, Dr Ujjwala Anand Mohite then addressed conference, saying the current proposal is not an ‘attractive or viable career option’ for SAS doctors who want to work in primary care.

Dr Anand Mohite said: ‘We do not believe that it is viable to create a separate role for SAS doctors in primary care as it would lead to a category of less GP and could lead to these doctors being exploited as a group.’ 

In April, GPC England deputy chair Dr Kieran Sharrock said the committee would ‘vociferously oppose’ the plan unless certain requirements were implemented to make it safe and feasible. 

And later that month the RCGP said it was ‘not in a position’ to support the introduction of SAS doctors to general practice because NHS England had not yet ironed out concerns around funding and patient safety. 

During the debate, most GPs were strongly against the proposal, saying it would not address the GP workforce crisis and citing concerns around having to supervise SAS doctors who are not trained to deal with undifferentiated care in the same way as GPs.

Dr Rachel Ali from Devon LMC said: ‘If they want to allow highly trained, excellent SAS doctors to work in primary care, let them work in primary care in community clinics run by secondary care, doing secondary care work in specialist areas. It’s got nothing to do with general practice.’ 

Dr Manu Agrawal called on LMC leaders to reject the idea that SAS doctors are less qualified, but said they are more suited to working in hospital or community settings.

He said: ‘Personally, I am fed up of supervising multiple roles on a daily basis and would love to have a workforce which can work independently, and I can get on with my day job.’

Many GPs also expressed concerns that around inequalities since the SAS doctor cohort is disproportionately from ethnic minority and IMG backgrounds. 

Dr Carter Singh, chairman of the Nottinghamshire LMC, said: ‘This will create a two-tier system which may confuse the public and undermine this grade of doctor.’

He added: ‘Our hospital SAS doctors are highly skilled but often undervalued, and I suspect, from the ones I’ve spoken to, very few are sadly in post out of choice but rather as a result of institutional racism and a lack of training and mentoring.

‘It is further segregation and division of an already exploited workforce masquerading as inclusion. It will be us over-stretched GPs that will have to pick up the pieces when this fails.’ 

Last week, the GPC published a draft position statement which said the SAS doctors proposal could cause doctors to be open to exploitation under a ‘two-tier system’.

In March, speaking at the Pulse Live conference, GMC chief executive Charlie Massey said regulatory hurdles must be lifted to admit ‘sizeable’ pool of SAS doctors who are ‘itching’ to work in general practice.

Motion in full

NORFOLK AND WAVENEY: That conference asks GPC to reject the GMC’s proposed changes to the
Performers’ List to enable non-CCT holders to work within general practice as primary care
doctors. PASSED


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Please note, only GPs are permitted to add comments to articles

Some Bloke 18 May, 2023 7:06 pm

A bit short sighted from LMCs. While, just like Dr Agrawal, I am also tired and fed up of supervising multiple roles, I would rather have more choice in whom I have to supervise. I may well prefer supervising another Dr compared to another pharmacist or half trained paramedic.

David Church 19 May, 2023 2:17 pm

To become a real GP, a doctor (after F1/F2 time), needs to complete a 3-year training course including a year spent working supervised in General Practice, and the Exam.
To become an SAS doctor working in General Practice, a doctor needs to complete 3 years after F1/F2 and Full Registration, including at least 2 years of ‘relevant experience’, which obviously means 2 years of working supervised in General Practice, but does not appear to have to pass the Exam.
The apparent difference is that the SAS doctors do more of an ‘apprenticeship’ than a formal training course, and are presumably incapable of passing the exam (or just don’t want to fund the RCGP!).
I think this under-rates SAS Doctors substantially ! Is it just a way to exploit them?
The one saving seems to be if a doctor decides, PART-WAY through advanced training, that they wish to switch to General Practice from a hospital specialty :- but that is already possible, and in theory the Deanery or VTS scheme can ALREADY give them credit for hospital specialty training, and reduce the VTS course length by 1-2 years in respect of additional training undertaken – although they would quite possibly be at a disadvantage in the administrative timetable for taking the Exam.
Either or any way, this does not improve recruitment or retention to GP jobs.
Brexit may have made more of a difference, by allowing non-european medical school graduates to work in training posts in GP – which being in Eurovision made impossible if they had not worked in GP in europe in the past, for some wierd and unexplained reason.

Lise Hertel 20 May, 2023 11:17 am

Its all just rubbish anyway, there just aren’t all these SAS doctors wanting to rush to general practice, SAS doctors are equivalent to consultants. They are experts in their own right, why would they want to be patronised by a bunch of GPs who don’t even understand what an SAS doctor is? They also already have jobs- its not like they are all waiting for this opportunity because if they were, they would have become GPs already. This is just another distraction by the government to put blame on GPs for being unreasonable. It should be called out for what it is.
A dead cat thrown on the table to distract us from the destruction of the NHS.

John Glasspool 20 May, 2023 7:00 pm

Anyone remember Summative Assessment? It was pretty good but got desttoyed by the RCGP’s gadarine rush towards empire building.

John Glasspool 20 May, 2023 7:01 pm

Anyone remember Summative Assessment? It was pretty good but got destoyed by the RCGP’s gadarine rush towards empire building.