GPs moving to England from overseas: revamped scheme eases transition

Case study summary

Dr Maria Drakou was a GP in Greece for two years but now works in London. She shares how the GP Induction and Refresher Scheme helped smooth the way into general practice in England.


Despite the funding pressures and workforce shortages, it is safe to say that general practice in the UK is recognised as among the best in the world – attracting the brightest national and international talent.

One of them is Dr Maria Drakou, who worked as a qualified GP in Greece for over two years before moving to London in 2012 to pursue her dream.

“UK and Sweden are pioneers in primary care, and UK, in particular, is known for its high standard of general practice all around the world. Since I did my degree at an English-speaking university, I thought it’d be the best place to continue my medical career and develop special interests with generalism,” she says.

Drakou currently works as a part-time salaried GP at Grafton Medical Centre in Tooting, greater London, and feels a great sense of pride in her job.

However, it wasn’t all smooth sailing, she recalls, referring to the challenges of entering the scheme and adapting to a new work culture.

Her entry into the health service was made possible by the GP Induction and Refresher (I&R) Scheme, run jointly by NHS England and Health Education England (HEE). The induction route is only for qualified GPs who have never worked in the UK previously whereas the refresher pathway is suitable for GPs who have previous

NHS experience and want to return to practice after being away for two or more years.

The scheme has been recently revamped to make it easier for qualified GPs to join or return to NHS general practice – the aim is to attract an extra 500 doctors by 2020-21 by providing increased practical and financial support.

At a time when the profession is struggling with staff shortages, it makes sense to utilise and develop the reserve of existing medical practitioners. The General Practice Forward View, launched last year, has already set a target of hiring an additional 5,000 GPs by 2020 and the I&R scheme is part of that wider plan.

Dr Richard Weaver, director of GP education at HEE, says, “previously there has been a lot of frustration among the applicants due to lack of information and having to spend considerable amount of money towards training, exam fees and other expenditures”. He adds that there was also major frustration around complex processes, for example, the forms and number of organisations involved, and often conflicting advice.

To address some of these issues, NHS England and HEE revised the I&R policy in November 2016. Prior to April 2015 no funding or support was available but now a bursary of up to £3,500 per month during the placement period and help towards indemnity and other fees is provided. Each GP returnee is assigned a dedicated account manager to provide them with practical support and assistance. In addition, most parts of the scheme can now be completed from overseas even before moving to England.

Drakou welcomes the improvements. “It’s great there is more funding, more support and more thought into it. I remember there were times when my overseas colleagues and I were stressed about the finances.”

She started her nine-month placement in November 2014 at Grafton Medical Centre – where she still works – and is all praise for her supervisor, Dr Judy Roberts.

“As part of the placement, I kept a log book of my work-based placements. Dr Roberts sat with me during consultations and we’d later reflect on these consultations and my learning. This really helped me get to grips with how the NHS works. Its systems and internal processes can be different to other countries’, so every GP new to the NHS needs time to adapt.”

Weaver agrees with Drakou. “Medical knowledge is pretty much standardised across Europe and other places; the difference lies in cultural perspectives. Overseas doctors need support and help with cultural indicators to understand how to work in the NHS.”

He says more changes to the I&R scheme are in the pipeline, and will be implemented from March 2017, such as greater flexibility with the length of placements and more individual support for the doctor through a dedicated expert adviser.

Drakou believes these measures will make a big difference. “The I&R scheme is essential for the applicants – I wouldn’t have been able to get straight into the NHS without it.

“And I love being a GP. I love being the person to whom patients come to with their problems – it can be physical, mental or emotional. The diversity is very precious and it’s something you only find in general practice.

“This also makes it very exciting – you’ll never know everything but that’s part of the challenge. It makes you want to learn continuously and be the best doctor for your patients.”