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"Golden Hellos" for Rural GPs and Indemnity Charges

Date published: 12/10/2017


Trainee GPs will receive a £20,000 "golden hello" to work in parts of the country struggling to recruit, as part of a package of measures announced by the Health Secretary Jeremy Hunt to strengthen general practice.

From 2018, surgeries in hard to recruit to areas will benefit from a new Government-backed scheme – the Targeted Enhanced Recruitment Scheme – which will offer a one off payment of £20,000 to attract trainees to work in areas of the country where training places have been unfilled for a number of years.

The Department of Health has also asked the training body, Health Education England (HEE), to make sure many of the 1,500 additional medical training places that will be funded from next year are located in priority areas, including rural and coastal communities.

Speaking at the Royal College of General Practitioners’ Conference in Liverpool, the Health Secretary will state his intention for a renewed focus on recruitment and retention across general practice, with measures including:

  • new flexible working arrangements, including the opportunity to take on mentoring and leadership roles, for GPs considering retirement;
  • a new international recruitment office set up by NHS England to help local areas to recruit GPs from overseas, with plans to expand potential fast-track routes into general practice for doctors trained outside the European Economic Area in countries such as Australia; and
  • a consultation on the regulation of physician associates to provide further clarity on the scope of the role, and exploring how support staff can bolster healthcare teams across the country.

The Health Secretary is also expected to signal plans for a new state-backed scheme for clinical negligence indemnity for general practice in England, providing a long term solution to the increasing fees which are forcing doctors out of the profession.

While in recent years NHS England has protected GPs against the rising value of claims, the average GP now pays around £8,000 a year on their clinical indemnity cover. Alongside HM Treasury, the Department of Health will work with the General Practitioners' Committee, the Royal College of General Practice and the four Medical Defence Organisations on the best way forward.

Secretary of State for Health, Jeremy Hunt, said:

"Last month, the Care Quality Commission gave a glowing verdict on the state of general practice in England, but this should not distract us from the fact that the profession is under considerable pressure at the moment.

"By introducing targeted support for vulnerable areas and tackling head on critical issues such as higher indemnity fees and the recruitment and retention of more doctors, we can strengthen and secure general practice for the future.

"Our talented GP workforce is one of the reasons why we have the best healthcare system in the world, and our commitment of an additional £2.4 billion a year for primary care by 2021, will ensure this continues."

Professor Wendy Reid, Director of Education and Quality & National Medical Director, Health Education England said:

"Since its establishment in 2013, Health Education England (HEE) has honoured its commitment to invest more in GP training by increasing the number of training posts available. We spend nearly £500 million a year on GP training. We are working closely with NHS England to provide 5,000 more doctors in general practice by 2020. More doctors than ever before are entering general practice and this is illustrated by the GP training fill rate figures for 2016 which at 3,019 is the highest number ever.

Through the work of the GP Forward View, we are working with partners including NHS England, The Royal College of General Practitioners (RCGP) and the BMA GPs committee (GPC) to increase numbers of GPs and make sure we have a skilled, trained and motivated workforce."


BMA Press Release
Plan for rural GP recruitment will not solve GP workforce crisis, warns BMA

Responding to announcements from the Secretary of State for Health on "golden hellos" for rural GPs and indemnity changes, Dr Richard Vautrey, BMA GP committee chair, said:

"General practice is facing unprecedented pressure from rising workload, stagnating budgets and a workforce crisis that has left many parts of the country without enough GPs to treat patients. These proposals do appear to acknowledge the specific problems facing rural areas in England. But "golden hellos" are not a new idea and unlikely to solve the overall workforce crisis given we are failing badly to train enough GPs to meet current demands. There is already an incentive programme for "hard to recruit areas" that has been operating since 2016 and it is not clear whether this new announcement, which comes without any real details, is any different from that scheme.

"There are also many other areas of the country, including urban areas, that are also suffering from GP shortages. A recent BMA survey found that one in three practices nationwide had vacancies that they were unable to fill after 12 months.

"The government is not on course to reach its target of 5,000 extra GPs by 2020. We need the government to commit to a long-term plan that gives general practice the resources it needs to deliver the service patients deserve.

"On the announcement on indemnity, it is encouraging that the Secretary of State has recognised this unacceptable financial burden being placed on GPs. Average indemnity costs have risen by more than 50 per cent between 2010 and 2016. There is clear evidence from a recent NHS England survey that this is reducing GPs willingness to work, for example, in out of hours settings where the average annual indemnity rise is around 20 per cent.

"It is vital that every GP has this form of insurance, but they should not be expected to be in a system where they are facing inflated yearly increases, especially at a time when many GPs are working increasing numbers of hours to provide care to patients. The commitment to provide state-backed indemnity cover is a particularly welcome step after the talks the government has being having directly with the BMA over the summer. We do, however, need more detail on the financing of this scheme and it must cover all GPs whether they are a partner, salaried, locum, prison or other GP. It is also important we make progress quickly and deliver real change."