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A new GP contract has been negotiated in Scotland, which if approved by GPs, will have a significant impact on what general practice looks like north of the border. The effect on salaried and locum doctors, and those with portfolio roles has yet to be seen. There is a commitment to retaining and updating the model salaried contract, but also a clear aim to improve the workload for GP practices, provide stability of income for partners and reduce the risk of owning property. There is more information on the changes being proposed in Sandesh’s blog. We are all watching Scotland with interest, as the proposed solution is quite different to what is being suggested in England, Wales and Northern Ireland. The difference between all four nations is becoming more pronounced, and moving at a rapid pace. I have sought assurances from Alan McDevitt, Chair of the Scottish GPC, that sessional doctors are considered in this plan, and there will remain a role for them.
While there are so many changes happening across the UK, we do need those of you out there, working in and experiencing some of these changes to keep in touch. Please let us know what’s happening in your area, good and bad. We are especially interested in whether you are involved in, or have any knowledge of changes happening with STPs in your area. The voice of sessional GPs is often not being heard; in some areas LMCs are not being given any voice on STP plans. Designing the future of general practice without hearing from the workforce of the future is a grave mistake, and we continue to stress that in all parts of the UK, leaving general practice completely remains a very real option for many sessional doctors. Until that is recognised and taken seriously, the real sense of urgency to address workload and funding continues to be lacking.
Zoe Norris is the sessional GPs subcommittee chair
I am a locum GP workin gin East Sussex in OOH and WIC. The workload here is terrible and put at risk the profession. I agree with the colleague Dr Norris that locums are completely unheard.
To be honest the way things are I don’t think there is a future for general practice - at least not one with Drs in it anyhow. The only sustainable way to be a GP these days is for the bulk of your work to be involved in something that doesn’t involve actually seeing patients - i.e not being forced to see 20 patients in 10 minute slots and paying enormous insurance danger money for the ‘privilege’. Unless there is real radical change very soon there won’t be a Primary care service provided by Drs in the UK within the next 5-6 years
As a GP in Scotland, I can tell you that not all of us share Sandesh's rose-tinted view that GP's will do the interesting and intellectual work while squads of AHPs do the donkey work of minor illness etc.
In my opinion there are two problems with this:
It's not clear where this army of AHPs will come from....
We are surely aware of the patients who bring their 'minor' problem as wrapping for the major one or who use how we deal with the small stuff to build a relationship (I think it's called continuity of care...) The potential fragmentation of care is scary.
I read your blog with a saddened heart because if only the voices of sessional GPs were heard, I believe the world of general practice could be incredible.
I am a GP in Scotland. I am a very passionate, committed, hard working and ambitious GP. Sadly, I am painfully learning that this doesn’t mean much in Scotland because I’m now a locum.
I recently left my partnership of four years to pursue my dream of a portfolio career. I love being a GP and have interests that will enhance both my clinical practice and personal development which my partnership simply couldn’t facilitate.
Having been on the LMC for 3 years I developed a strong interest in medical politics and have thoroughly enjoyed being part of the developments of the new GP contract. One aspiration of leaving partnership status was to continue down this avenue, step up to represent and provide voice to my peers moving forward. Sadly, I found the reality to be very different. A a locum GP, there was no place for me.
Sessional GPs are the reason why practices haven’t collapsed as yet. They sustain the practices without whom the practices would fail to deliver adequate patient access to healthcare. They do the job they are trained to do ie. be GPs whilst supporting their partner peers to have much deserved annual leave or time off. Without sessional GPs, practices with partners off on long term sick or on maternity leave would crumble with direct negative impact on patient care. In an era where patient needs and demands are rising, it is the rise of sessional GPs that is that is helping patch up the cracks. If everyone was a partner and the same issues were to present, we would need to borrow partners to help cover. We would be in more of a pickle than we are today!
The recent GP contract, a highly aspirational and positive contract for GP principals in Scotland. Ive been left confused to not hear much about the role of sessionals moving forward. In fact, we don’t feature in the new contract. It assumes we want to be partners when many of us have actively chosen not to be. How is the new GP contract going to help reduce the business risk to portfolio GPs? How is the the new GP contract going to support and provide resources to sessional GPs in the same manner as those in partnership? Some Scottish LMC constitutions don’t even have a proportional representation of what is the largest workforce of GPs. In fact in some areas of Scotland, some committees have as few as 1-2 seats on their constitution to represent the voice of sessional GPs yet we pick up the slack where practices struggle.
The new contract is flawed for it does not take into account the modern world of medicine with recognition of portfolio GP as a popular career choice. Many from entry level have a portfolio career mapped out. They want to be GPs, they just don’t want to be partners. No amount of resource investment is going to change this so why not include us in the discussions and negotiations? Why not give us equal merit and seats for representation?
I wish it could be recognised that sessional GPs are no less expert generalists than their partner peers. They perhaps may even have more expert skills that when invited to join in can help provide a more dynamic and rounded representation of modern day general practice. Dr Krishan
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We are concerned that a standardised exam would overburden students in their final year.
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If you are the owner of an online website that sells a particular product or service, you may want to consider promoting or showcasing that product or service. You can easily do this by showing samples of your work.
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