A Surrey GP practice is making three GPs redundant due to ‘new ways of working’, including virtual appointments and the use of ARRS staff.
The 19,000-patient practice invited its 11 salaried GPs to apply for voluntary redundancy in December, and the three who took up this offer will be leaving at the end of March, according to the BBC.
Managing director Joe Todd told patients in an update yesterday that they had ‘identified a need to make some changes’ to the practice team after a ‘number of recent improvements and the introduction of new ways of working’.
He said the practice is ‘working differently’ due to a ‘significant increase’ in online requests and virtual appointments, based on patient preference.
The update said: ‘These improvements, which are helping to increase access to our services and improving experiences and choice for our patients, coupled with the introduction of many new roles at the practice – including pharmacists, first contact practitioners for musculoskeletal conditions, advanced nursing and paramedic practitioners and paediatric nurses – mean that we are working differently and, more efficiently to help people get the care they need from the right healthcare professional.’
‘Many of these improvements are outlined in the NHS national Primary Care Recovery Plan and, as we have started to work differently, we have needed to re-look at our staffing so we are aligned to deliver services in this new way,’ Mr Todd added.
The LMC told Pulse that many of the GPs who received the voluntary redundancy offer contacted them for advice.
Surrey and Sussex LMCs chair Dr Julius Parker said he agrees with the BMA’s GP Committee’s (GPC) position that GPs should be included within the ARRS programme.
Dr Parker, who is also deputy chair of GPC England, said: ‘However, the LMC believes that had the considerable financial support associated with the ARRS programme over the past five years been directly available to General Practitioners for use within their practices, without the constraints on recruitment
associated with the PCN DES specification, this would have created a far more flexible, responsive and sustainable solution to the workforce crisis facing General Practice.
‘The LMC also believes this would have resulted in better value for money from ARRS funding in terms of patient care.’
Since the scheme’s introduction in 2019, more than 31,000 ARRS staff have been recruited to work in general practice.
But GPs have recently expressed concern that the increase in ARRS staff has led to a scarcity of GP salaried roles and locum work.
In November, a Pulse survey of 612 GP partners revealed that there has been a 44% reduction in the number of GP vacancies advertised since the same month in 2022.
GP leaders attributed this reduction in vacancies to a number of factors, including an increase in the ARRS success in hiring staff and a lack of resources and space to house GPs.
And some GP locums have been asked to consider decreasing their expected hourly rate amid a reduction in available roles, in part due to the increase in ARRS staff.
Surrey Heartlands ICB told Pulse that practices in the area are taking forward ‘a range of improvements for patients’ in line with NHS England’s GP recovery plan.
A spokesperson said: ‘Practices are already working differently due to an increase in the use of online services, where Surrey has some of the highest usage rates in the country, and other changes that are happening nationally, including the introduction of new roles, where the NHS is bringing in professionals with very different skills, to enhance the practice team and the local offer to patients.
‘As a result of these changes, the practice has re-looked at how they operate and considered opportunities to work more efficiently, including the workforce they need moving forwards – and the changes they are making locally, reflect this.
‘We monitor access and waiting times for all our GP practices to make sure people have good access to local services and we will continue to monitor access closely to ensure people are getting the care they need, when they need it.’
I would imagine that they are struggling financially and putting work through ARRS money which (for now) is a given. Good luck to the supervising GPs / Clinicians!
Do they really believe the rhetoric that this constitutes an improvement?
They do need to be aware that under BMA model contract , if employed for more than two years they are entitled to redundancy pay for their lifetime NHS employment ( and locum work) not just time employed in the contract with the practice .
Could be expensive !
Further proof that GPs are being actively replaced (not supplemented) by non-doctors.
A financially stricken practice…with a shrinking practice population. ARRS cannot replace GPs, they will never be like for like. What’s not mentioned is how many of their GPs will hand in their notice after being denied redundancy…it’s a failed situation.
So where’s the shortage of GPs, when a practice can afford to let three go? It won’t be the only one. Thousands of GP locums already effectively unemployed. Reports of newly qualified GPs unable to even find salaried posts and another 4,000+ ST3s qualify in the summer. Practices now saturated with non doctors/AHPs. Where are the jobs? What will thousands of unemployed GPs come summer do?
Race to the Bottom!
Locally, there’s also a 19,000 patient practice run by 3 Principals, 3 salaried and, previously, a handful of locums (who’ve been axed) but now by many ARRS roles. It’s an innercity, high deprivation, high BAME patient population practice with poor patient service/access etc. The GP Principals extract >200k income (while only working p/t actually seeing patients), the salaried GPs get BMA rates and the previous locums get £0 in work. Isn’t it about time it was realised that collaborating GP principals are the willing/unwilling handmaidens to this destruction of the NHS by the politico-managerial complex? And so, salaried and locum GPs need to wake up to the fact that the Principals’ interest is very different to theirs. Ballot for strike action, go down fighting while there is still something worth fighting for.
I understand the G.M.C. will remove my temporary registration on 13th. March to make way for more ARRS staff
Surely the GMC can tell their ARRS from their elbow?! And surely Pulse will allow you to keep contributing your musings..
3 GP Principals for 19000 Practice and 3 salaried GPs- wow that’s about 3100 patients per GP . Only 3 partner-another wow-these guys will be counting pennies before throw of hat. Of course all this when they pledge in name great patient care and access. But there is limit on ARRS in surgery I think so something wrong.it will be same with private firms they will bend rules and hire more ARRS.
This is purely a resource issue. There is money for the MDT (who in our experience have been fantastic) If the funding scheme moves into core contract without limitations and of course some element to reflect the employment burden then this will right itself. We cannot have an increase in medical personnel training resource without the reciprocal increase in future employment resource otherwise we are just training lots of GPs for other worldwide health systems 😩
Dear oh dear
Rot does tend to spread more quickly than you think
‘ARRS funding’ is essentially discriminatory against GPs – which is perverse
It’s another very effective way to hollow-out a valuable service
What’s with the absolute refusal to fund the core GP service properly??
All the very best to the GPs who left. It sounds as though they made a wise choice and I hope they find a substantive role in a practice where they are truly valued.
Looking at the practice feedback – it seems as though they are not in a position to be letting anyone go.
Conversely I’m a partner in top 1% nationally for patient satisfaction in the 2023 GP patient survey. That patient satisfaction came from working hard to employ enough staff to provide enough appointments. However pay for partners has been static and indeed has been eroded by inflation over the past decade. The only benefit from being in the top 1% was a thank you letter from ICB. It is hard to remain motivated, paying out of pocket to maintain high levels of availability in lieu of sufficient funding. I feel sad that articles like this are of increasing interest in the face of once again no rise in partner income once you factor in obligated staff pay rises and running costs
As a partner in a 3 partner practice, 2FTE , 4400 patients and no salaried with appointments available FTF on the day, we offer the traditional service but following bench-line cuts and loss seniority financially stuffed. Yes it does make me angry at the few of our colleagues who have essentially gamed the system at the expense of patients. I hope the Salaried GP’s find a Practice where they are valued. PS I was once salaried for 5 yrs and still cant understand why on being made redundant was entitled to years that I never worked for that service.
I would ask for the salaried GP’s there to contact their LMC for their legal rights and also to consult the BMA for support. There are surrounding surgeries that I am sure would be very lucky to take on established doctors. I am sure that the patients would then follow their doctors to these surgeries if they were to move as patients do value continuity of care and the relationship that they have built with their doctor over the years.
this should never be underestimated.
The PCN Clinical Director led destruction of General Practice and the devastation of the future careers of the next generation of GPs will continue as long as financial rewards are offered in return from them replacing their GP colleagues with often inappropriate use of lesser qualified staff. in my opinion. They should not be supported in my view in their current catastrophic self motivated destruction of general practice as is clearly shown by the current state of Primary Care and their ongoing actions subject to the scrutiny of their colleagues.
I left my salaried post because despite being seriously under Doctored the PCN CD and CEO refused to use the budget to appoint more Dr’s choosing instead to spend the money on themselves and PCN support staff. NHSE don’t care they want to break the current model. Greedy owners will reap significant financial rewards if they are unscrupulous and care little for their fellow Professionals
GPs are so good at turning on each other and blaming each other. Let’s not waste our time on this, it never gets us anywhere.
This is part of a political strategy by all parties to restrict the cost of the NHS despite increasing demographic-driven need. Look at what is happening in hospitals – huge increase in doctors and nurses now being marginalised for training and forced out of careers by PAs and NAs who will be the core NHS workers in the future. Better paud than a starting post foundation doc but hugely less expensive than a consultant. Look five years down thr line – those who want to specify consulting a doctor without a referral from a PA will have to think again.
In the full NHSE PCN DES specification document there is no individual named as being responsible -signing this document off
The faceless architects of ARRS recruitment and deployment have constructed a scandalous waste of public money depriving our patients of services and allowing primary care to wither on the vine. The billions spent have simply aided the implosion of GP services with impractical misguided constraints and rules.Yet these bureaucrats will shrug their shoulders secure in their salaries and pensions and remain hidden- impervious to accountability and comment.Another NHS reorganisation will repeat the process with the same individuals.
Meanwhile PCN clinical directors build small empires in proportion to their vanity blaming the system for failing to pass on support to primary care. Advisers such as KIngs Fund -where not a single clinician sits-offer clueless Utopian suggestions
All of this is not what the Government intended nor our communities deserve.
A full review with naming of those responsible is long overdue otherwise mistakes will simply be repeated
Exactly the same thing happening in Northern Ireland with the bloated and frequently discriminatory federations hoovering up a very large percentage of funding and managed by Drs who prefer talking hot air and power to actually seeing patients. A parallel bureaucracy of non GP managers who had no prior experience of general practice and some of whom have displayed little understanding of proper holistic general practice. The BMA and RCGP were sadly cheerleaders for this evisceration of general practice from within.
Is this an aPMS practice?