Regulatory hurdles must be lifted to admit a ‘sizeable’ pool of SAS doctors who are ‘itching’ to work in general practice and fully utilise their skills, the GMC chief has said.
In a keynote speech to the Pulse LIVE conference in London today, Charlie Massey argued that regulation is not ‘keeping pace’ with the changing nature of the medical workforce.
And he warned that waiting for more GPs to come and plug the workforce gap ‘risks killing the primary care model’.
In response, he said that it was ‘vital’ that NHS England makes this possibility a reality by updating Performers List rules.
He told the conference: ‘The medical workforce is changing but the rules that govern it aren’t keeping pace. Dated ideas are holding SAS doctors back and patients are being denied their skills in the process.
‘I believe the key to tackling the challenges confronting the service is to make the most of what we already have, both in terms of GPs and the wider medical workforce.’
He added: So it’s vital NHS England and others enable these changes, so we can realise the benefits to both the public and profession.’
He said the ‘first’ thing that needs to happen is to ‘reform to the Performers List, which determines which doctors can work in primary care’.
‘Changing the criteria could allow SAS doctors to work alongside GPs in complementary roles. Exactly what that mix looks like would be down to primary care leaders, and would vary according to the needs of different locations.’
According to Mr Massey this could include ‘having a SAS doctor with a particular specialism, such as in paediatrics or elderly care, to work within that area of practice in a primary care setting’.
Another model could see SAS doctors who are ‘skilled in emergency care being used to triage patients’.
‘This would allow GP time to be freed up, so they could focus their time where their skills and expertise are most in demand,’ he said.
But, addressing the GP audience, he stressed that he wanted to ’emphasise that this isn’t about SAS doctors substituting for GPs’.
‘And I’m certainly not suggesting that GPs don’t have a particular and expert set of skills and knowledge. Instead, what I am arguing for is that the rules should be changed to allow other doctors with relevant expertise to work alongside GPs and the primary care team.
‘If we get this right, we can open up primary care to a new part of the medical workforce, using the skills of SAS doctors in combination with the wider team to the good of patients.’
Highlighting current pressures on GPs, he said: ‘The state of play today is intolerable – both for patients, who feel that their needs aren’t being met, and for GPs themselves, who are unable to provide the quality of care they want to provide for their communities.
‘All of this tells us that just expecting more GPs to plug the gap will not give us the sustainable and long term answers we need. Instead it risks killing our primary care model altogether.’
Pulse exclusively revealed in October last year that the GMC is hoping for 10,000 or more SAS doctors to be able to join the general practice workforce, both from the UK and overseas.
The controversial proposal has been met by a mixed response from GP leaders, who have said they will need to see more detailed plans drawn up.
But Mr Massey’s Pulse LIVE speech acknowledged that ‘altering the composition of the primary care workforce in this way is, of course, not without its challenges’.
‘The devil is in the detail, and the mechanics of how these changes play out on the ground will require careful thought and attention. That includes how SAS doctors will be supported and supervised by experienced GPs, without increasing their workload.
‘It is not for the GMC to work out the answers to all of these questions. But there is reason to believe that primary care is well placed for this sort of reform.’
He concluded: ‘Doing things as we’ve always done will not create the sustainable workforce we need. It threatens the very survival of our primary care model.
‘To sustain general practice fresh thinking is needed. We at the GMC, working with partners across the system, are committed to playing our part.’
Pulse 365 LIVE is two-day conference (21 and 22 March) with a comprehensive programme covering the latest clinical updates, career development workshops, and policy updates. The event is run by Cogora and is taking place in Hammersmith, London.