Thousands of newly qualified GPs could be unemployed this August due to a ‘nearly non-existent’ job market in some areas, the BMA has warned.
Speaking at the UK LMCs conference last week, chair of the union’s GP registrars committee Dr Malinga Ratwatte warned that of the 4,000 registrars achieving their CCT over the summer, many may struggle to find work.
Pulse understands the areas most affected by GP unemployment are in the Midlands and northern England.
Dr Ratwatte blamed the Additional Roles Reimbursement Scheme (ARRS) which does not allow practices to hire GPs with the funding.
‘A ring-fenced funding pot such as ARRS that cannot be used by practices to hire staff such as GPs is unhelpful, arbitrary and restrictive,’ Dr Ratwatte told Pulse.
He continued: ‘The question to the Government is this: Now that these 4,000 GP registrars are weeks away from being fully trained and ready to work, how will practices afford to hire the GPs that patients so desperately need?’
Pulse has reported on several examples of GPs struggling to find work or redundancies in recent months, and the BMA GP Committee for England has recently noted that general practice has moved from a recruitment to an employment crisis.
Dr Ratwatte added: ‘We potentially have a situation where thousands of GPs will be unemployed come August, with those on temporary visas being forced to leave the UK permanently, should they not be able to secure employment.
‘This is a complete failure of retention strategy and workforce planning and will leave patients with even poorer access to GPs.’
The inclusion of GPs in ARRS had been a ‘red line’ for GPCE in 2024/25 contract negotiations but NHS England declined the request on the basis that GPs are core, rather than additional workforce in practices.
But this has led to increased competition for the fewer salaried GP vacancies that are available, with some recent job adverts receiving over 40 applications.
GP leaders in Lancashire and Cumbria have said the job market is ‘looking really dire’ for the GP registrars who will qualify this summer, with one trainee reportedly ‘trying not to pass because of the fact they won’t then have a job’.
GP practices have also been forced to make GPs redundant due to the changing financial situation.
In Surrey, a practice made three GPs redundant, citing ‘new ways of working’ including virtual appointments and the use of ARRS staff. Pulse later revealed that the GP partners had been unable to take any drawings in the previous year since the practice was ‘running at a loss’ and needed to save £350,000 per year.
Up to 80 members of staff at a Plymouth GP provider could soon lose their jobs following a redundancy process aimed at reducing the number of clinicians who work remotely.
And Pulse reported in March that as many as 150 clinicians working for eMed, the new owner of GP at Hand, could be affected by a large-scale redundancy consultation, said to be affecting ‘mainly GPs’.
Shameful failure of Royal colleges GMC and wider BMA
Shameful failure of HMG / NHSE to deliver a joined up workforce plan.
This was the case in the 1990s. I was going to job interviews with 20-30 others. It did have some benefits in that it encouraged trainees to learn other skills and do other jobs outside of GP trainee land to enhance their CVs. In recent years the CCTs we have interviewed have no minor surgery, IUD/implant, joint injections, DCH, DRCOG etc etc skills.
Perhaps the BMA could “condemn” this and then take “strong” action and survey these newly qualified GPs about how they feel about their situation…
While maybe HMG sets up new nationwide APMS contract/s to employ these GPs, with corporates who can buy and sell and speculate with these contracts in the future….disgraceful..
Dr Jeffries, it’s 2024.
This was always the plan.
Encouraging the greedy “managing partners” to take on pseudo doctors for free (turkeys and Christmas) whilst getting them to shoot themselves and their colleagues in the foot by utterly devaluing medical primary care.
I wouldn’t advise any young doctor to consider GP.
If you have an interest in any hospital speciality try to get a training number or even cser to consultant GP in the UK is dying.
Alternatively, look abroad.
It was always clear that once the ARRS money was spent there would be no major investment in primary care but rather than keep this money for a few years and wait for the newly qualified GPs we all spent it on cheap substitutes.
We could have held on if we had not accepted all the high NNT preventative stuff that has decimated our appointment systems
General Practice has been destroyed. It’s gone and it isn’t coming back. People now have the service they want to pay for via their taxes. Paramedics seeing new patients; a man with an acutely swollen knee with no trauma. PM didn’t examine him. Just gave him some gel and told him to rest, though cycling would be OK.
Male, 67 has had a new pigmented lesion which has been there for some weeks. Someone says he should get it looked at. 2 retired GP friends said they thought it wasn’t a MM but couldn’t be sure. Scores 3/7 on MM scoring system. Man tries to book appointment. The only ones online are telephone ones. Goes to practice and says has an urgent problem that needs F2F appointment as might have a MM. Receptionist says, “That isn’t an urgent appointment” and offers a F2F one in 2w. (So if it is a MM that’s going to be 4 weeks before being seen) Man thinks, “Fcuk that” and arranges his own private dermatology appointment for a week’s time.
Specialists are realising how destroyed GP is now and are often accepting private appointments without GP referral. It must be so common now that people can’t get a timely appointment.
I think it’s wrong to blame the ARRS for this crisis. The problem isn’t that we’ve got funding to pay for ARRS staff, they’re a welcome addition to the workforce.
The problem is that practices have no money because of reducing real terms funding and big increases in costs and workload. That’s why we’re all hiring fewer doctors. The ARRS scheme has failed to adequately address these problems but isn’t the root cause.
DOI: GP Partner and PCN CD
I am a GP Partner, big part of my job is managing the surgery, and growing my team.
not long ago you could not get a GP- salaried or locum- for money or for love, so we had to consider alternatives like investing in development of our nurses, several of whom are now prescribing ANPs, managing multiple issues- chronic illness, womens health, even palliative care. We also employed a PA, who turned out to be very good and very quick learner. We now have a well functioning unit with clearly defined roles and responsibilities and we simply don’t need more Doctors and don’t have any funds to emply more GPs either.
Is it my fault that during the times when no GP could be found, I did something to improve service by developing my non medical employees? And now, like other practices starved of funding, I have to turn away perfectly good GPs enquiring about jobs here. I have two trainees qualifying soon, I worry about their employment prospects very very much. We are going to loose these very good Doctors to better places
Fcuk conservatives!
And labour.
I have to laugh, don’t you?———a G.P. trainee trying to fail rather than pass
This isn’t 1990s, There were no computers, litigations, many dont have mrcgp . In 1990s the cost of living was low conaored to salary. The whole system needs a good shake. Some will pay for 1998 pensioners TILL THEY ARE 70 . These old pension schemes should also be abolished.
Increasingly practices are being taken over by private companies (many of them owned by GPs) who are providing a minimalist and poor quality service to their patients in the cheapest way possible usually using ARRS. They are lining their own pockets at the expense of their patient’s wellbeing and the future of our profession.
john mccormack30 May, 2024 7:42 pm, most practices are owned by partnerships of GPs, to that effect they are private companies. Only few failed practices have been renationalised back into “NHS family” and are owned by NHS trusts. Imagine the quality of service there. (I can because I live near one)
Legally GP principals are contractors to the NHS, but practically they’ve always been fully “employed” by the NHS – best of both worlds. When the recent history of primary care comes to be written, especially since the 2004 contract and the increasing marketisation of the GP service by both Labour and Tory Govts, GPs will look to put all the blame for the failing service on DHSC and NHSE politicians and managers. But truthfully GP principals have been midwifing this privatisation and corporatisation of primary care for both Labour and Tory Govts, pushed by US libertarian free marketeers. But the public will have no sympathy for GP contractors earning £150k-£200k+. The public will only want to know how much GP principals earn given they’re considering IA.
Apparently it was just like this 35 years ago. Physicians assistants, practices forbidden from using their budget to hire GPs and patients totally pissed off because they are unable to see a GP. It was all going in the 1990s. Before mobile phones, the internet, QOF and effective treatment for HIV..the GP job market was just like it is today. All the problems we have are because todays registrars aren’t skilled enough, few of them can do joint injections and minor surgery. This is the reason they cant get a job. This is why we are forced into using PAs instead. Thanks learned colleagues
I know GP colleagues overseas who are in utter disbelief about what has happened to, and the decline of General Practice in the U.K. A total scandal, and the scary thing is the public are still largely unaware, and national press seemingly more interested in narcissistic politicians
Until PCNs are dismantled and cast into history becoming part of the darkest era of General Practice with their unnecessary CDs and managers , the situation & prospects for the next generation of doctors and locums will not improve
To the advocates of medicine on the cheap via ARRS :
Numerous examples of poor practice eg Patient with obvious stress fracture seen by nurse practitioner and told ‘tendonitis’ and that MRI is no good at diagnosing stress fractures! Patient with ear wax told by Pharmacist to hop on one leg to dislodge it!
I could go on but it’s too depressing.
General Practice has faced crises in previous decades, but the current problems look and feel existential. ARRS and the wider use of non-doctors may be part of the problem. But until the chronic underfunding of NHS General Practice is addressed it does appear to be facing terminal decline.
This string demonstrates the extent to which General Practice has become fragmented, and divided. Unless the profession and the GPC presents a united front, nothing will change.
The cause of the problem lies now uncomfortably but squarely with those PCNs, PCN CDs and Board GPs financially manipulating the current chaos for their own personal gain pushing the continuation of these PCN groups..
It is not the ARRs who have rightly availed themselves of the current opportunities and situation and where practices pay variably £40 to £70,000 plus pension to ARR staff who add some value but in other cases are taking 20 to 30mins to do a simple review which would could in a large number of cases be done in a standard GP 10min appt as an addition to another main presenting problems, hence in cost terms per patient contact costing the NHS £100,000 to £250,000 compared to GPs.
As a partner, I have escaped the disastrous effects wreaked by PCN groups with their overall worsening of NHS standards in quality of care and the further resultant negative impact on particularly their younger colleagues careers.
However , in each area their will be handfuls of the same GPs and GP names we have seen for decades on ICB boards, PCN CDs and occasionally on LMC boards gathering information but often doing little for the GP collective and using information gathered on these boards and this via PCN fiasco for substantial personal benefit.
The government cannot succeed without being aided by these GP groups.
I totally
@ Michael Johnson,
It is not greed of partners but the greed of the young GP to earn more than partner and do locum with no responsibility. Most of the locums are like DIY and I have noted that they increase the work of rest of the team by ” to have BT and see GP ” plan. Hence many practices are looking for the alternatives like PA, ARR and ANP, Paramedics to help them. The locums demands are very strange like no home visit / no admin etc. They think surgeries are there to pay for their Ltd company locum rates to enjoy life.
@Some Bloke30 May, 2024 6:22 pm,
You are Spot on. The current situation is brought upon by young GPs. Apart from a year as Salaried and broken promise of view to partnership. I had been a partner and enjoyed being partner.