Search the website

Returning to general practice

A joint GPC/RCGP policy statement
January 2007

The Royal College of General Practitioners (RCGP) and the BMA’s General Practitioners Committee (GPC) jointly state that the current lack of support for returning to work as a general practitioner is iniquitous and indefensible.

Many GPs are prevented from returning to work following a career break because of the current lack of funding to support their refresher training. This is disadvantageous to the doctors concerned as well as to patients and the wider NHS. It is financially nonsensical as supervised refresher training is cost-effective, particularly vis-a-vis the high level of funding already invested in the training of a new doctor (namely, the cost of medical school, junior doctor/foundation training and specialty training for general practice). This previous investment is being wasted if those already qualified are prevented from returning. The RCGP and GPC therefore call upon the government to take urgent steps to rectify the situation.

There are many reasons why GPs take a career break. The most common reasons are for family and caring commitments, or due to illness or disability. Others doctors choose to work overseas for a period of time, often on charitable projects. On choosing to return to NHS general practice, a GP must be on a primary care trust's (PCT’s) performers’ list in the country in which they wish to practise. Many PCTs in England require doctors who have been out of general medical practice for two years or more to undergo a period of refresher training/supervised work before being fully included on the performers’ list and so to be able to work as an independent GP.

Until early 2006, a centrally funded GP returners’ scheme was in place, whereby local postgraduate deaneries arranged for an educational programme of support and supervision that facilitated a doctor’s return to general practice work. This well-regarded scheme provided funding to the GP training practice and a salary to the GP returner. It was an excellent mechanism for encouraging qualified GPs back to work following a career break, and also represented very good value for money to the NHS. Regrettably, the Department of Health has withdrawn central funding for this important scheme.

While some local GP deaneries have been able to provide limited funding for refresher training, this is often without funding for the GP returner’s salary. The employing practice is therefore required to fund the salary, since recent expert legal advice received is that, under the Minimum Wage Regulations, GP returners cannot work for free even on a voluntary basis. The knock-on effect is that, due to the lack of funding, training practices will understandably not wish to be involved in such a scheme if they have to meet the burden of paying the returner’s salary. This means that those who wish to return are now unlikely to be able to find practices willing to take them on during their refresher training.

The BMA’s GPC has made numerous representations about the withdrawal of the central funding for the GP returners’ scheme to the Health Department, including a meeting with the then Health Minister, Lord Warner. The BMA has also published and publicised a dossier of GPs who have been prevented from returning due to lack of funding, as well as producing guidance for potential returners. The BMA’s GPC has also sought legal advice which indicates that the lack of financial support for the returners’ scheme, the fact that there is currently no other way for a doctor who has been out of practise for a period of time to return to work, and that the majority of potential GP returners are female has Sex Discrimination Act implications. As a result, the GPC is currently pursuing this with the Department of Health.

The GPC and RCGP hope that this joint statement sets out further the current problems and disadvantages which the lack of a properly funded GP returners’ scheme has on doctors, their patients and the wider NHS. For the sake of the NHS, the RCGP and GPC appeal for the funding for the GP returners’ scheme to be resurrected.