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A&E ‘streaming’ competition is causing locum shortages for quarter of GPs

Exclusive A quarter of GPs are finding it more difficult to employ locums due to competition from GP ‘streaming’ services in A&E departments.

Since last winter, acute trusts have had to ensure they have GPs on site at all times to divert and treat patients who do not need hospital care.

To date, researchers are undecided about the impact of the £100m scheme, with one study claiming GPs saw patients ‘quicker’ using ‘fewer resources’, while another failed to show any impact on overcrowding issues.

However, as predicted by GP leaders, Pulse can reveal that GP practices are feeling the impact on an already-stretched GP workforce.

In all, 24% of respondents to a Pulse survey of around 650 GPs said they – or the practice where they work – are finding it harder to get locums due to a related increase in competition for sought-after staff.

GPs responding anonymously to the Pulse survey suggested some A&E departments were paying more than they were able to and that GP locums were giving ‘short-notice cancellations for more lucrative jobs’.

Meanwhile Dr Paul Evans, a GP partner from Newcastle and Gateshead, said: ‘Several emergency departments have used GPs locally, in a region that already struggles to recruit GPs, thus offering yet another option for work for locum GPs – on top of walk-in centre, out of hours, hub and traditional GP –  often on an hourly rate above that which many surgeries can afford. 

‘This means we have on occasions been unable to find locums to cover during a colleague’s maternity leave and have been faced with a choice of cancelling planned leave or running uncomfortably light on staff on some days.’

According to Dr Evans, the GP streaming services are yet ‘another factor that has tipped the market in favour of the seller at the expense of the buyer’.

‘Whilst some locums charge what we consider fair fees, the majority we deal with have put up their prices and increasingly attached conditions such as no visits/scripts/phone calls etc,’ he added.

BMA GP Committee chair Dr Richard Vautrey said: ‘The whole NHS system is under pressure and with a widespread workforce crisis the role of GP locums is crucially important in enabling the maintenance of services to patients.

‘With limits on the number of GPs available, as the NHS in England expands the services in evenings, weekends and in A&E, it needs to take in to account the knock-on effect this can have on practices trying to maintain day-to-day activities.’

RCGP chair Professor Helen Stokes-Lampard said: ‘We don’t have enough GPs in the NHS, and we know that many practices are not only struggling to fill long-term vacancies, but to hire short-term locums as well. The reality is that there are only so many doctors to go around and demand is exceeding supply.

‘It’s essential that the forthcoming NHS long-term plan is underpinned by a coherent, properly-funded workforce strategy, and address the adverse impact workforce pressures are having on our profession and the care we are able to deliver to our patients in the community.’