College writes to NHS Director on GP jobs shortage funding

College Chair Kamila Hawthorne has written to NHS England Director for Primary and Community Services Amanda Doyle asking for reassurance on the future of ‘lifeline’ funding for GPs who are finding it difficult to find jobs, at the same time as patients are ‘crying out’ for appointments.

The College campaigned for the Additional Roles Reimbursement Scheme (ARRS) to be opened up to GPs who were finding it hard to get jobs after qualifying, and we welcomed Health Secretary Wes Streeting’s recent announcement of an additional £82 million into ARRS ringfenced for GP newly qualified roles.

But our members are concerned by a lack of clarity about the continuation of this funding after March 2025, so we are calling for public commitment from NHS England that they will identify funding for future years, and we have asked for this to become part of the core GP contract. We also recommend to NHS England that further support is given to employers and GPs to ensure those that need it are able to obtain visa sponsorship, and that protected learning time is incorporated into these roles where at all possible. You can read our letter here.

I'm writing in response to the publication on Thursday 26 September 2024 of the updated Network Contract DES specification covering new GP roles under the Additional Roles Reimbursement Scheme (ARRS).

As you know, the College has been deeply concerned about the shortage of GP posts which is causing many GPs severe difficulties in finding employment at a time when patients are crying out for GP appointments.  This is a situation that we attribute to the chronic underfunding of general practice over many years. Alongside others, we have previously called for employers to be able to use ARRS funding to recruit GPs as a short-term measure to help ease this crisis, and we welcomed the Secretary of State for Health and Social Care's announcement in August that he would be making available an additional £82 million this year to provide a lifeline to those who have recently qualified and do not yet have a GP post to go to.  

We recognise that the Secretary of State has made clear that he sees this as an emergency measure and has signalled recognition of the need to tackle the underlying fundamental funding and workforce planning problems, as part of the Government's important commitment to a broader shift of NHS resources in general practice and community-based care.  Unfortunately, the details of the scheme which have been subsequently published and the accompanying communications surrounding this leave a level of uncertainty that is important to resolve.  

We understand that the funding for these roles is currently only continued through ARRS until the end of March, with questions of future funding being considered as part of contract discussions for next year. However, it is essential that those taking up the new roles receive as much reassurance as possible about their future employment prospects and that the roles offer an attractive experience that supports them as they embark on their careers as fully qualified GPs.

We urge NHS England to alleviate the uncertainty around the roles by confirming resourcing will be identified to maintain funding for these posts in 2024-5 and in future years.  We believe that this resourcing should be consolidated into the core GP contract, as part of an overall settlement designed to put the service on a firmer footing and begin to increase the proportion of NHS funding spent on providing general practice care.

In addition, it is vital that those struggling to secure GP roles know about these posts and are able to access them easily.  The scheme should provide GPs with an employment offer that is practical for them and does not put them at a disadvantage compared to their peers who are directly employed by practices. We recommend that NHS England takes action to support Primary Care Networks (PCN)s to ensure that the following features are incorporated into the scheme:

Streamlining applications and visa support for international graduates: Ensuring applications to these roles are as streamlined as possible will be important given the urgency to create these posts. Given that around half of GPs qualifying are international doctors, additional assistance from NHS England may be required to support international medical graduates to secure swift access to posts which can provide visa sponsorship, so they are not disadvantaged. 

New to practice support: We are seeing high numbers of GPs leaving the profession early in their careers. We must take this opportunity to ensure that newly qualified GPs are given the support they need to stay in general practice. Support should be modelled along similar lines to 'new to practice fellowships' and should include protected, funded time of 1 session a week for learning, mentorship or other developmental activities, such as developing extended roles where required.

Continuity of placement: Wherever possible, the new roles should be based in a single practice or clinical setting, to provide peer support, build their experience, and to facilitate continuity of care - rather than working as akin to an internal locum across a range of practices within a PCN. 

While we recognise that it will be for PCNs to decide how to use the scheme, particularly given the short timeframe involved in creating these new posts, we believe that the provision of further advice and support along these lines from NHS England will be key to achieving a positive outcome.  We also stand ready to provide support where we can, including potentially by advertising vacancies, if that would be helpful. 

Signed:

• Kamila Hawthorne, Chair of Council, RCGP

Further information

RCGP press office: 0203 188 7659
press@rcgp.org.uk

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.