Women doctors could bring the NHS to its knees. So says Dr. Max Pemberton in his Saturday column in the Daily Mail (29/8/15). He adds that is a crisis caused by having too many women doctors. Services across the NHS face closure because women have gone on Maternity Leave or now work Part Time. Two thirds of GP’s are now women.
When I carried out a survey of GP Manpower earlier in the year I carefully avoided making the comment that there were too many women GPs. In fact, I simply took the view that there were too many GPs of all ages both male and female working part time and that was why in my view there was a crisis in GP Manpower. NHS England need to take control again of the allocation of contracts and monitor carefully working hours. Part time GPs need to be encouraged to Job Share and any GPs working less than 4 days need special approval in warranted circumstances.
Here again are my findings.
GP Manpower Survey 2015
During May and June 2015 information was collected about the sessional commitment to the NHS of 312 family doctors who look after around 458,839 patients and work at total of 1,956 sessions.
The average number of days worked by GP’s is 3 and the average number of sessions worked is 6.
Many thanks to the 58 Practice Managers who responded to the Survey which asked questions about days and sessions worked and factors that might reduce face to face sessions such as being a trainer or attending CCG meetings.
The survey also looked at the quality of the services offered to patients. Could patients be seen on the same day or be offered a telephone consultation?
The ‘new’ Working Week
Since the mid 1990’s the trend to work a four day week has grown. In 1995 some 87% of GPs worked full time i.e. 9 sessions over 5 days. Now around 55% of GPs work a 4 day week, arguably the new full time of 7, 8, or 10 sessions. Only 26% of GPs are salaried and in the main work no more than 3 days and 5 sessions.
Consequently many practices report difficulties recruiting additional or replacement GPs with doctors increasing their work commitment to cope with demand. Whilst some 26% of GPs have reduced their sessional commitment since 2004 whilst 13% have increased their commitment. The question for practices is what to advertise – how many sessions and how many days are needed.
Simple Sessional Tool
Based on an average personal list size of 1,800 patients an 8 session GP would be responsible for 225 patients. Dividing a practice list size by 225 would give a guide to the number of face to face sessions required in a practice.
Techniques to Handle Demand
Practices are trying various methods to deal ‘demand’ and workload.
- 93% offer telephone consultations
- 40% employ a nurse practitioner for about 8 hours per GP
- 51% employ trainee GPs
- 84% offer a same day appointment
- 52% are able to offer the doctor of choice
- 74% work extended hours
- 21% work on Saturdays
- 3% work on Sundays
Practices are planning for the future as more GPs retire early and the balance of female to male doctors in general practice changes. Workload demands cause GPs to look for a shorter working week and do not want to own a practice. Here are some pointers to consider when looking for help:
- Networking – meetings, VTS scheme, CCG contacts
- Practice List Size – Manage boundary and outliers
- Shared Advertising and Recruitment with other practices, CCG, Alliances and Federations
- Partnership Structure – retain balance between partners and salaried GPs
- Part-Time Doctors – Manage requests for ‘part-time’ working
- Job Sharing – Use ‘job sharing’ to ensure posts are covered
- Partnership Workload Agreements – Ensure that new GPs share workload – embody in contract or partnership agreement
- Curriculum Vitae – Keep Library of CVs
- Premises Management – Close branch surgery and centralize services
- Recruitment and Locum Agencies – Use Recruitment Agencies
But Practices are also using other ‘techniques’ to manage services such as Extended Hours, Nurse Practitioners, Telephone Consultations and Triage.
Many thanks to all those who contributed to the Survey – a full copy of report can be obtained from firstname.lastname@example.org.
September 2015 (Revised)