National GP Retention Scheme: Key Features and FAQs

In England, the GP Retention Scheme is a national effort to keep experienced GPs in the field. It helps GPs stay in general practice by providing incentives and support. This is part of a larger strategy to tackle workforce challenges and ensure a sustainable primary care system.

Now, let's delve into the key aspects of the programme and answer common questions about the conditions, duration, and principles of the GP retainer scheme.

Key features of the GP Retention Scheme

Financial support

GPs participating in the retention scheme may receive financial incentives or a salary supplement. The exact financial arrangements can vary, and it aims to recognize the value of the experience and skills that retained GPs bring to patient care.

Flexible working arrangements

The scheme provides flexible working options to accommodate the personal circumstances and preferences of GPs. This flexibility may involve part-time work, reduced hours, or other arrangements that allow GPs to balance their professional and personal commitments.

Educational support

GPs in the retention scheme have access to educational and professional opportunities. This could include support for continuing professional development, training, and skill development.

Programmes to facilitate mentorship and peer support will be included in the scheme. This helps GPs, especially those transitioning back to work or facing challenges, to receive guidance and support from more experienced colleagues.

Well-being and work-life balance

Recognizing the importance of well-being, the scheme includes initiatives to support the mental health and work-life balance of participating GPs. This could involve access to well-being services, counselling, and resources to manage stress.

The scheme offers opportunities for career development within general practice. This could include leadership training, involvement in decision-making processes, and pathways for progression within the profession.

Frequently Asked Questions about the Scheme

• What does the GP Retention Scheme entail?

This programme offers comprehensive financial and educational support crafted to assist physicians who may be considering leaving the medical field. Its main goal is to encourage their continued involvement in clinical general practice.

Notably, the scheme provides support to both the retained GP (RGP) and the employing practice. Financial assistance is granted recognizing the unique nature of this role, distinguishing it from a typical part-time, salaried GP position. This distinction lies in the increased flexibility and educational support it offers. RGPs can engage in the scheme for up to five years, with an annual review ensuring their continued eligibility and the practice meeting its commitments.

• Who qualifies for this initiative?

To qualify for the programme, doctors need to consider leaving general practice while staying on the National Medical Performers List. Reasons may include personal factors like caring for family (children or adults) or health concerns. Other factors include nearing retirement or the desire for more flexible work within or outside of general practice. Eligibility also applies when a regular part-time role doesn't meet the doctor's flexibility needs, like requiring shorter clinics or annualized hours.

Moreover, eligibility is determined by the need for extra educational supervision. This applies to recently qualified doctors aiming to work 1-4 sessions weekly because of caregiving duties or those involved in 1-2 sessions, where the pro-rata study leave allowance isn't enough for consistent professional development and networks.

To participate, doctors must have full registration and a licence to practice with the General Medical Council (GMC) and be included in the National Medical Performers List.

• Why is this initiative essential?

The General Practice Forward View (GPFV) is set to roll out an improved GP retainer scheme starting April 1, 2017. Alarming workforce data reveals a concerning trend: a significant rise in GPs leaving, notably in age groups 55–59 and 60–64, with peaks in their 30s and 55–59.

This initiative aims to support those contemplating leaving general practice at any career stage, especially when conventional part-time roles don't meet their flexibility needs. It also addresses cases requiring additional educational supervision.

• What is a RGP contract?

The retained GP will be treated as a salaried employee of the practice. The BMA made a retained GP model contract, like the salaried GP contract.

As mentioned earlier, RGPs can be in the programme for up to five years. They'll have an annual review with the GP Dean or their chosen deputy to assess their needs and decide if they should continue on the scheme. RGPs still need to follow revalidation and have an annual appraisal through their responsible officer.

1. BMA members can get contract checking and advice by email at bma.org.uk/support.
2. Non-members can get general information by visiting Contact-BMA.

• What are the merits of participating in this program? How does it contribute to my benefit?

The General Practitioner Retention Scheme provides crucial support for GPs facing potential departure. This is especially relevant when a standard part-time role doesn't meet a doctor's need for flexibility, requiring additional educational supervision. Participation for Retained GPs (RGPs) lasts a maximum of five years, with an annual review ensuring ongoing necessity and practice obligations.

Each RGP qualifies for an annual professional expenses supplement, ranging from £1000 to £4000, based on weekly sessions. Disbursed through the practice, this supplement, though subject to tax and national insurance, isn't pensionable.

The scheme allows physicians to sustain clinical practice with a maximum of four sessions per week (totaling 16 hours and 40 minutes), adding up to 208 sessions annually. This allocation includes protected time for ongoing professional development and educational support.

• Can I participate in the scheme within my current practice?

Certainly, as long as the practice offers suitable work to the RGP and supports the upkeep of skills in various general practitioner tasks. The RGP needs to be part of one GP practice to have peer support at work and ensure continuity with patients.

Practices wanting to qualify must show they can meet the educational needs of the RGP and understand the educational supervision approach. The Health Education England-designated RGP Scheme Lead assesses this based on the doctor's requirements. An educational supervisor, like a GP trainer or F2 supervisor, is required and should have completed a relevant training course in supervision. Specific details will be provided by the designated HEE RGP Scheme Lead.

• Can I enrol in the scheme if I’m not on the National Medical Performers List?

To join the scheme, doctors need to be fully registered and have a licence from the General Medical Council (GMC). They should also be on the National Medical Performers List. If you are not on the list but have practiced in the last two years, it's a good idea to check with the local Responsible Officer for advice on getting back on the list.

• What evidence can I provide to show that I'm seriously thinking about leaving or have already left general practice?

You can show your genuine consideration by providing documents like:

1. an appraisal
2. a resignation letter
3. initiation to receive a pension payment
4. or stating your intention to leave.

• How long can I stay in the programme?

You can be in the programme for up to five years. Every year, the assessment checks to see if you still need to be in it and to ensure the practice fulfils its obligations.

• How many sessions can I work?

The RGP can work up to four clinical sessions per week, totaling 16 hours and 40 minutes. This adds up to 208 sessions annually, allowing time for CPD and education. For annualized sessions, the RGP should aim for at least 30 weeks out of 52.

Extended hours during the week or on weekends are possible by mutual agreement, as long as the total hours worked stay within the contract limits. Extended-hour sessions are included in the job plan, allowing assessment of the balance between clinical work, admin, and CPD.

• What is an induction programme?

Every RGP, regardless of their experience, is required to participate in an initiation program. This programme is tailored to individual needs and is developed through discussions with them.

During the programme, RGPs are introduced to all key members of the primary care and allied teams. They gain insights into:

1. The computer system, including its use for consultations, prescribing, templates, protocols, BNF, and internal messaging systems.
2. Practice systems for managing chronic diseases, such as adding to disease registers, creating care plans, setting up patient alerts, implementing recall systems, achieving targets, and understanding team roles in disease management.
3. The location of practice policies and procedures.
4. Local and practice-specific prescribing policies.
5. Local referral pathways, collaborative working arrangements, and main service providers. In-house services are available, such as phlebotomy and ECG.
6. Essential phone contact numbers.
7. Practice appointment systems and on-call arrangements.
8. The location of emergency drugs.
9. Procedures for reporting significant events.
10. The location of the panic button and the protocol for reporting violent incidents.

• What happens when the programme ends?

You can go back to a bigger role if you want when the programme ends, but you don't have to. After 24 months with the same boss, you get all your work rights, and the boss has to keep your job even after that. If something changes in your job, talk to your boss about it and get advice. The boss should also tell the HEE RGP Scheme Lead if there are big changes that might affect your job, like if the practice merges with another, moves, or changes its NHS England contract.

Final Thoughts on the Pros and Cons of the GP Retention Scheme

The National GP Retention Scheme in the UK presents both advantages and considerations for retained GPs. The scheme offers financial incentives, flexible working arrangements, educational support, mentorship, and initiatives for well-being. Retained GPs can benefit from annual professional expenses supplements, contributing to their sustained clinical practice.

However, tax implications and non-pensionable aspects should be considered.

While the scheme promotes work-life balance and career development, it requires compliance with revalidation and an annual appraisal. The programme's merits include addressing workforce challenges, supporting GPs at various career stages, and offering financial and educational assistance. The maximum participation period is five years, with an annual review to assess the continued need for participation.

The scheme facilitates continued practice within the current practice, emphasizing peer support and patient continuity.

However, the practice must demonstrate its ability to meet the educational needs of the RGP.

Participation requires full registration, a licence from the GMC, and inclusion in the National Medical Performers List.

To join, evidence of genuine consideration to leave general practice, such as an appraisal, resignation letter, or initiation to receive a pension payment, is necessary. The induction programme ensures a smooth transition for RGPs, introducing them to key practice elements.

Upon programme completion, RGPs can return to a larger role if desired, but it's not obligatory.

After 24 months, full employment rights are granted, and the employer must maintain the job.

Communication with the employer and the HEE RGP Scheme Lead is crucial for addressing changes that may affect employment.

In essence, the GP Retention Scheme provides a valuable support system for GPs contemplating departure, promoting professional and personal balance while contributing to the sustainability of primary care.