We have only been able to recruit female GPs at our practice. We have been criticised for this by the CQC, and have also received complaints from patients. What can we do?
Locum GP: Consider a long-term locum or ‘buddying’
Although it’s tempting to argue that female GPs now outnumber their male counterparts,1 I would try to take the criticism from the CQC and the patients on board. The CQC judges a practice on the five key areas of safety, effectiveness, caring attitude, responsiveness and good leadership, so inspectors could argue the practice is not responsive to the needs of patients who would like to see a male doctor.
At the next practice meeting, include the criticism as a major item on the agenda. Ask the practice manager to employ male GP locums whenever possible; if you have the funds, you might also try to employ one long term. Someone might know a retired male GP who could be enticed into doing a few sessions a week of clinical work without the burden of admin.
Another option might be to buddy up with a neighbouring practice that has a good number of male GPs. The buddy practice might be prepared to ‘swap’ a male GP for one of your females or GPs with special interests for a few sessions a week.
The practice could also consider becoming a training practice. This is a worthwhile long-term investment and at some point you are bound to attract a male registrar, who may consider working at your practice after qualifying or at least promote your practice to his male peers.
Share these plans with the CQC and your patients to show you are addressing their concerns.
Also, tell patients about other local practices that do have male GPs in case they wish to register elsewhere. After all, practice choice is ultimately patient choice.
Dr Mabel Aghadiuno is a locum GP in south London
GP partner: Stay firm and get your patients on side
The CQC could justify criticism under the question of whether your service is responsive. You should demonstrate to inspectors that your recruitment process is appropriate. Give them a copy of adverts, person specification, applicants received, process for shortlisting and how the final decisions were made.
You should feel reassured by your ability to recruit GPs during the workforce crisis, which suggests that you are performing well as a practice. You could refer the CQC to its own conclusion about workload and workforce pressures causing the unprecedented challenges that general practice is facing. The CQC recognises that workload has increased significantly in recent years, which has not been matched by an increase in either funding or workforce.1 In addition, the number of female GPs has outstripped male GPs since 20142 and currently 54% of all GPs registered with the GMC are female, as are 63% of those who qualified since 2010.
It is vital to get your patient participation group on side. Ask them to survey patients’ views but ensure this includes asking whether patients would prefer the practice to wait until they can appoint a male GP, even if this means a shortage of appointments and worse access. Examine your Friends and Family Test and other feedback to see whether these are supportive of the practice in general.
Dr Grant Ingrams is a GP partner in Leicester
Legal view: Use positive action carefully
This scenario presents a challenge – to follow a fair recruitment process without falling foul of discrimination laws. The starting point is to think about the genuine practice need – here the CQC and patients are requesting more male GPs. This under-representation of male GPs could be addressed through positive action.
Sex is a protected characteristic under The Equality Act 2010 (the Act).3 Favouring one sex above the other in recruitment is discriminatory and is generally prohibited in law. However, the Act allows lawful ‘positive action’ where persons who share a protected characteristic have particular needs, suffer a disadvantage or are disproportionately under-represented. If one or more of these conditions is present, the practice can address the issue without being exposed to claims of discrimination, such as by placing job adverts in publications predominantly read by men.
The Act goes one step further and provides that, in a situation where an employer is faced with choosing between a male and female candidate of equal merit, a practice can take into consideration whether one candidate is from a disproportionately under-represented group in the workforce. Therefore in this scenario, in a tie-break situation the practice may be entitled to select the male candidate. However, anyone involved in recruitment will know a genuine tie-break situation is rare and so this may be difficult to apply in practice.
If the business need is for a candidate with a particular interest in men’s health issues because of patient demand, this could be expressed as ‘desirable’ in the job specification. This would not, of course, preclude female applicants.
Be warned, a blanket policy treating persons of a disadvantaged group more favourably than others regardless of merit is not allowed. Positive action should not continue indefinitely – particularly if the action has remedied the situation. Advice from a solicitor is recommended.
Jade Linton is a senior partner at Thursfields Solicitors
2. Female GPs outnumber male GPs in England for the first time. Pulse March 2014
3. UK Government. The Equality Act 2010; 15: Part 2, Chapter 1