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Older GPs should not be expected to work five days a week, says health minister



Exclusive The NHS must accept that older GPs ’do not want to go on working five days a week’ and find ways to accommodate them, the head of the Welsh health service has said.

In an exclusive interview, Welsh minister for health and social services Professor Mark Drakeford told Pulse that this was one of the reasons why the Welsh health service is organising GP practices in clusters where older GPs can develop portfolio roles.

According to Professor Drakeford, the only way to avoid a retirement boom will be to find ways to retain GPs by ‘beginning conversations early’, avoiding burnout and situations – as recently seen in England – whereby whole practices fold due to unmanagable workload.

In the same interview, Professor Drakeford also opened up wider use of alternatives to the independent contractor model in Wales, where several practices are already being run by health boards employing salaried GPs.

Professor Drakeford said: ’People do not want to go on working five days a week as they have in the past.

‘We need to go on retaining the contribution that [experienced GPs] can make for as long as they feel able to do that. I think it’s about discussions with people earlier on, so we have a sense of what’s important to them and where they might see that contribution.

‘And that is in, for example, continuing to practice a few days a week in an area, like diabetes or dementia. You know, if you are a GP with a special interest you might be willing to go on providing, within a cluster, a specialist service of that sort… I think that might well be attractive to people in the future.’

Professor Drakeford said that although he did not want to ‘load too much into clusters so early in their development’ the Welsh NHS has already seen examples of GPs coming back to provide a specialist service across a cluster.

As for younger GPs, Professor Drakeford said that ‘new generations coming to work as GPs, or in primary care more generally’ are interested in ‘a wider range of potential models’ rather than just the independent contractor model. Professor Drakeford said that although he did not want to ‘load too much into clusters so early in their development’ the Welsh NHS has already seen examples of GPs coming back to provide a specialist service across a cluster.

He said that although he was not ’hostile in any way’ to the partnership model – which he believes will ‘continue to be the dominant practice in Wales for some time’ – other options could include health boards taking on back-office functions for GP practices or even employing the practice team.

He said: ’We need to be able to support people who want to take some experimental steps in that direction. It’s a pragmatic approach really.’

But his comments come as Welsh LMCs have accused health boards of ‘double standards’ after it was revealed NHS-run practices could be funded up to a third extra per head compared to GP-run surgeries.

A pragmatic approach?

Welsh GPs will be pleased that their health minister seems more attuned to the crisis in GP recruitment than their First Minister. 

Carwyn Jones was last month accused of being ‘in denial’ after telling a newspaper that Wales has ‘more doctors and nurses than ever before’.

GPC Wales chair Dr Charlotte Jones has said the two-year contract deal secured last year provided some stability for GP practices, but one year on she still used her Welsh LMC Conference speech to stress that ’workload, workforce and resources’ are the three most powerful strains affecting general practice in the devolved health economy.

And Mr Drakeford’s comments come as a large number of Welsh GP practices have already come under health board control as a result of difficulties with recruitment in some areas.

Meanwhile, in England, a number of folding practices have been taken over by trusts instead.