As GP locums struggle to find work, Jaimie Kaffash reflects on whether the recruitment crisis has returned to where it was a decade ago when younger GPs were left unemployed
As you may have seen, after 64 years, Pulse will be printing its final ever issue in January and concentrating our efforts on digital. This has given me a chance for reflection. Having been at Pulse since 2012, one story (other than Covid) has dominated my time – the GP recruitment crisis.
When I first started as a reporter, I remember going to a briefing after a BMA GP Committee meeting back in the days when they did that sort of thing. One of the big themes was how impossible it was for younger GPs to find partnerships, but also struggle to find jobs at all.
That changed pretty much overnight. Soon, we were hearing stories of practices being unable to fill vacancies, and it has stayed that way ever since.
I can reel the stats off the top of my head: in England, promises of 5,000 and 6,000 new GPs by various health secretaries, with the result being a loss of thousands.
So there is something poignant about this issue potentially going full circle. We are hearing more and more reports of locums struggling to find work. And perhaps even salaried jobs not being available.
This is by no means universal. We know some practices are still looking for GPs and struggling. But it does feel as though – at least in some areas – this recruitment crisis has come full circle.
The reason behind this in England, it seems, is that underfunded practices are having to rely on the cheaper options paid for by the additional roles reimbursement scheme (ARRS). At the moment, the focus is on physician associates.
There are ethical issues around this, of course. I reject the idea that PAs are straight out of school, with no training etc – and I absolutely agree that any personal abuse towards them is wrong (though those who do insult personally are few and far between).
But – just like pharmacists, paramedics or first contact physios – they aren’t GPs. They are all great when given task-specific work compatible with their training and capabilities but are a threat to patient safety if filling in the role of GP.
However, them filling in for GPs was the always the logical conclusion of the ARRS. If you fund practices to employ one sort of professional, the chances are that that is what they will employ. Especially when you are effectively reducing their funding during a cost-of-living crisis. This gives the illusion that enough appointments are being offered while also requiring space that stops GPs from being employed.
There is a really easy way out of this, of course: allow practices and primary care networks to use ARRS money to employ locums. This will improve patient safety, which has to be the priority for the NHS and the Government. And putting the trust in GPs to spend this funding on the right roles is a much better approach than the current ‘NHS knows best’ attitude that would have made a 1960s GP blush.