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Less than a quarter of recently qualified GPs become partners in five years

By Alisdair Stirling

Exclusive: A 'disproportionate' number of newly qualified GPs remain as locums or salaried GPs five years after finishing training, RCGP figures show.

A study looking at the career paths of more than 1,000 young GPs who are part of the college's First5 scheme found that only 23% become partners within five years of qualifying, while more than two fifths are salaried and a further quarter are locums.

The findings come a week after Pulse revealed that NHS South West Essex had scrapped a flagship incentive scheme, aimed at boosting GP partnerships, in order to cut costs.

The First5 figures - from the RCGP scheme that supports new GPs in their first five years after training - have led to claims that the younger voice of the profession could be overlooked, but others argue younger GPs are pursuing sessional posts by choice.

The research, based on 1,040 responses out of 7,738 GPs invited to take part, was carried out by Dr Clare Taylor, a GP registrar in Birmingham and clinical lead for the First5 scheme.

Some 42% of the respondents were in salaried posts after five years, while 25% were locums and only 23% were partners. The remaining group, classed as 'other', included GPs working in military and academic jobs.

Dr Taylor cited the findings of the study in her manifesto for the 2011 elections to RCGP Council.

In the manifesto, a copy of which was passed to Pulse by another member of the college, Dr Taylor warned: 'There are disproportionately more salaried and locum GPs amongst First5 members.'

'In areas such as commissioning, there is the potential for the First5 voice to be less well heard than that of more established members who are more likely to be partners.'

Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs, said further figures from the study he had obtained showed that approximately two thirds of the First5 salaried and locum GPs were female and two thirds of those in partnerships were male.

'Nowadays most new GPs are female and want more flexibility and work-life balance. The profession is changing. The partnership fitted into the social, political and economic landscape of the 1950s but not so much today.'

'I was at a recent First5 meeting and out of 80 delegates in their first year post-qualifying, three quarters were locums. The worry is GPs don´t receive any proper training in how to work as a locum - even though that´s what most of them end up doing.'

GPC negotiator Dr Peter Holden said a wider range of options meant that young GPs were less likely to go straight into partnerships.

'I'd be unhappy if these figures meant they were really having difficulty finding something but I think there´s an element of some people being very choosy and geographically constrained - they don´t want to move around.'

'But turning this on its head, some partnerships are struggling to find candidates of the right calibre. The last two times we´ve advertised, the field has actually been very poor.'

'Newly-qualified GPs say they can´t find a partnership but are actually unwilling to commit or make the necessary compromises and put in the hard graft.'

Dr Peter Bouzyk, a sessional GP based in Gloucester and director of the Doc2Docs GP recruitment agency, said: 'Currently, ads in the BMJ are about 50:50 for partnerships and salaried posts. More people want flexible working and with the commissioning changes, more people are waiting to see what happens before taking the plunge into partnership.'

'A lot of young GPs are opting for locum work because at the end of the day they can maximise income by doing other things like out-of-hours or medicolegal work - if they want to. It´s the flexibility that appeals.'

Dr Ishani Patel - who qualified as a GP in February - has taken a salaried post at her training practice in Brent involving some commissioning work and is still doing additional locum work.

'There's so much going on at the moment and I´m a person who wants to try a lot of different things. I think I´m speaking for my peers when I say that people are feeling a bit hesitant about partnerships at the moment because everything´s changing and income from partnerships is changing.'

'There´s a partnership vacancy in my practice in the next 18 months but I´m not sure I want to take it. A lot of my colleagues are keen just to locum so they don´t have o bother with the politics or the financial side of partnership. It does make a lot of sense. Before, the prize was partnership but now people don´t necessarily want to commit.'

Dr Ishani Patel