With individual GP practices allowed to manage their own recruitment, there is no overall strategy for managing succession planning within general practice. NHS England has little influence on the appointment of doctors, and the pool of available GPs to take on permanent positions is dwindling, as some GPs choose to work as locums or for “out of hours” services. Recruitment is often limited in some practices where partners take higher drawings. The result can be understaffed practices that struggle to replace retiring GPs.
It’s A Numbers Game
With GPs rejecting the ‘long hours’ culture, and external commitments for some to Clinical Commissioning Groups meaning others are left seeing patients, friction can build up. Increasingly, practices are made up of full and part time staff working different days and sessions. Pressure is being brought to bear to work extended hours and take back out of hours services. It’s costly and difficult to find locums to cover longer absences, and it’s hard to recruit doctors to permanent positions.
Advertising and recruiting early might be a key to success. Painting your practice in the most positive light is crucial. The location, age of premises, leasehold or freehold, the type of computer system used may be key to attracting excellent candidates. Consider too what the practice can realistically offer in terms of flexibility: candidates may prefer a salaried option or reduced sessions, but make sure you can cover the shortfall.
A Training Solution
Becoming a training practice or organising training courses can aid recruitment long term. Keep in touch with trainees, and see if CCGs and Federations can help recruit. Perhaps CCG could manage “GP banks” operating like nurse banks? Retain (subject to data protection) CVs submitted by doctors who have completed vocational training. Ask local practices to share CVs of unsuccessful applicants (with their agreement).
Practices that cannot replace retiring doctors may have to offload excess patients and reduce list sizes. Done arbitrarily, this can have a very negative impact, including the loss of patients that add to the income of the practice more substantially than those remaining.
Succession Planning is the solution!
The best way to tackle manpower problems is to forward plan, ideally for five years. “Succession planning” involves understanding your patient list, and establishing how many doctors and sessions are needed. Profile current doctors and expected retirement dates. Set out options for developing the practice, its services, and its premises. Consider the income required to run the practice efficiently and effectively. Think about retention of branch surgeries, managed reduction of list size, utilisation of different types of health practitioner. Discuss recruitment options and solutions, and problems that may be encountered.
Thinking ahead makes more sense than firefighting when the shit hits the fan, and drawing up a clear succession plan, looking ahead at least five years, is key.
Finally, good luck in your recruitment campaign: and don’t forget to think about a succession plan for your practice manager too!