GP Recruitment Crisis; it’s a common problem
If you hang around with GP partners or practice managers for any time at all you’ll soon find the conversation turning to a common theme, recruitment, or lack of it. Everyone in primary care knows a surgery that are struggling to recruit or retain clinical staff.
Why is this?
Well, the answer you’ll get from most people will be the lack of GPs, but is this correct? Most of the areas where people struggle to find a permanent member of staff don’t have anywhere near as much trouble staffing their clinics with locum staff, so there are GPs in that area.
The problem isn’t likely to be solely due to the lack of available qualified GPs in the local area, but more likely to be the lack of GPs in the area who want to accept any of the current vacancies. More specifically, there is a lack of GPs who want to move from locum work into a permanent post.
Why don’t locums want to be salaried GPs or partners?
If you look at the direct comparison between the common working pattern of a locum vs a salaried GP it’s obvious what the differences are. Firstly, and most importantly, locums have total control over their workload. They set the terms of work. If they don’t like visits, they don’t have to do them, they can negotiate what times to start and finish, they can take leave whenever they want, including all the busy holiday periods and so on. On top of all that they often earn more money than salaried GPs in the same area.
So how do we attract locums to salaried posts?
If you look at the few practices that seem to have no problem attracting salaried GPs they are a few keen themes.
Firstly, they provide a fixed workload. They also remove any duty doctor or on-call commitment. They have therefore removed the most stressful part of being a GP, an unknown or unlimited workload. The unknown and not being in control is very stressful.
Secondly, they remove the most boring part of a GP’s day, they remove the need to do clinical admin such as repeat prescribing, clinical letters and reports.
The GP’s then know that when they come to work they will not be asked to do any more than their fixed working schedule and no boring paperwork. Some practices going even further and remove the need to provide home visits.
If you look at the pattern of work in these practices its hard to see the difference from that of a locum. There are very few differences, but most of them are positive: job security, sick pay, team environment, continuity, practice education etc.
It is no surprise that these practices don’t have any problems recruiting GPs to salaried roles. A practice who offer all of the above have recently recruited no less than five salaried GPs!
But we can’t provide an environment like that, what else can we do?
The first place to start is to look at your job adverts.
I can’t believe that people are still using the same old statements in their job adverts.
I’ve lost count of the ones that state lines like: “…join our hard working, high achieving practice with excellent QOF performance”, “looking for a hardworking, dedicated person…”
The language is all wrong!
An applicant will read from this “sounds like they are working way too hard to me!”.
People are no longer looking to work themselves into an early grave to demonstrate their commitment to their patients. They want a work-life balance and manageable workload. They want some energy left at the end of their working day for themselves and their family. Your advert needs to reflect that.
You need to demonstrate what you have in place to manage the workload and provide some form of work-life balance. For example, do you offer flexible working times? Why do we stick rigidly to two surgeries at fixed times? It’s not very family friendly for the school run. Do you offer term-time working?
Could you offer a portfolio career with sessions spent in other areas such as the CCG or other clinical areas? Do you offer leave for sabbaticals? Do you support further training or research?
You can’t achieve a more balanced workload without investing in your practice. Training your staff to manage clinical correspondence or to work as care navigators are only two examples of the many ways you can try and reduce the clinical workload.
Do you actually need a GP?
It’s finally been recognised in the NHS plan that we don’t always need a GP to see every patient in primary care. However, practices that have struggled to recruit GPs have already embraced this fact through necessity and have looked elsewhere for staff to manage their growing list of patients.
Could a first contact physiotherapist manage the huge percentage of musculoskeletal conditions that come through the door every day?
Could a mental health worker manage a suitable cohort of patients?
Other allied health care workers such as paramedics, pharmacists are finding a place in lots of surgeries along side non-clinical staff such as care navigators or social prescribers.
Modern GPs are looking for flexibility alongside a fixed workload. Jobs where this is offered will attract candidates over more traditional roles.
Portfolio careers are important to many GPs and jobs that allow or offer this will also stand out.
Once last thing. Even if you can only offer a job where the applicant is going to have to work pretty dam hard for the foreseeable future, please don’t shout about it!
Shout about the other things that might mitigate against the workload, such as the supportive environment you can provide, the new premises, the pizza night on a Thursday or the regular brew breaks etc.
Everywhere has something positive to offer. This is what should be front and centre in your adverts.