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Offers aimed at boosting workforce numbers fail to impress GPs

Measures designed to boost the number of GPs working in Wales will only have a minor impact, GPs have warned.

Among a range of steps agreed as part of 2018/19 contract negotiations, GPs at independent practices may receive access to wider employment benefits, in line with those enjoyed by health board-employed GPs.

The Welsh Government is hoping the measures, agreed with the BMA Wales GP committee, will encourage GPs to join, stay or return to the workforce.

The bid will also include an evaluation of the retainer and returner schemes, as well as improved mentoring and coaching arrangements for GPs.

In addition, the parties will look at whether the indemnity barrier can be removed for recently retired GPs.

This comes along with a funding increase – pending the DDRB’s recommendation – £11.67m including, 1% for pay, 1.4% for general expenses and £2.7m towards the rising costs of professional indemnity.

And as as the RCGP has estimated an additional 485 GPs will be needed by 2021/22 – with training places pushed up to 200 a year, compared with a fill rate this year of 144.

Dr Eamonn Jessup, chair of North Wales LMC said the contract agreement was a good deal in a time of economic stringency but needed to be seen as an ‘interim measure’ ahead of next year’s GP contract announcement, which will see Wales going its own way.

He said North Wales had major concerns around recruitment and retention of GPs that need addressing.

He added that measures around health board employment benefits, retainer and returner schemes, mentoring and changes to indemnity for recently retired GPs all had the potential to help but ultimately it would not be enough.

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‘It is clear that any contract offering in Wales will have to be better than that on offer in other parts of the UK so we can attract doctors preferentially especially to North Wales.

‘I’m afraid until there is a fundamental review of financing for the NHS in Wales we will struggle to keep GP-led primary care alive in North Wales.

‘In essence this contract announcement alone will not do it but perhaps as an interim measure and as a first step to build upon it has merit.’

Dr Jeremy Honeybun, a partner at a practice in Abergele, said some of the proposals may help bring in extra GPs but it did not solve the problem that many are retiring early because of changes to pensions which are unlikely to be reversed.

And he said for newly qualified GPs there is little incentive to work full time because so much of their income is lost in tax and pension contributions.

‘So, they decide to limit their lifestyle to their income and only work two days. This is bad for them, and more importantly for patients, because it destroys continuity of care,’ he said.

He added making it easier for GPs to return from working abroad could help a bit but the numbers are likely to be small.

‘It is really more about making GP an attractive proposition again, and increasing medical student numbers – you almost need to double them to stand still because so many are opting to work part time now.’

RCGP Wales chair Dr Rebecca Payne said the profession was facing significant pressures including a shortage of GPs but it was encouraging the problem was being acknowledged.

She said:‘The contract next year will hopefully provide more solutions and we can work on this as an interim step.’