Partners must ensure career progression for younger GP colleagues, says primary care lead
It is incumbent on GP partners to provide their younger, salaried GPs with a career structure outside partnerships, NHS England’s primary care director has said.
Speaking at the NHS Confederation conference in Manchester last week, Dr Amanda Doyle told delegates that the ‘new generation of GPs don’t want to become a partner at 29’.
She said there was only so much that can be done from the centre, and it is up to GP practices and localities to provide career progression to younger GPs.
Dr Doyle also said that moving to at-scale organisations would be essential to retain salaried GPs, and that there needs to be a change in attitude within the profession, especially around at-scale working.
The comments came following a question by Dr Margaret Ikpoh, a Pulse columnist and the RCGP’s vice-chair for professional development, on how to convince GPs to stay in the profession when there are worries around unemployment.
Dr Doyle told delegates that career progression has always been an issue in ‘a sector where we’ve traditionally been loads of small units’.
‘I became a partner in my late 20s and that was it, career progression over. That was as far as you go,’ she said. ‘I have progressed my career by doing something outside of provision and it is really important that when we do think about the new world of primary care, and when we talk about scale, we acknowledge that the new generation of doctors don’t want to become a partner at 29 and stay there for 40 years.
‘But what they do want is to work as GPs. So we’ve got to create a career structure that enables progression and specialism. We can do this much more easily if we think about primary care as a scale provider across a place as much as individual partnerships. We have to recognise that where people do want a salaried role, that role requires career and salary progression.’
She said that it can’t just be NHS England supporting these GPs: ‘I can’t do all that from the central. I can put some of the mechanics in place and incentivise things in the way that we contract, but actually people locally need to recognise it needs to happen.’
In the same session, Dr Doyle made comments around the need for a change of attitude within the profession. She said: ‘If primary care is going to grasp the opportunities that the next few years will give, it will not be about arguing the toss about who pays for phlebotomy or earwax or any of that stuff that I never want to hear about again. It will be about who can organise themselves in a way to develop GPs and clinicians in the sorts of careers that we just talked about.’
To do this will involve GPs being involved in the management of at-scale organisations. She said: ‘Have proper, robust, expert management in getting their innovation right, the technological solutions, having the right financial planning, right governance, right ability to navigate the wider system. Because it’s never been as stacked in favour of primary care and others taking these opportunities.
‘We won’t do it by saying we just need to do what we’ve always done, and it’s too busy, so we can’t do it anymore, and we’re going to switch off our online consultations so that no one can get through to us, so we don’t need to worry about being busy. What’s that all about? We need to organise ourselves, so patients can access us, and can safely meet demand.’
In the same session, she said that the upcoming 10-year plan would be ‘GP-centric’, but GPs can’t expect a huge influx of funding.
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READERS' COMMENTS [6]
Please note, only GPs are permitted to add comments to articles
Big ask on access
Not much money for at scale (presumably PCN Fed ) role ? leading neighbourhood teams
Change or die ?
The government and NHS England clearly want neighbourhoods in place quickly/expectation that these will return tangible system benefits before winter.
No funding identified to support the development of these neighbourhoods but without it expectations are unrealistic
10 year plan I bet will have some investment but hanging on to see if roll out of modern general practice does the heavy lifting first
For PCNs and practices, then, the smart move would be to push for the neighbourhood teams that they think will make the most difference to be put in place, and at the same time be clear both about the additional resources required for these to be effective, and what level of expectation is realistic as to what these teams can achieve.
Last opportunity here for general practice to take the leadership role in implementing changes and integrated working that will actually make a difference, and to secure the resources (once they are announced) to make this happen.
Do nothing and Trusts will take charge so practices and PCNs could be left with insufficient resources and unrealistic expectations for whatever is planned.
The system is already developing a neighbourhood plan might subsume general practice
Fish are very good scale providers…..glub glub glub
Anticrates the Cynic
“She said: ‘If primary care is going to grasp the opportunities that the next few years will give, it will not be about arguing the toss about who pays for phlebotomy or earwax or any of that stuff that I never want to hear about again.”
ah yes . The age old cry of NHS managers wanting work done without funding it. Of course she doesn’t want to hear GPs wanting their work funded
This is part of the problem , not part of the solution
These managers in my opinion, are part of the problem expecting others to create career paths and add further stress, responsibility with no description of allowances in time etc. that they have chosen to leave even if partly, attracted by huge salaries £200,000 or thereabouts of entering NHSE, ICB director roles etc. etc.
Partners already overburdened by responsibility and risk, yet the solution of these perennially failing NHS managers at all levels within NHSE is to burden them further.
Just because a failing NHSE says working at scale is the future , does not mean this is the case and that all should follow again in a sheep like manner. Like previous schemes after scheme, this will be proven to be another false dawn once hundreds of millions have been drained from taxpayer budgets.
NHSE via PCNs have delivered mass GP unemployment, inappropriate staff where doctors were required , increased conflict and staggering wastage of NHS resources with worsening of health inequality.
The only at scale intervention required is at scale removal of underperforming NHS managers.
Considering the world beating ongoing failures of the managers within NHSE , in terms of a collapsing Primary Care Services, vast sums of taxpayer funding being wasted by PCNs, collapsing hospital departments, patients dying in emergency departments while awaiting treatment , waiting lists bursting at the seams why would any sensible person pay any heed to NHSE??
In
NHSE is going isn’t it? so is anyone still listening?