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Part-time working offers general practice a glimmer of hope



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I often get asked by other trade journalists what it’s like working with GPs and I always say it’s great. GPs are among the most outspoken, passionate, dynamic and innovative people I have met.

These qualities should be perfectly suited to the general practice model. Implemented correctly, the model encourages innovative thinkers while allowing the freedom to speak out as advocates for patients when things go wrong (ideal for us journalists).

The problem is that in recent years, far too much has gone wrong, so GPs’ other qualities are often stifled. It’s almost impossible to innovate when you’re working 14-hour days and battling burnout.

It’s for this reason – among others – that many GPs are deciding to work part time in general practice, as our cover feature this month shows. In reality, these GPs are not traditional part-time workers – the current demands of general practice mean they can end up working just as much as full-time staff in other professions, and they often have other healthcare roles outside of general practice.

Recruitment messages are highlighting the flexibility of general practice

But what they are trying to do is bring a semblance of control back into their lives.

There are two obvious problems with this part-time revolution. The first is that continuity of care inevitably suffers. It is basic logic that patients are less likely to see the same GP if that GP is there less often. But this is not insurmountable.

As Dr Zoe Norris explains eloquently this month, it may simply be a case of adapting continuity of care: writing more comprehensive clinical notes and clear plans, only providing guaranteed continuity to those with certain conditions, and so on. Patients may have to adapt as well, but something has to give.

The other problem with the move to part-time working is far more obvious and far trickier – it increases pressure on those who still work full time. To this, there is no easy answer. In the short term, there is a faint silver lining for full-timers under the cosh – a part-time colleague is better than one who is burnt out and on long-term sick leave. As the case studies in our cover feature show, this is the stark choice many GPs face.

In the long term, though, I believe the move towards part-time working could be the saviour of general practice. Because those outspoken, passionate, dynamic and innovative medical graduates will be the ones who most drawn to portfolio work, flexible hours and the ability to shape their own careers.

As regular readers will know, I rarely praise NHS England and Health Education England’s recruitment efforts, but I think they’re finally getting the message about attracting the next generation of GPs. Gone is selling dreams about GPs signing off patients to go skydiving (if you don’t remember this, go to pulsetoday.co.uk/skydiving for a guaranteed laugh). Instead, we have messages about the flexibility and innovation inherent in general practice, so it’s no surprise that last month saw a record influx of graduates. At this rate the sheer numbers of new GPs could well offset their part-time hours.

This is in no way diminishing the problems faced by GPs in the current climate. But it may just be that the kids are alright.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk