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20 Nov, 26 tweets, 8 min read

Policy paper discussions about to commence at #RCGPCouncil. A reminder: comments are from individual Council members and not necessarily reflective of RCGP policy

First up, #RCGPCouncil is asked to consider the implications of widening the primary care workforce to accommodate a non-GP grade of doctor, and whether RCGP should explore the concept further

For the purposes of the paper, the non-GP doctor is referred to as 'Primary Care Doctor' #RCGPCouncil

#RCGPCouncil member: concerns around the creation of a two-tier (GP/non-GP) system of doctors in general practice. What would the role of Primary Care Doctor be? How would they be perceived by patients? Would there be unintended consequences on GP workload re: supervision?

#RCGPCouncil member: there are implications around GP training, the GP exam etc. There would be a way to make the concept work, and all work together, perhaps a role of 'Community clinician' as opposed to 'PC doctor' might allow for greater inclusion of other roles?

#RCGPCouncil member: support for College to explore concept further - can see pros and cons - but concern around where the role of Primary Care Doctor would sit

#RCGPCouncil member: this is not about lowering standard of MRCGP exam or patient care, but opening up the options for doctors who have already been invested in. Lots of thinking to do in this space before solid options are discussed

#RCGPCouncil member: currently only way to work in NHS if you are a doctor who hasn't specialised is in hospitals. Primary Care Doctor role would allow them to work in general practice

#RCGPCouncil member: concerns around non-GP grade of doctor as undermines achievements of newly qualified GPs achieving MRCGP and would be confusing for patients

#RCGPCouncil member: this group of doctors, who have not specialised for whatever reason, must not be forgotten

#RCGPCouncil member: RCGP should explore this space further, but thinking should be modeled on different career stages and type: 'new in practice', salaried, partners, and late career/retired

#RCGPCouncil member: opportunity for the College to contribute to the development of a Primary Care Doctor role. Similar role has existed in secondary care for years with benefit & could be made to work in general practice. Would help attract more to choose PC and ease workload

#RCGPCouncil member: patients want to be cared for by a competent person - if the different competencies of GPs/non-GP doctors are explained to them, they would accept a new role, especially as could improve access

#RCGPCouncil member: want to understand the evidence, the data, what is good, what is bad re: intro of non-GP doctor role, so would welcome College exploring concept further

#RCGPCouncil member: important that focus on exploring concept of non-GP doctor doesn't detract from support of GPs. Need to explore reasons people have difficulty achieving CCT

#RCGPCouncil member: need to explore idea of doctors who are specialists in other areas of medicine who want to switch to general practice and routes for them to do this

#RCGPCouncil member: concerns around supervision burden and decision-making support Primary Care Doctors may need and how this would impact on GP workload

#RCGPCouncil member: inverse care law very much alive, CMO in England has identified severe GP workforce issues in coastal towns and dire impact on patients - Primary Care Doctor role could be part of solution

#RCGPCouncil member: trainees want to know College is engaged in this debate and not leaving it to other organisations to make decisions that affect the profession on its behalf. We should also not always see a supervision role as a burden despite workload pressures.

#RCGPCouncil member: need to be clear re: what the purpose of introducing a non-GP doctor role in general practice would be, and whether this would be best way to achieve it

#RCGPCouncil member: important for RCGP to be an active stakeholder in any discussions about Primary Care Doctor role

#RCGPCouncil member: role of College is to maintain standards, how can we if we're not part of the conversation? 30% of medical doctors in UK are SAS doctors - this should be an opportunity

#RCGPCouncil member: in army and navy always employed 'general duty medical officers' - in effect working as GPs - gaining lots of experience in primary healthcare with great benefit. Many who don't want to be GP at start of career, change mind after working as GDMO

#RCGPCouncil member: exploration of new role should consider potential unintended consequences, with learning from when new roles have been introduced previously. Will need to agree an evidence framework.