While many GPs work as full-time partners in their practice, alternative career paths and increased flexibility to have a better work-life balance are becoming more established.
An increasing number of GPs are choosing different work patterns, balancing clinical with academic work or portfolio careers, which offers them the professional satisfaction that being a family doctor brings, with career diversity.
Enabling GPs to have a more flexible career supports the commitments outlined in the General Practice Forward View (pdf) – NHS England’s five year plan for general practice, published last April. It’s backed by the promise of an extra £2.4bn per year, to support general practice services by 2020/21.
NHS England and Health Education England are taking steps to increase the options available to GPs. The Induction and Refresher scheme, which helps returner GPs back into practice, has also been revamped so that it’s more flexible, with increased financial and practical support available. There is also a drive to ensure that considerable expertise already in general practice is maintained with the GP retention scheme offering support for GPs who need to significantly reduce practice commitment and otherwise may have left the profession.
Dr Arvind Madan, NHS England’s director of primary care, says this significant investment demonstrates that the government recognises not only the importance of GPs but is committed to fund more flexible working practices.
He also acknowledges that the traditional GP role is changing and a new skills mix is emerging to meet increased patient demand. He says: “Wider members of the practice-based team will play an increasing role in providing day-to-day coordination and delivery of care. Greater use of skill mix will be key to releasing capacity, if we are to offer patients with complex or multiple long-term conditions longer GP consultations.”
Flexible options
Dr Gurbaksh Badial is completing the Darzi Fellowship in clinical leadership at the London Leadership Academy. He is one of five GPs on this year’s programme and is working on change projects to bring about technological innovations in primary care, while still completing three sessions per week at a practice in London. He says, ‘‘I love being involved in developing new technologies that can make a difference to the services for patients in general practice. Taking part in this fellowship allows me to continue to practice, and to work to shape the future of primary care”.
Dr Kate Matheson, 40, has followed a more flexible career path since she qualified 16 years ago. She works two days a week – one full- day and two half- days – in a busy Leeds practice as a salaried GP. With three children aged under seven, the fixed working hours means she can do the school run on four days and can spend more quality time with her family. Matheson also knows that when her youngest child reaches school age she can easily increase her hours. Taking on term-time only locum work is one possibility: “I’ve got lots of friends following other careers who have had to go back to work after having children and do more days than they might like or even change career. Being able to work two days a week as a GP means that I can keep professionally up to date. I also like being able to offer patients’ continuity of care, which I can do as a salaried GP, and also be part of a team that I know.”
The desire for a better work-life balance is also attractive to GPs approaching the end of their career. Dr Anne Houghton, 62, retired from full-time work four years ago but then almost immediately returned as a salaried GP. “When I was working full-time I had a portfolio career – I was a partner and worked three full days in the practice and spent the other two on other work including clinical commissioning. We moved to Scotland when I retired but I decided almost the next day to go back to work three days a week.”
It’s a career choice Houghton never dreamt would be available when she first qualified 40 years ago. “It was very difficult then – in the 1980s if you were a female GP you were expected to work full-time.”
Today Houghton relishes the freedom she has from day-to-day management and business responsibilities she held when she was a partner at the Leeds practice where she worked for 35 years. “I can just go back to being a GP and that caring role. What I feel is really important as a GP is to offer continuity of care and I can do that in my present role because I am putting in the hours in one place and am there for the patients. I definitely feel like I’m doing a better job compared to when I was doing nine weekly sessions.”
The option of flexible working is increasingly influencing GP career choices. Dr Helen Stokes-Lampard, chair of the Royal College of GPs, notes: “The flexible career option is so much more exciting and popular – the days of becoming a GP and working your way up to partner and remaining a partner for life are evaporating. General practice is one of the most flexible careers you can have in medicine and it doesn’t just appeal to women. There are many men who want to work part-time with patients and do other things like sports medicine or education while for others they want to spend that time doing the school run and being a good dad.”
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