SAS doctors ‘will not replace’ GPs in primary care, says NHS England

Exclusive Plans to allow specialty and associate staff (SAS) doctors to work in general practice are not about replacing GPs, NHS England’s national director of primary care has said.

Instead, SAS doctors could work in primary care networks (PCNs) as part of a multi-disciplinary team just like nurses and pharmacists, Dr Amanda Doyle told Pulse.

The NHS and Government have committed to allowing SAS doctors to work in general practice, but have not yet given a timetable as to when this will happen.

In an exclusive interview with Pulse, Dr Doyle said: ‘This is not about specialty doctors coming in to replace GPs. This is about future-proofing the regulations, so that doctors who have a degree of expertise in a specialist area can legally be employed in primary care as part of a multidisciplinary team.

‘We are not saying that we think we can make up for the shortage of GPs by employing SAS doctors. It is not about having SAS substituting for GPs.

‘It would only be where primary care teams want to employ those sorts of doctors in the same way that we’re all happy to employ nurse practitioners, pharmacists, paramedics, physios, dietitians.’

She highlighted that SAS doctors have particular ‘skills to offer’.

‘So if you’re trying to scale up a network-level frailty service, for example, it might be really great to be able to employ a specialist doctor in geriatrics to be part of that frailty multidisciplinary team across your network,’ she said.

The NHS workforce strategy confirmed Government plans for doctors to join the primary care workforce.

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. 

But the BMA recently claimed the plans have been delayed following ‘significant opposition’ from the doctors’ union and other stakeholders.

Dr Doyle told Pulse: ‘Actually, because there’s been quite a lot of feedback and a lot of questions raised about this, the Government hasn’t put this through with the current regulatory change.

‘We’re giving time for people to feed back further so that we can understand people’s concerns on this.’

The BMA’s GP Committee England has warned that the proposal could cause SAS doctors to be open to exploitation under a ‘two-tier system’ and LMC leaders have also opposed any changes to the Performers’ List which enable non-CCT holders to work in general practice.

Earlier this month, the Department of Health and Social Care told Pulse it is still ‘committed’ to plans ‘to facilitate ways in which doctors, other than GPs, can work as part of multidisciplinary teams to help increase practice capacity’.

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.