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Any good motorist knows that safe motoring begins with basic maintenance. And it gets no more basic than checking the oil. It is a simple message that was beautifully encapsulated decades ago by the ad campaign that declared: ‘The Esso man means happy motoring.’
In general practice, the lubricant that keeps the machine running is the sessional workforce. That nebulous group of peripatetic specialists who move around the system filling critical gaps, sealing workforce leaks and generally protecting hotspots from meltdown. This is a group of highly experienced and dedicated doctors who feel unappreciated by NHSE (NHS England) and are generally unhappy about recent public criticism of their motives by senior health management figures.
Against this background, the BMA sessional GPs subcommittee ran a survey of salaried and locum doctors and the findings should force a revision of these negative stereotypes. Over 2,000 responses were received – 15 per cent of all sessional doctors.
Any workforce is strengthened by diversity and that is doubly the case for our locum pool, who end up working in the most heterogenous settings faced by our wider profession. Diverse doctors for diverse environments.
Our survey shows that our sessional workforce is drawn from all backgrounds and ages, with a significant trend for former partners – who might otherwise leave medicine – remaining within the workforce. A staggering 40 per cent of sessional doctors previously worked as partners, while one in five have already begun to draw their pension. The message is clear – GPs who would otherwise leave our collapsing workforce are continuing to deliver care within sessional arrangements.
The average age of a sessional GP is 46, with the average female being 44, and male 49. The age profile shows balance across the range of a career, but there is a clear message from ex-partners. A whopping two thirds of sessional GPs who were formerly partners reported that they have reduced their work burden with the same proportion, describing their new working pattern as preferable.
The kick is in the intentions of this cohort if the NHS continues its anti-locum rhetoric. Seventy per cent of locums say they will leave the NHS if a statutory cap was to be placed on locum work. One in five say they would retire completely. As that number have already been drawing their pensions it is hardly a hollow threat, but a statement of the obvious that would devastate whole geographies of NHS general practice.
There are many messages to be gleaned from a detailed review of the survey responses, but a clear one is that we must nurture our sessional workforce. We are proud members of the truly great profession of general practice. Many of us will move through different contractual stages at different times in our career, and we must all remember that we are GPs first and partners, salaried or locums last. We must celebrate the vital work done by our locum and salaried doctors and I call upon NHSE to acknowledge this vital lubricant.
The Esso man understood that happy motoring began with the right oil. It is time for NHSE, the Department of Health and the very centre of Government to learn from him. Read more about the detailed analysis of the results of the survey.
Mark Sanford-Wood is a BMA GPC England executive team member
This is fascinating reading and as an ex-principal and portfolio GP for 5 years now, the survey itself is an encouraging step forward. I have just been elected to RCGP Council with a view to better professional development, standards and accreditation for such GPs, particularly those who take their GP skills into alternative environments. I believe that RCGP needs to reduce the burden of the appraisal process and move-away from the annual ‘tax-return’ approach that has grown in recent years. This may be naïve but nothing ventured? Rob Hampton - Portfolio GP and Occupational Physician,
GPSI in Offender Health and Substance Misuse, GPSI in Musculoskeletal Pain Management
Yes I agree with one point Rob made about annual appraisal.
It has metamorphosed from a cosy educational annual review , to an IT enhanced exercise in bureaucratic overkill and is frankly out of control having taken on a life of its own. Most doctors including myself support appraisal. As currently construed it is sinking under its own weight and needs trimming down as a matter of priority. It has been made over--complicated and is hugely time consuming with very little return except perhaps inducing some of our colleagues to take early retirement. ! .. .. that time would be better spent seeing patients. The GPC needs to act now on behalf of all its members.
JUst a small correction - it was the Esso SIgn that meant happy motoring, so maybe this should be the BMA Sessional GP Sub Committee that means happy doctors?
How do we get engagement from doctors? It is an impressive response, 2000 busy GPs took the time and trouble to feedback the questionnaire but that was only 15% of the total number of sessional doctors represented by the subcommittee and so is not representative of the total. It would be interesting to look at the demographics of the non-responder and see if they differ - we may be chasing the wrong goals for the wider group?
As for appraisal - it was never a cozy chat - always challenging with plenty of reflection and soul searching. It did give you the opportunity to benchmark, hence I became an appraiser. Appraisal is formative and normative, when done well - but it is now becoming an information gathering regimented process for revalidation and the responsible officer and therefore is more scary to many. Appraisers also seem to have lost the way somewhat and asking what can be allowed/disallowed in appraisal. It is beoming an impersonal templated process to make it easier to score the individual - how long until ranking systems are introduced? Lets focus on the hard-pressed individual doctors and see what we can do to support them in the workplace instead - it might be more creative.
Keep up the good work though!
Factually incorrect. Esso sign not Esso man meant happy motoring. How lubricated can our engine be if the oily rag of GPC can't get it right.
yes its the Esso sign not man means happy motoring but perhaps advert more a reflection of the laughable lack of diversity on the GPC Committee