19 August 2014

Thousands of Doctors Prevented from Returning to GP Workforce by Red Tape

Up to 5,000 family doctors who have emigrated or opted for early retirement are being prevented by needless red tape from returning to the GP workforce if they wish to – at a time of a growing crisis in general practice, according to new research.

The Royal College of General Practitioners and the British Medical Association (BMA) say that the rules governing the eligibility of family doctors to work in England are being interpreted in such a bureaucratic way that thousands of qualified GPs who would like to return to work after extended periods of maternity leave or practising medicine abroad are effectively being disbarred from the GP workforce without good reason.

They have written to NHS England calling for the regulations of the Performers List – the list that all doctors must be on in order to work in England – to be applied more flexibly so that GPs who want to return to the workforce are able to do so without coming up against unnecessary and costly bureaucratic hurdles.

While both organisations accept that checks need to be carried out to ensure GPs remain competent to treat patients in the UK, they are concerned that the current rules are being interpreted in an overly bureaucratic fashion that is effectively preventing thousands of trained GPs from treating patients.

The revelation that thousands of GPs who would like to return to the workforce could be prevented from doing so comes at the same time as the growing crisis in general practice is leading to longer waiting times for GP appointments and increasing fears among doctors that they could miss something serious in a patient due to their unprecedented workloads.

During the last five years for which figures are available 5,229 GPs under 50 left the workforce – 3151 of them under 40.

As workloads for GPs in England continue to balloon and resources plummet increasing numbers of family doctors are leaving the workforce prematurely either to take a career break, to retire early or to work overseas.

In 2009, 392 GPs under 50 retired left the workforce. However, by 2013 this figure had risen to 733.

One GP, Dave Berger, had been hoping to return to general practice in England after working abroad as a GP for two years. However, he was told in a letter from NHS England that he would be removed from the Performers List because he had not completed at least one clinical session in England during the previous 18 months and would need to complete the returner’s scheme assessment and associated training.

RCGP Chair Dr Maureen Baker said: “It seems nonsensical that at a time when we have a chronic shortage of GPs and patients are having to wait longer and longer for a GP appointment that we have a ready-made taskforce of GPs who are being effectively barred from caring for patients because of red tape and an arcane set of rules.

“These are qualified and experienced doctors who could effortlessly slot back in general practice – and ensure that our patients receive the care they need, when they need it.

“The inflexible way in which these rules are being interpreted is even more short sighted when a large number of the doctors affected have been working in medical settings abroad so their clinical skills are up to date, and many say that the care they can provide to patients has improved as a result of their experiences.

“We understand that NHS England have their job to do and it is imperative that doctors’ skills are relevant and fit for purpose, but we cannot allow bureaucracy to get in the way of common sense – especially when there are consequences for our patients.

“We need around 8,000 more GPs in England alone to ensure that we can provide safe care to our growing and ageing population. But we are caught in a pincer movement of working age GPs leaving the profession - many before their time because they are burnt out and exhausted - and young medical graduates spurning general practice as a career because they see the pressures that family doctors are under.

“By applying its rules so rigidly, NHS England is helping to make a bad problem even worse. We need to get some flexibility into the system so that we can get competent and willing GPs back into the workforce and doing the job that they do best – providing cost effective care to patients in the community.”

Dr Chaand Nagpaul, Chair of the BMA’s GP committee, said:

“We are reaching a serious point where general practice does not have enough GPs to treat the sheer number of patients arriving for treatment at GP practices. Recent GP trainee recruitment figures showed hundreds of vacancies across the UK with areas in the Midlands and the North particularly badly affected. A recent BMA survey also suggested that six out of ten GPs were considering early retirement with a third actively planning for such a move in the near future.

“This is happening in a climate where general practice is under unprecedented strain from rising patient demand, falling resources and the government’s desire to move more care into the community. A shortage of GPs alongside these pressures will make it even more difficult for GP services to provide patients with the appointments, access and care that they deserve.

“To help begin to tackle this crisis, the BMA is calling on NHS England and Health Education England to fully implement the recent GP Taskforce recommendations calling for a fully funded returner programme, prioritising the funding for GP returners to train in under-doctored areas. This will help get competent GPs who have taken a short career break to get back into the workforce,  particularly those who have taken time out to bring up a family.”

Further Information

RCGP Press office - 020 3188 7574/7575/7581
Out of hours: 0203 188 7659


The Royal College of General Practitioners is a network of more than 49,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.