Thousands of doctors are being prevented from working in overstretched GP surgeries across the UK because of unnecessary “red tape”, leaving NHS patients experiencing “unprecedented” waits for care, the head of the doctors’ regulator in the UK has said.
Charlie Massey, the chief executive of the General Medical Council, said barriers that stopped medics from being deployed to meet areas of high demand, such as in primary care, must be removed urgently if the NHS workforce crisis was to be resolved and access to care improved.
“Red tape is stopping the UK from making the most of many of its skilled and experienced doctors,” he said. “Without action, patients will suffer.”
The regulator will on Tuesday call for a relaxation of rules so the fastest-growing part of the medical workforce – skilled doctors in non-training roles – can undertake a wider range of work beyond hospitals, such as in GP surgeries.
According to a report by the GMC, also to be published on Tuesday, the number of doctors in these roles is increasing at six times the rate of GPs. By 2030, they could be the largest group in the medical workforce, it will say.
But existing rules, such as the performers list – which lists practitioners approved to work in primary care – restrict these medics, known as specialty and associate specialist (SAS) and locally employed (LE) doctors, mainly to working in hospitals.
“There are no easy answers to the challenges facing the NHS. There is no army of new doctors coming over the horizon, so part of the solution must be to make sure that we have more doctors in the places that patients need them,” Massey said.
“The government should make a start immediately by changing the performers list criteria so more doctors are allowed to work alongside GPs. That needs to be done urgently.
“But beyond technical changes there is also a need for fresh thinking in the way our health services are structured and in how teams of health professionals work together. We can’t keep doing things the same way they have always been done, or nothing will change.
“Without a collective rethink on how we can make our health services flexible and fit for the future, patients will be the ones who will suffer.”
Massey said many SAS and LE doctors were seeking better and more flexible opportunities.
“Lots of these doctors tell us they want better career development and progression, and to have more flexibility in the positions open to them. But there are barriers that hinder their development, and rules that prevent them fulfilling some important roles,” he said.
“They are a fantastic resource of experienced and skilled doctors. If, for example, they could use those skills to complement the existing GP workforce it would begin to address some of the difficulties patients have accessing primary care, without lowering standards.”
Between 2017 and 2021, the number of licensed doctors in SAS and LE roles increase by about 40%, from 45,578 to 63,740. At the same time, GP numbers increased just 7%, from 60,690 to 65,160.
“These are skilled doctors who do hands on work but are not in training to become a consultant or a GP,” Massey said. “Many have made a positive choice to work in non-training and non-specialist roles in secondary care, where they do hugely valuable work.
“But we know there are significant numbers who want wider opportunities. We need fresh thinking about how these doctors are deployed, and how they can be best used to benefit patients.”
The GMC’s report found that SAS and LE doctors, many of whom come to the UK after qualifying in medicine abroad, were more likely to leave after short spells working in the NHS.
“The UK’s health services are yet to properly understand how to make the most of these talented and able doctors. At a time when patients face unprecedented waits for care, now is the time to discard dated ideas and to tap into the skills and experience these doctors provide,” Massey said.
The Guardian has approached the Department of Health and Social Care for comment.
