The 10 Year Health Plan was published in the summer with great fanfare, but now that the dust has settled, what impact (if any) of this ambitious plan can we expect to see on the sessional GP workforce? Could it signal the start of an improvement in the underemployment crisis?
The plan commits to invest more money as a proportion of health spend in the community and increase the proportion of staff trained for community and primary care roles, in order to support a term known as ‘left shift’, which is the movement of services out of the hospital and into communities.
In order to support this, the government plans to launch new ‘neighbourhood health centres’, which will see the co-location of GP practices, diagnostics, rehab, mental health and acute care services delivered by professionals across the whole multi-disciplinary team. It is expected that these will be open for twelve hours a day, six days a week.
‘Prevention’ gets a big plug in the 10 Year Health Plan, and weight loss medications feature heavily in this section, so one could reasonably assume that these neighbourhood hubs may well take on a role in the prescribing and monitoring of these, which of course would require clinical oversight, likely from a GPwSI, who could be sessional. Thirty are planned to open by 2030, in communities where healthy life expectancy is the lowest.
These will of course need to be staffed, or at least supervised, by GPs, and possibly GPs with additional specialist skills. It’s therefore reasonable to anticipate that with a growing workload from this ‘left shift’, more sessional (whether salaried or locum) GPs are going to be required.
The health secretary has promised to ‘end the 8am scramble’ by training thousands more GPs (no specific detail on that) and offering same-day GP appointments to patients in need. Part of this played out in the new GP contract requirement that came in from 1 October which I have analysed from the point of view of a sessional GP here.
However, the NHS Medium Term Planning Framework suggests the introduction of a new target for 90% of urgent cases presenting to General Practice to be seen on the same day. This could be tackled by the proposed acute care hubs in neighbourhood health centres, but these are a long way off from being established, so I predict that practices will have to shoulder this burden themselves if it becomes a requirement any time soon. This will ultimately mean further workload pressures and demand for appointments, so practices may recruit salaried GPs or engage more locums to help them with this demand.
Overall therefore, the implementation of this plan is going to require more salaried and locum GPs either at a practice level or at a hub level, both for traditional acute work, or more specialist services, including those with a public health prevention focus. I wonder whether ICBs and neighbourhood teams even know what skills and expertise lie out there in their sessional GP workforce that they could tap in to? This could be one role for NASGP in the future – connecting to the workforce and advertising the specialist skills and experience that a lot of sessional GPs bring to the table these days.
Read more sessional GP perspectives on the launch of the 10 Year Health Plan.
Dr Clare Sieber is the National Association of Sessional GPs’s sessional GP workforce advocate.
