Somerset Primary Healthcare Ltd

Case study summary

The primary care workforce in Somerset is under immense pressure – over the next five years nearly half of all GPs in Somerset will be over the national retirement age of 55. Somerset risks being unable to meet short and longer term demand as well as losing huge amounts of local clinical knowledge, skills, mentoring and well-established relationships held by these GPs.

Somerset Primary Healthcare Ltd (SPH), Somerset CCG and Somerset LMC developed a scheme that provides six months of paid, facilitated peer support sessions (£300 for each session attended) to experienced GPs who are seriously thinking of leaving or who have recently left. The result has been that nine GPs have been recruited onto the first cohort, with participants reporting how it has revitalised their enjoyment of and participation in general practice. Collectively these GPs now work 15 additional clinical sessions per week, compared to before the scheme.

Background

The GP Career Plus pilot was launched in March 2017 and aimed to test new models of retaining experienced doctors through pooled working arrangements with a view that additional flexibility and variety of work will persuade GPs to remain in practice. Where schemes have been successfully implemented they are helping to improve workforce resilience across the local system. The pilot contributes towards a range of measures that will help reduce the number of GPs who leave the profession early, provide an alternative option to be a locum and contribute to the Government’s target to increase the number of doctors working in general practice by 5,000.

The issue

The primary care workforce in Somerset is under immense pressure – over the next five years nearly half of all GPs in Somerset will be over the national retirement age of 55. Somerset risks being unable to meet short and longer term demand as well as losing huge amounts of local clinical knowledge, skills, mentoring and well-established relationships held by these GPs. Many of these GPs do have a desire and would be willing to continuing working in a clinical capacity, provided some stressors were removed, including organisational, financial and workforce pressures alongside increased demand, social expectations and media bombardment.

The solution

Somerset Primary Healthcare Ltd (SPH), Somerset CCG and Somerset LMC developed a scheme that provides six months of paid, facilitated peer support sessions (£300 for each session attended) to experienced GPs who are seriously thinking of leaving or who have recently left.

The good relationship between the local organisations has been a key factor to the success of the scheme. By working together they have been able to fully understand the GP demographics locally and develop a suitable scheme to retain those looking to leave general practice.

SPH has worked closely with the local LMC to develop the package of facilitated peer support and identify a suitably experienced GP as the clinical champion for the scheme.

Impact

Nine GPs have been recruited onto the schemes first cohort; four of these GPs had not recently practised in general practice and the remainder were seriously thinking of leaving. Seven of the GPs were aged 50 and over and two mid-career. Of the nine that are on the scheme seven are undertaking clinical sessions across SPH’s footprint through Somerset GP Locums. Some of the GPs are also undertaking NHS management or leadership roles too.

GPs have been positive about the scheme. The six GPs who were surveyed as part of the wider pilots interim review all responded that they had improved morale and a reduced sense of professional isolation as a result of being on the scheme.

Analysis has shown that the first cohort of GPs on the scheme now work 15 additional clinical sessions per week, compared to before the scheme. There are two GPs in the first cohort who had decided to leave general practice but who are now working happily as a GP locum again and two have indicated they may want to become GP Partners again in due course.

GPs on the scheme acknowledged the enormous benefit of the scheme over the past nine months and how it has revitalised their enjoyment of and participation in general practice.

Lessons learned

The following are the key lessons learned from the scheme:

  • Relationships with the pastoral team at the LMC and Somerset GP Locums have both been key to recruitment of GPs onto the scheme.
  • You need people that are known and trusted involved with the scheme so that messages reach the right GPs and they understand the offer.
  • Good project management is key. This meant ensuring that the scheme was designed following consultation with key people, using local knowledge and understanding the current climate so that the structures worked for the needs of our area. SPH managed the project according to this plan, keeping an open, supportive and inclusive culture with all those stakeholders in the project.
  • The key to success has been inviting skilled and experienced GPs to share their experiences and contribute to discussion about all sorts of matters relating to general practice. This has led to the group becoming an expert resource for ideas and proposals to be considered and developed. This productivity is likely to be far more valuable in the long term than the modest service commitment members might otherwise have provided.
  • GPs themselves are an amazing mutual support and resource to one another – the key is providing them with protected time for them to get together and help each other in this extremely rewarding but challenging job.

Key contacts

A detailed case study can be found on the FutureNHS Collaboration Platform which details how SPH set up their scheme and how the facilitated peer support sessions were run. The FutureNHS Collaboration Platform is a platform designed to share best practice and learning. To request access, please email england.primarycareworkforce@nhs.net.