SAS doctors in general practice ‘risk exploitation’, says BMA

Bringing staff and associate specialist (SAS) doctors into general practice could cause doctors to be open exploitation, the BMA has warned.

The BMA GP committee considered a range of possible ways that SAS doctors in primary care could operate and said that they are ‘yet to see evidence that the proposals are feasible’.

UK LMC representatives will vote on whether SAS doctors should be allowed to work in general practice and under what circumstances during their annual conference taking place in London next week.

In a draft position statement ahead of the conference, the GPC said there was ‘a risk of creating a two-tier system with a lower tier of supervised doctors being undervalued and open to exploitation’.

Last month, in a letter to NHS England, GPC England acting chair Dr Kieran Sharrock referenced plans to pilot the use of SAS doctors in primary care, but said the committee ‘vociferously oppose’ this plan unless certain requirements are implemented to make it safe and feasible.

Now the committee said that any decision to develop a scheme for SAS doctors in primary care ‘should only be made with the support of the profession’, and it is ‘imperative’ that the NHS ‘does not rush into a decision that has unproven benefits and risks diminishing the GP role’.

The document said: ‘Due to years of government underfunding and underinvestment we do not believe that general practice currently has the staff, financial or premises resources to accommodate an intake of SAS doctors.

‘Acknowledging that SAS doctors are experienced clinicians, their lack of general practice experience means that a scheme of this kind would create considerable additional supervision responsibilities for GPs, which would be significant at the outset of their transition into the general practice setting.

‘The supervision required to manage the risk for this role would be an additional burden on an already overstretched GP service.’

The document concluded that the BMA is ‘sceptical’ about the validity of developing a scheme which involves SAS doctors working as specialists in a primary care setting, adding: ‘This would effectively be a transfer of secondary care work into primary care and secondary care work is not funded under the global sum. It would be inappropriate for any premises capacity that can be found in primary care to be used in this way.’

It also outlined suggestions for a pilot of such scheme, which should:

• ‘Foster networking between GPs who have switched from a hospital specialty later in life and those contemplating switching from a SAS role.
• ‘Be clear about what success would look like, evaluating for improvements within general practice after 12 months and involving GPC reps in the development of the evaluation.’

Last month, the RCGP said is ‘not in a position’ to support the introduction of SAS doctors to general practice due to ‘unresolved’ concerns around funding and patient safety.