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Induction & Refresher GP Stories - Frances

Frances, a GP in Derbyshire explains why there's never been a better time for GPs to return to the NHS.

The first time Dr Frances Clement tried to return to general practice after a 10-year break she was faced by a wall of unhelpful bureaucracy and gave up in frustration. But thanks to the revamped NHS scheme to attract GPs back, she has returned to work as a salaried GP in Derbyshire, having been supported and funded through retraining.

The 49-year-old, who now works seven sessions a week for Royal Primary Care in Chesterfield, says: “I’m absolutely delighted by what I have achieved. It’s obviously the right thing for me at my stage in life. But if you had asked me two years ago, I would not have been able to imagine how I would be able to make this choice.”

It has been made possible by NHS England and Health Education England’s newly-simplified GP Induction and Refresher (I&R) scheme, which aims to make it easier for GPs to return to practice after taking time to have children, work abroad or following a change in profession. The hope is to attract an extra 500 doctors through this scheme into the NHS by 2020-21 by boosting financial and practical support.

It is part of a broader plan to encourage more GPs into the profession and support the vision set out in the General Practice Forward View to attractan additional 5,000 doctors into general practice within the same time frame.

Rosamond Roughton, director of NHS commissioning, announced modifications to the I&R system in November 2016 to boost financial support and streamline the process for returners. She says, “there was previously real frustration among potential returners to practice, with no sense of people being welcomed back. I want doctors making their first contact with NHS England about returning to practice to be made to feel that the system wants them back.”

In Clement’s case, her successful return to general practice - from gaining a place on the I&R scheme to starting her current job - has taken 11 months. She had a bursary of £2,300 per month to do it, and a supervised placement overseen by accredited GP trainer Dr Helen Rainford.

Those coming onto the I&R scheme from November 2016 receive even more. Their bursary has been increased to £3,500 per month during the scheme, with assistance with indemnity, General Medical Council membership and Disclosure and Barring Service fees. Practical support has been expanded to include a new national support team based in Liverpool, to provide each returner GP with a dedicated account manager and contact point to support them through the process.

Clement is clear that she would not be where she is without the I&R scheme. Having gained her medical degree in Cambridge in the early 90s and qualifying as a GP in Avon in 1998, she moved into public health while her three children were small, because of her interest in drug and alcohol addiction. She little imagined how hard it would be to get back into clinical practice.

Back in 2007 she looked into coming back to practice as a GP and recalls: “It looked really challenging – you had to pay for your training, you were not paid whilst you studied and you had to set it up yourself. You had to take exams but it was completely self-funded. I was really angry because I was told that I would not be able to continue with my job in public health at the same time.” So she decided not to join the then I&R scheme and came off the NHS performers list of those eligible to practise in the health service.

When she came across the I&R scheme again in 2015, which was launched as part of the GP workforce 10 point plan, she found previously closed doors had opened – financial assistance was available, she was made to feel welcome and so she applied through Health Education England’s Yorkshire and Humber deanery. She succeeded in passing the access exams at her second attempt in May 2015 and started a six-month placement in September 2015 at Ashville medical practice in a deprived part of Barnsley, South Yorkshire, seven sessions a week.

Clement’s training supervisor, Rainford, who is passionate about training and being a GP, says: “I try to make a purpose-built rota for people so that they can learn in an environment that is supportive – in Clement’s case, as a working mother.”

Far from being a passive learner, Clement taught her trainers about public health and demonstrated her advanced report writing skills.

More improvements to the I&R scheme are in the pipeline in 2017, including greater flexibility and a reduction in the length of placements.

Despite the uncertainties over recruitment and funding of general practice, Rainford is an enthusiastic advocate. “Being a GP is still a very worthwhile job, even though it is also very tough,” she says. “You have to know a lot about absolutely everything and you have to make a decision every 10 minutes, but there is still a lot of job satisfaction.”