DAUK is part of SOS NHS Coalition of health organisations and unions which has written to the prospective prime minister urging him to secure the long-term future of the NHS.

The letter, which has been featured in the Guardian, also asks Burnham to meet members of the coalition to listen to their experiences of the NHS and social care.

Meanwhile, DAUK GP co-lead Dr Steve Taylor has contributed to an article exploring ‘a surge in portfolio working’ among GPs.

Underemployed and unemployed GPs

GP Online has reported that two-thirds of UK doctors have portfolio careers, which combine clinical work with work in other areas such as teaching and research.

Dr Taylor said: “There’s the element of underemployed and unemployed GPs – many have been forced to look for alternatives.

“It’s also the case that the intensity of working five days a week in NHS general practice is too high.”

Dr Taylor also provided comment to GP Online on its report that half of GP workforce growth in the last financial year came from jobs created through the additional roles reimbursement scheme (ARRS).

Workforce rebalancing

He said: “There needs to be a rebalancing of the workforce, because we’ve been under-employing GPs for some time.”

Elsewhere, Dr Taylor welcomed new NHS England guidance for planned patient care which sets out what patients and carers should expect when patients are referred for non-urgent NHS care as ‘a step in the right direction’ but said it ‘doesn’t go far enough’.

Speaking to Pulse, he said: “Patients are currently left in the dark about the referral process and where they are on the journey to seeing a specialist or waiting for an investigation. This should save some time for GP practices.”

Picture credit: Andy Burnham/Facebook

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Doctors Association UK (DAUK) has written to health secretary James Murray urging the introduction of clear national standards to ensure patients referred to hospital by a GP are assessed by a doctor.

DAUK GP co-leads Dr Sarah Jacques and Dr Steve Taylor wrote to Mr Murray following coroners’ reports into the deaths of nine-year-old Dylan Cope and eight-year-old Ethan Hanson.

They were both urgently referred to hospital by their GPs with suspected appendicitis but, according to the coroners’ findings, were not assessed by a doctor after arriving at hospital.

The letter has been featured by The BMJ, Pulse and Doctors.net.uk

In it, Dr Jacques and Dr Taylor called on the government to introduce national standards requiring patients urgently referred to hospital by a GP to be assessed by a doctor.

The letter also asks to ensure that no patient with undifferentiated symptoms is assessed or discharged without doctor oversight.

DAUK has invited Mr Murray and Department of Health officials to discuss the proposals.

Read the letter in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Dr Taylor contributed to a new investigation by Pulse into the ‘lottery’ of local enhanced services funding experienced by GPs.

He said: “You could be on the other side of the street from another GP surgery and not be able to offer a service, just because you’re in a different ICB.

Funding lottery

“It’s a lottery, depending on which part of the country you’re in – you really don’t know what you can get and what you can’t get.”

Read the Pulse investigation.

Dr Taylor has also spoken to GP Online for its report on how some additional roles reimbursement scheme (ARRS) GPs are facing redundancy or reduced hours due to budgetary issues.

Core contract

He said: “It reflects the complexity of funding streams in general practice … GP practices, the BMA, RCGP have all been asking for money to be moved to the core contract [to help practices hire GPs] rather than it being manipulated via ARRS.”

Read the GP Online report in full.

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Dr Steve Taylor was speaking to Pulse after new figures revealed the money spent on primary care in the past decade by NHS England and ICBs.

The data, Pulse reported, showed that ‘primary care consistently received one of the lowest shares of funding’.

Underfunded primary care

Dr Taylor said: “Successive governments have underfunded primary care and in particular GP services.

“These figures demonstrate what is seen week by week with issues of access to services.

“These figures demonstrate government would be better off spending NHS funding on community services rather than gimmicks.

“There are 6,300 neighbourhood centres already in walking distance of 80% of people – GP practices.”

Read the Pulse article in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Jess’s Rule is a safety initiative urging GPs to ‘think again’ if they see a patient three times with the same symptoms.

It was welcomed by DAUK when it was introduced last year.

Jess’s Rule

Speaking to Doctors.Net, Dr Taylor, DAUK’s GP co-lead, said the requirement in the new contract to expand the use of advice and guidance (A&G) could be at odds with the requirements of Jess’s Rule.

He said: “A&G changes will reduce patient choice and the ability of GPs to refer patients.

“GPs are generalist experts in patient care and when they refer it is always for good reasons.”

New GP contract

He added: “The new GP contract has a number of big issues which will affect patient care adversely and reduce the ability of practices to provide high quality care.”

Read the article in full on Doctors.Net.

Meanwhile, Dr Taylor has also commented in the medical media on new online access figures.

Pulse has reported on NHS England data showing GP practices received 9.2 million online requests in January, up from 7.8 million in December.

GP appointments

Dr Taylor said the increase in online requests did not mean there had been an increase in the available number of GP appointments.

He said: “Online forms are work for GPs and their teams, so the data means 2 million more bits of work without the resources to provide them.

“GPs want better access to care for patients but they recognise it’s not online forms that patients want, it’s GP appointments, and without the resources reality will not be met with the expectations raised by this Government.”

Read the article in full on the Pulse website.

DAUK is run by volunteer doctors, who campaign on issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Dr Steve Taylor was speaking to GP Online on the findings of the latest Health Survey for England.

GP Online reported that the survey reveals rising pressure on general practice as a growing proportion of the population lives with poor health and long-term illness.

He said: “The lack of investment in health has created this.

“We are reaping what we sowed over 15 years of austerity.

“There’s also an element of an ageing population, more long-term issues because of the huge waiting list, more people who are ill and overstretched GPs with not enough time to spend on prevention, so the problems increase again.”

DAUK in the media

Read the GP Online article on what the Health Survey for England shows about pressure on GPs.

Meanwhile, Dr Taylor spoke to Pulse on a survey by United Medical Associate Professionals (UMAPs).

The survey found that 76% of PAs said their scope of practice has been restricted since the publication of the Leng review.

Dr Taylor said: ‘I would say their scope has been reduced rightly, because I think there was significant risk for patients with somebody that’s had such limited training to be seeing undifferentiated patients.”

Read the Pulse article in full.

DAUK’s committee members are all volunteers. They campaign and speak in the media about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Figures obtained by the Medical Protection Society (MPS) under the Freedom of Information Act show the regulator has appealed a further 23 Medical Practitioners Tribunal Service (MPTS) cases since the Government committed to disallowing GMC appeals in June 2018. 

Government legislation to strip the GMC of its right to appeal is still not in place, despite the Government making its intention clear in June four years ago.

Doctors Association UK co-chair Dr Matt Kneale told Pulse ‘no other regulatory body under the Professional Standards Authority (PSA) has the power to overturn tribunal decisions, but the GMC continues to have this exceptional ability despite the Williams review being published four years ago. 

‘The case of Hadiza Bawa-Garba proved that the GMC would not be trusted to exercise this power with due care and diligence, yet it remains in place. With the recent concerns surrounding the higher rates of MPTS cases amongst black and ethnic minorities, prompting our own request for the PSA to intervene, it is crucial that the Williams review findings are implemented as soon as possible.’

Read the full article here

PULSE: Recently qualified GPs are receiving deportation letters soon after completing their medical training, the professional development vice chair of the RCGP has told MPs today. 

New doctors are ‘literally going from celebrating the fact that they’ve become a GP to receiving letters threatening them with deportation’, Dr Margaret Ikpoh told the House of Commons Health and Social Care Committee during an evidence session on the future of general practice.

Pulse revealed in April 2022 that up to 1,000 overseas GPs could be at risk of being deported despite completing their UK training because of complex immigration rules that mean they are unable to extend their visas.

The Doctors’ Association UK (DAUK) said it is ‘utterly appalled’ that newly-qualified GPs face deportation despite having completed their GP training in the UK and are left ‘in limbo’ with this threat ‘hanging over them’.

DAUK spokesperson Dr Dolin Bhagawati said: ‘This simply defies belief and demonstrates the siloed thinking that is present in Government when it comes to NHS staffing. These doctors, who worked during the pandemic, are ideally placed to help address the problems faced by a dramatically understaffed GP service currently.

‘Yet the Government’s immigration stance runs counter to alleviating this simple immigration issue. A Parliamentary Bill to give Indefinite Leave to Remain to all NHS workers that worked during the pandemic has been repeatedly kicked into the long grass. Despite being a simple measure to implement, the Government have chosen to embrace foolish bureaucratic madness rather than take measures to address a crippling NHS shortage.’

DAUK co-chair Dr Ellen Welch added: ‘We are short of thousands of GPs in the UK and desperately need these doctors to stay and work in the NHS. 

‘If the Government is serious about bolstering the workforce then they need to take immediate action to ensure these doctors are not deported and are granted indefinite leave to remain to use their skills within our crumbling health service.’

The story was also covered in the Lancet and the Morning Star

Listen to our Five Live appearance here

As reported in Pulse,

A medical degree apprenticeship scheme has been ‘approved for delivery’ and could start from September next year, it has been announced. 

The scheme, which has been met with scepticism from doctor unions, will see students employed for the duration of their medical degree, doing ‘on the job’ learning through clinical placements alongside attending medical school. 

Last July, Health Education England (HEE) launched a consultation on a proposed doctor apprenticeship scheme with the aim to roll out the programme from September this year. 

In April last year, Doctors Association UK members voted unanimously to oppose the new scheme due to reports it would have a heavy primary care focus. 

The union raised concerns about inadequate training and warned that GP trainers would lack time to train apprentices.

DAUK met with Professor Hughes from HEE last year, and we have written to her again to seek clarification on this scheme. here is our letter

Doctors Association UK representative Dr Louise Hyde, a GP in Tywyn, Wales, says her rural patient group is ‘generally not very demanding or well off’, but despite this she is seeing ‘way, way more’ of them choosing to pay for care.

‘I’ve recently had an elderly lady say she’s too old to wait two years for her cataract op, so she’s going private. An elderly man made the same decision about his hip replacement,’ she says. 

Dr Hyde adds: ‘Urology waiting lists are really bad here and I’ve had one patient with bladder cancer and another with prostate getting tests and outpatient appointments done privately self-paid, although I think both then returned to the NHS for treatment.’ 

Read the full article here