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Only one in 100 GP returners pass new fast-track induction exam

EXCLUSIVE Just one GP was able to immediately begin practising upon returning to England in the first six months of the simplified induction and refresher scheme, Pulse can reveal.

Health Education England (HEE) had said the new national programme would fast-track GPs with UK experience back onto the performers’ list upon returning to England from working abroad as a GP, cutting out bureaucracy.

But data supplied to Pulse indicate there was a lower-than-expected success rate for the programme, which replaced a variety of differing regional processes last April in an NHS England bid to make it ’easer to return to practice after working overseas or taking a career break’.

HEE data showed that out of 108 GPs who sat the initial test required to enter the programme between April and October last year, 91 passed, but only one with the score required to return directly to practice without further assessment.

The lower-than-expected success rates on the test mean more GPs are required to take a second ‘simulated surgery’ assessment at a cost of £800, which they are refunded on completion of their placement.

This comes despite the programme’s director telling candidates that a GP with previous UK experience who has been practising in a primary care system similar to the UK should normally be ‘screened out’ of the process at the initial exam phase and not require further asseessment (see box), only do an e-learning module and a short placement of up to one month.

Dr Krishna Kasaraneni, chair of the GPC’s education, training and workforce subcommittee, told Pulse he had ‘heard from many who have found the scheme to be time consuming and still bureaucratic’.

He said: ’You’re right that only one person has gone through the whole system who didn’t need to go through the whole process, which can be time consuming. So it does need reviewing to see how things can be assessed in a way which values the experience these doctors have…’

‘The reality is the new scheme standardises certain aspects which were all over the place across the country [but that] there’s still a hell of a lot of issues we have to get through.’

HEE said it had been made aware of concerns over the programme, which is being reviewed before going into its second year in April.

A spokesperson said: ‘The [multiple choice questionnaire] assessments are key in ensuring safety and it is important to stress that all GP will have range of performance and they will not all achieve the same levels.

‘We are looking at this to see how it is working and to see whether changes are needed. The figures given need to be looked at in context.’

The scheme was the first of the ten iniatiatives to boost recruitment and retention to be rolled out last year, with GPC chair Dr Chaand Nagpaul welcoming the standardised national process, saying at the time that it would ’enable doctors, who are GPs but they have left the country or they have stopped working, to come back without the bureaucracy they currently face.’

What is the induction and refresher scheme?

Before the rollout of the new induction and refresher scheme there was huge variation across the country in the process that must be undertaken by GPs wishing to return to the performers’ list, involving the local education and training board and the NHS England area team.

In the programme, the length of placement is determined by a candidate’s achievement in the initial exam, where ‘band 5’ means a candidate can return directly onto the performers’ list while a ‘band 4’ or ‘band 3’ score means they have to do placements of up to three or six months respectively. During the placement, returners receive a bursary of £2,300 per month for a 37.5-hour week.

Programme director Richard Weaver told candidates, in correspondence seen by Pulse and confirmed by HEE, that ’the expectation of the I&R scheme is that a GP with previous UK experience (CCT, EU qualification or CEGPR) in the NHS as a GP who has been working overseas in an equivalent primary system to the NHS would normally be screened out of needing further assessments (Band 5) and only be expected to complete the e-Induction learning modules and undertake a short placement of up to one month in a GP practice and a satisfactory “Short Placement Report”.’