Revalidation – where next for Sessional GPs?

The final report on “Revalidation processes for Sessional GPs – A feasibility study to pilot current proposals” is now available to read here. The study set out to explore the potential problems locum, salaried and remote GPs might have with the proposed supporting information required for appraisal as part of the revalidation process. GPs who experienced the most difficulty tended to be peripatetic locums and out of hours GPs with no permanent practice base.

The findings will come as no surprise to these GPs and will make worrying reading for those tasked with implementing a revalidation process that is fair to all doctors. Concerns raised in the report included:

• lack of support by practices and locum isolation.
• There were significant problems with the key revalidation requirements of Clinical Audit, Significant Event Audits.
• Patient Satisfaction Surveys and Multi-Source Feedback.

Possible solutions suggested included peer groups for reflective discussions, locum Chambers, greater support from Deaneries, LMCs, practices, OOH organisations and PCOs, alternatives to audit and other requirements, mentoring schemes, and locum prescribing numbers.

The RCGP has already gone some way to find alternative evidence that it would be acceptable for Sessional GPs to collate, and Version 4 of the Guide to Revalidation of GPs describes “equivalent portfolios” that GPs in Special Groups can present. However, substantial problems persist, and it remains to be seen how much support for locums will actually materialise. Past experience would suggest that there is a steep uphill path.
The BMA, in its evidence to the GMC consultation, had a number of criticisms of the current proposals, and opposition has come from several other quarters.

According to “Pulse” today, the “Department of Health is planning to substantially scale back revalidation in light of concerns over cost and anger among GP leaders about the level of bureaucracy to be heaped on practices”, and the article suggests areas where cuts may be made. With so many concerns about the cost, process, and fairness of the current proposals, it is surely time for the GMC to go back to the drawing board.

How has the nature, complexity and length of your consultations changed?

Here’s an opportunnity for you to have your say @Pulse-today. The survey only takes a couple of minutes to complete.

John Pike, NASGP blogger

@RCGP reservations about GMC MSF

@Healthcarerep today reports that the RCGP have reservations about the only MSF tool that they have so far approved, that from the GMC. They advise doctors not to use it just now and the article reveals that a tool specifically for sessional doctors is being developed at its test site in Scotland. This is welcome news indeed and may, at least in part, demonstrate that the RCGP are listening to feedback they have received.  You can read more about my reservations about MSF on the NASGP blog.

 John Pike, NASGP blogger

Partners’ profits fall while salaried GPs’ pay rises

From NASGP blogger John Pike

This headline caught my eye in “GP” this week. New figures from the NHS Information Centre reveal that the average income of a GP partner in the UK fell by 1.5% to £106,072 in 2007/8. Meanwhile,  UK salaried GP pay rose by 3.4% to £55,790 over the same period (2006/7 to 2007/8).  So, once again, salaried GP pay on average was still only fractionally more than half the profits of GP partners. Hmmm.

Watch NASGP CEO talk about Sessional GPs and professional unity

NASGP CEO Richard Fieldhouse was interviewed last week by GP Newspaper about how the profession needs to think more about Sessional GPs. Apologies for excessive hand movements and we can report that no journalists were hurt in this interview.

‘GP’ looking for sessional GP bloggers

With increasing numbers of Sessional GP bloggers out there, why not try and turn one of your articles into cash? GP Newspaper and the RCGP are offering 3 GPs up to £150 for an article on life as a GP – anything from 300 to 800 words. And if one of the 3 winning articles relates to life as a salaried  or locum GP, we’ll give the author/s a year’s free NASGP membership worth over £70. If all three winning entries are about Sessional GPs, i’ll do something silly like run a marathon or something.

The salaried/partner divide

NASGP member John Pike puts forward the case for a seperate trade union for Sessional GPs.

Most salaried doctors believe a damaging split has opened up between them and GP partners, a “GP” newspaper survey reveals.

It is clear that the profession is deeply divided and a divided house will fall. There has been much talk in recent years of tackling this most serious issue, but little if anything has changed.

A few weeks ago, a “GP” survey showed that, on average, salaried GP pay was just over 50% that of PMS partners.

Despite tht greater burden of management that Partners must bear, I do not think that can justify such a huge differential and, in addition to the issue of pay, I have seen anecdotal evidence to suggest that some Partners do not always treat their salaried colleagues fairly in other ways (eg contractual).

As has been highlighted on the NASGP blog recently, it is impossible for the BMA to represent both Partners and Sessional GPs when their interests are so different and, indeed, opposing in some aspects. What is needed is a new union, specifically for Sessional GPs, without a conflict of interest issue, and to address matters of pay and contracts without further procrastination.

BMA letting salaried GPs down

Salaried GPs really need to see both sides of the BMA coin. On the one hand, the BMA, through its General Practitioner’s Committee (GPC), has an active Sessional GP Subcommittee; produces an excellent Salaried GP Handbook; has a veritable army of industrial relations officers and has the fair representation of salaried GPs enshrined as part of its core business.

But this wonderful altruism towards salaried GPs lacks one very basic yet fundamental law: an organisation designed to represent employers can not possibly ever do the same for its members’ employees. I’ve yet to come across any other trade union in the democratic world that makes the same claim as the BMA.

The BMA is the doctors union, predominantly representing employed hospital doctors and, through its craft committee the GPC, GPs. These GPs, however, are mostly contractors and not employees – only 17% of GPs are, strictly speaking, employees. 25% are locum GPs and the remaining 60% are PMS/GMS contractors.

It’s a representational mess and the BMA is just tying us in knots. And its salaried GPs who are being strangled.

Here at the NASGP we get email after email from bullied, neglected and abused salaried GPs, often too scared to make a fuss as, not only do they know that ‘making a fuss’ will be followed by them being ostracised for being an employee at another practice, they will be unable to get impartial help from their trade union that also represents even more GPs on the other side of their employment contract.

So the BMA needs to make a choice and let go of its hold on the representation of either its employers or employees. Although it has been looking after PMS/GMS contractors the longest, I actually think it’s this lot, already well organised and empowered, who would be the best group to be jettisoned from the BMA, leaving Sessional GPs under the protection of the BMA, particularly as the BMA already looks after many more employed doctors in secondary care.

If they don’t make up their mind, or whilst they’re trying to decide what to do, Sessional GPs need to consider an alternative to the BMA-GPC-LMC trade union axis and join an independent trade union. I’m not saying that Sessional GPs need to necessarily resign from the BMA – the BMA offers services above and beyond a trade union – but we need to belong to a trade union independent from our employers.

Salaried pay rise a desultory 3% compared to 58% for GP Principals

The National Audit Office has today issued its report on GP pay and, tucked away in the report, is the startling fact that the average pay of a salaried GP is £46,905, having only risen by 3 per cent since the new contract was introduced, compared to 58% (from £72,011 in 2002-03 to £113,614 in 2005-06) for GP Principals. This figure does not, however, represent the average full time salary. The results of a workload survey published in July 2007 by the Information Centre for Health and Social Care indicated that the average salaried GP works 23.8 hours per week. This suggests that a full time salaried GP receives around £74,000 per annum.

For the full report see the NAO website. See also Pulse for information about the Salaried GP survey.

“Making the most of being a salaried GP” – BMA conference

The BMA is organising the conference ‘Making the most of being a salaried GP’ on Monday 23 April 2007 at BMA House, London, aimed at current salaried GPs and all other potential salaried GPs. Topics include effective part-time working, how salaried GPs can increase their chances of success, guidance on how to become and work as a GP with special interests, employment rights including sickness, maternity and redundancy issues, as well as guidance on contractual rights following maternity leave and at the end of FCS and Retainer Scheme funding and lots more.

The cost of attending the conference is £50.00 + VAT for Members or £80.00 + VAT for Non-Members. See the BMA website for more details, email the conference unit at confunit@bma.org.uk or call 020 7383 6605/6137.