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  1. How revalidation pushes GPs to retirement

    Revalidation is helping to push GPs towards early retirement, according to a new analysis.

    The findings come from a fresh look at a major survey of GPs in the West Midlands conducted last year.

    Some 1,192 doctors took part in the original survey and 978 of these stated they wanted to reduce their commitment to general practice within the next five years.

    Responding to a check-list of issues, doctors referred to work-load pressures, lack of job satisfaction and time spent on unimportant tasks as key factors.

    The latest study has analysed free-text responses to the survey to assess the impact of revalidation.

    Some 42 doctors mentioned revalidation and appraisal as factors in the study, reported in BMC Family Practice.

    The analysis showed that 76% of these were over the age of 50 and 72% had stated their intention to retire within five years.

    This compared with 41% overall in the survey announcing an intention to retire within five years - and 46% of participants being over the age of 50.

    The comments described appraisal and revalidation as "bureaucratic, inflexible" and being of little education value and to having relevant to professional development or quality of care.

    Some doctors suggested that revalidation, appraisal and practice inspections should become a single process to reduce the time and cost.

    The researchers, from Warwick Medical School, write: "Through its impact on GP morale and burnout, the current appraisal and revalidation system in England appears to be contributing to the workforce crisis.

    "The findings indicate that the appraisal system may be in urgent need of re-design to increase its relevance to individual GPs’ experience and seniority, clinical activities being undertaken and professional development needs."

    The general practitioner workforce crisis in England: a qualitative study of how appraisal and revalidation are contributing to intentions to leave practice. BMC Family Practice 20 July 2016 [abstract]

  2. Hunt reveals deficit plan

    Health secretary Jeremy Hunt has revealed his plan to tackle growing deficits in the NHS - and it relies on the success of his crackdown on locum costs.

    Mr Hunt made his comments to a reporter in Somerset as he found himself in a local hospital on the day it was revealed as facing a £10 million deficit.

    Mr Hunt told the Western Gazette reporter that he needed more money for GPs, maternity care, mental health and other projects.

    He was visiting Yeovil Hospital in Somerset just as a Care Quality Commission report criticised the hospital as needing improvement in five out of eight areas inspected. These included staffing levels in the emergency department.

    The hospital is part of a Symphony programme aimed at integrating health care in South Somerset.

    Mr Hunt said: "I am very keen to tackle the issue of deficit and I want to make as much money available to departments that do not have the funding it needs because money is being sucked up by the deficit.

    "The main way that we're trying to do this is introducing national rules about the rates paid to agency staff and locum doctors. We have a big problem in the NHS, which is that you could have two nurses working at the same hospital, doing the same work, and one could get paid 50% more than the other because they happen to be employed through an agency rather than on a full time contract.

    "We are stamping that out, and I think that will be a help to places like Yeovil Hospital and across the NHS.

    "We need to address that and look at making more money available for things like GPs, maternity care, mental health and departments like symphony care. That is an issue I am extremely keen to tackle."

    * Meanwhile the head of the Care Quality Commission said he understood that hospitals could let waiting times slip and waiting lists increase to help balance the books.

    Speaking to his board, chief executive David Behan warned the next few years could be "uncomfortable" for his organisation.

    Quoted by the Health Service Journal, he said: "I see the evidence of waiting times increasing, times in A&E increasing, where people are trying to hold on to quality and doing their best to hold on to quality and balance money.

    "If I was trying to run a trust at the minute I think that is the balance that I would be trying to strike, to be honest.”

  3. Hospital plan for GP employment

    An acute trust could employ GPs and provide their services to local practices, it has been reported.

    The plan is being developed in Sussex, according to the Health Service Journal.

    It would see East Sussex Healthcare Trust employing GPs and deploying them as locums or on placements in local practices.

    The local clinical commissioning groups say the idea could help reduce the cost of locums for practices.

    In return GPs, probably newly-qualified, would not have to commit to a practice.

    The idea is being backed by CCGs in Hastings and Rother and in Eastbourne, Hailsham and Seaford.

    Hastings CCG chair David Warden told the journal that it would be a "portfolio contract."

    He said: "Doctors can work in a GMS practice but still be employed by the acute trust, all that would be required is that those GPs working from the trust be on the GP performers list in order to work in primary care.

    “Essentially what we will be offering is that if a doctor wants to work in primary care but doesn’t want to commit to an individual practice they would have that employment option with the trust.”

  4. Welsh consider junior contract talks

    A survey of doctors in Wales could open the way to negotiations on junior contract changes.

    The British Medical Association is to launch the survey after receiving assurances from the Welsh government that there would be no contract imposition.

    The BMA hopes to publish preliminary results in September.

    It says the survey will ask its members their views on the English junior doctor dispute and also about training and service provision.

    Dr Philip Banfield, who chairs the BMA Welsh council, said: "If there is to be any negotiating of contracts, it will be principled and based on creating an NHS that values and cares about its staff in order to train, work and live in Wales."

    He said the BMA had a positive relationship with Welsh health minister Vaughan Gething based on "mutual respect."

    After meeting the BMA, Mr Gething tweeted: "We prefer dialogue and agreement over dispute and imposition — we will not impose a junior doctors’ contract here in Wales.

    "I welcome BMA Cymru Wales’s plans to survey junior doctor members to judge their mood in relation to the contract situation."


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