The NHS workforce strategy has confirmed Government plans for Specialty and Associate Specialist (SAS) doctors to join the primary care workforce.
The Government and NHS England will work together to ‘ensure that doctors other than GPs are more easily able to work in primary care’, the long-awaited document said.
According to the plan, the medical workforce ‘is expected to change over the next 15 years’, with more SAS doctors and doctors in training choosing different career paths including general practice.
Ensuring that doctors other than GPs can work easily in primary care will give general practice additional capacity, improving patient access and creating opportunities for these doctors to develop and progress in their careers, the plan said.
The Department of Health and Social Care is consulting on reforms to the Medical Performers List to ‘retain the flexibilities introduced during the pandemic’ to allow doctors other than GPs to work as part of a general practice team.
NHS England said that SAS doctors ‘form an increasing proportion of the medical workforce’, including at a senior level and the commissioner is committed to working with DHSC, legislators and employers to support SAS doctors to have ‘a better professional experience’, by improving equitable promotion and ensuring options for career diversification.
The document said that locally employed doctors (LEDs) are ‘another rapidly growing group’ who generally undertake more junior roles, requiring direct or indirect supervision, and provide ‘considerable input’ to the medical workforce.
It said: ‘The number of SAS doctors and LEDs on the GMC’s medical register has increased at six times the rate of GPs. LEDs are a huge asset to the NHS.
‘We are committed to working with partners to review medical career pathways and identify ways to better support postgraduate career progression for LEDs, including routes to progress their careers into high demand specialties such as cancer.’
NHS England pledged to continue building on the Out of Programme Pause pilot, working with the GMC and devolved nations so that taking out of programme opportunities ‘becomes a more accepted part of the training pathway’.
The commissioner said that this would retain more doctors in training by facilitating the return of those who want or need to take a break, and on their return accelerate their training when they have gained competencies working as an SAS doctor or LED.
The plan also considered ‘the future need for more generalist doctors’ and the modelled increases are ‘particularly targeted towards general practice’.
The document added: ‘This is reflective of a growing progressive professional consensus over the past decade that training should change, supporting a better balance of generalist and specialist skills so that doctors are equipped to provide the joined-up care required for people with multiple morbidities.
‘This is an important strategic objective, and we will work closely with medical schools, royal colleges, the GMC and employers to support the profession in making this agenda a reality.’
In March, speaking at the Pulse Live conference, GMC chief executive Charlie Massey said regulatory hurdles must be lifted to admit ‘sizeable’ pool of SAS doctors who are ‘itching’ to work in general practice.
But the idea has proved controversial, with the BMA saying that the proposal could cause doctors to be open to exploitation under a ‘two-tier system’. And last month, LMC leaders called on the BMA to reject proposals which would allow SAS doctors to work in general practice as primary care doctors.