More than four-fifths of locum doctors in England cannot find work, and a third plan to leave the NHS, according to the British Medical Association.
The union’s locum survey found that more than half are considering a career change due to the lack of work, even though patient waiting lists run into several weeks. A third have already made definite plans to leave the service.
The BMA said that the current ARRS model (Additional Roles Reimbursement Scheme), which only funds non-GP roles, was a key factor in GP unemployment and lack of work for locums.
Seventy-one per cent of respondents felt this to be the case.
Doctor workforce
ARRS was introduced by the government in 2019 with the aim of improving access to primary healthcare via non-GP roles such as pharmacists, mental health practitioners and dieticians. ARRS budgets cannot be spent on doctors.
Last year’s BMA GP practice finance survey found that 54% of practices were having cashflow problems that meant they often went without locum cover.
One locum from Dorset said she couldn’t find work because “GPs are being replaced by cheaper staff”.
She said: I’ve explored countless options within the NHS to no avail so I’m taking up GCSE tutoring to make ends meet.
“I’m a single mum with a child who has special needs and I thought if I studied hard, worked hard and dedicated myself to the NHS then I’d be able to provide for myself and my children.
“But after nearly 30 years of service, I’ve been driven out of the NHS by a government scheme that blocks general practice from employing general practitioners – it’s maddening.”
Another GP from London said they had begun looking for a salaried role because finding a locum position was so difficult. Even then, they applied for almost 30 positions and only got three interviews, eventually securing a single role.
“Honestly, I feel lucky to have found a job, as I know many have not. Who would have thought that becoming a doctor would lead to job insecurity and worries about meeting mortgage repayments?” they said.
“The problem with replacing GPs with cheaper alternatives is that what might appear to be a routine condition, particularly in children, may actually turn out to be a serious illness.
“For example, a patient might come into a practice complaining of muscular pain, but only a trained GP can swiftly differentiate between muscular pain and deep vein thrombosis. This is why patients deserve to be seen by GPs.”
Dr Mark Steggles, BMA sessional GP committee chair, said: “On the one hand, we have thousands of GPs in England desperate to work more, but being driven into careers outside the NHS.
“On the other hand, patients in pain, needing care, are waiting record-breaking periods of time to see a GP. It’s difficult to comprehend how the NHS – a health service once world-renowned – has reached this point where thousands of highly-skilled doctors are unable to find suitable work within it and patients are suffering as a result.”
Professor Philip Banfield, chair of BMA council, added: “To have highly-qualified doctors turning to other jobs to earn a wage whilst GP practices cannot meet the demands placed on them and patients waiting weeks for an appointment, shows what a fiasco the NHS has been turned into.
“It is clear we have a government which has not only watched, but aided and abetted the decline of general practice and with it, the morale and goodwill of our GPs, especially in England. GPs are hugely underappreciated – there is no substitute for their skills and experience.
“NHS England and ministers should be absolutely ashamed of the mess that is primarily of their creation and now be doing everything in their power to try to restore and rebuild the cornerstone of efficient and effective healthcare – the family doctor.”
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