Practices told not to ‘waste money’ on ‘expensive’ GP locums

Exclusive A number of recruitment agencies are telling practices not to ‘waste money’ on GP locums as physician associates ‘can work like a GP’.

GPs have told Pulse there are concerns around ‘misleading’ wording used by some agencies that seem to be pushing for ARRS staff to replace GP locums.

It comes after reports of GP locums being asked to consider reductions in their expected hourly rate amid a reduction in available roles.

General Practice Solutions, a company that offers recruitment services for practices, PCNs and ICBs, included wording on its website which pointed to ARRS staff as ‘a cost-effective alternative to expensive GP locums’.

The wording, now deleted, said: ‘Don’t waste finance on expensive GP locums. Our provision of multidisciplinary professionals provides a cost-effective alternative to expensive GP locums.

‘At present, the PCN DES does not permit the use of funds to be spent on GP locums so why not get in touch, and we will advise you on the best model of care suited to your organisation whilst optimising the use of your allocated PCN DES funding rather than your profit margin.’

The company told Pulse that its clients had ‘expressed frustration’ because GP income has fallen for the 14th consecutive year, ‘due to increased costs and centrally mandated salary increases’.

Head of communications Janet Smart said: ‘Alike all businesses, we responded to gap in the market and established a national bank of ARRS staff who are deployed to primary care organisations in line with their specific requirements thus enabling them to fully utilise the “use it or lose it” funding.

‘We made the decision to remove a statement from our website and we apologise for any offence this may have caused.

‘We are supportive of multidisciplinary teams and the GP model with its own bank of locum GPs. We also work tirelessly to ensure salaried GP and ARRS positions are tenanted.’

GPs also told Pulse that they received emails from a GP locum agency claiming that ‘physician associates can work like a GP and an ANP’.

Huddersfield GP Dr Lucy Douglas said the email was ‘misleading as PAs currently require supervision’.

She said: ‘They are unregulated and don’t prescribe. Their training and qualifications are vastly inferior to that of a GP or an ANP.’

Similarly, a locum agency for PAs has claimed that a surgery was able to ‘save 40% on their locum costs and increase their number of appointments by 20%’ employing PAs instead of GP locums.

In a case study on its website, Locum PA ltd said: ‘Berrymead Surgery had struggled to recruit a salaried GP for a long time and were using locum GPs to cover 10 sessions per week.

‘They were looking to reduce expenses but still maintain an excellent and safe quality of service for patients.

‘We approached the surgery and offered some taster sessions to show them how experienced physician associates work in primary care.

‘We were able to save them 40% on their locum costs and increase their number of appointments by 20%.’

This wording was subsequently changed on the agency’s website.

A spokesperson for Locum PA told Pulse: ‘At no point has Locum PA ever iterated that physician associates are replacements for doctors, and we always stipulate that there must always be an experienced doctor supervising any physician associate we place.

‘We work to the standards set by the Faculty of Physician Associates. When used effectively with doctor supervision, physician associates are an effective member of any multidisciplinary team.’

Recruitment experts have told Pulse that there has been a rise in requests from surgeries to employ ARRS staff as they ‘can’t afford’ to employ GP locums due to lack of funding.

It comes after BMA GP committee chair for England Dr Katie Bramall-Stainer said that general practice has suddenly gone from a recruitment to an employment crisis, driven by the Government’s squeeze of practice finances.

Ash Higgs, managing director of MCG Healthcare Recruitment, told Pulse his company is supplying more ARRS roles because ‘that is what the surgeries are asking us for’.

He said: ‘There is definitely a shift towards ARRS roles but I would not say that it’s driven by agencies – it’s an agency’s response to what the market is asking for.

‘We are helping supply more ARRS roles because that’s what the surgeries are asking us for. They are not asking us for as many GP locum roles at the moment – we are doing lots of GP permanent roles but as for temporary and locum contracts they have certainly slowed down.

‘We have had an example of a practice using an ANP to cover for a GP’s maternity leave – so that is happening.

‘The key issue here is funding – practices and out of hours providers are utilising the ARRS scheme and we are seeing less requirement for GPs.  

‘The market is completely different from what it was even six months ago, we were doing more GP bookings than anything else and now we are doing more ARRS-funded roles – but we would never say to practices not to use GPs ever.

‘But practices are asking for those ARRS roles because of funding and they can’t afford to put a GP in place.’

Recently a Pulse survey of 612 GP partners revealed that there has been a 44% reduction in the number of GP vacancies advertised since the same month in 2022 and GP leaders attributed this reduction in vacancies to a number of factors, including an increase in the ARRS success in hiring staff and a lack of resources.

Earlier this year, a practice in Surrey said it is making three GPs redundant due to ‘new ways of working’, including the use of ARRS staff, and virtual rather than physical consultations.