NEWLY qualified GPs have been stopped from working for six months due to delays by the privateer Capita’s management of the National Performers List (NPL), which they need to be on to practice.
Capita advises applicants to allow 12 weeks to complete the registration process and checks, but GPs who completed their training in August are still being forced to turn down job offers because they are not yet on the list.
The affected GPs said they have received no update from Capita about when their status on the performers list will be confirmed, and the British Medical Association (BMA) said it is seeing increasing numbers of GPs seeking advice on how to approach Capita to claim for lost income.
NHS England said it was aware of ‘some unacceptable delays’ with the performers list but that it was working with Capita on urgent improvements and ‘intervening’ where necessary. Dr Thanujah Yogarajah, who qualified as a GP in Wales in August last year, had accepted a job offer in England and applied to join the performers list on August 22.
But because of delays processing her application she was forced to return to Wales – where her application was processed within days – to work as a locum. Dr Yogarajah would have been able to take on hospital work in England while waiting on her registration but she said: ‘I trained to be a GP. ‘I want to be a GP. I am not going backwards. ‘I’m not trying to blow my own trumpet, but I’m a damn good GP – you can ask any of my Welsh patients. I am not going backwards just so I can live near my parents in London.’
Meanwhile, Dr Bhavagaya Bakshi contacted Capita on November 22 after receiving her Certificates of Completion of Training (CCT) in England. This should only require a change of status to upgrade to a fully qualified GP but Dr Bakshi said that she is unable to work while waiting for the changes to be processed.
She said: ‘I have been refused employment as a result of not being updated but still paying indemnity whilst I wait. This has caused a huge amount of stress and anxiety for me… can you imagine what the public would think knowing a GP is sat at home because their paperwork could not be processed for over four months?’
BMA General Practitioners committee (GPC) education, training and workforce head Dr Krishna Kasaraneni said the doctors were not alone, with the BMA seeing a steady stream of calls from qualified GPs who cannot get on the performers list. He said: ‘In the last 24 hours, six of them have asked for help because they’re all struggling to get on the list.
‘These are UK qualified GPs who don’t actually need any different checks but the bureaucratic nature of Capita means they are having to go through processes which unnecessarily make it complicated.’
Dr Kasaraneni said the problems, which come as the short-staffed NHS is ‘desperate to bring GPs into work’, mean GPs are now forced to try to claim compensation for lost income. He said: ‘NHS England have contracted this to Capita, and Capita haven’t delivered on it. Now the conversations coming up are among individual GPs wanting to take up their cases with Capita for loss of earnings, and that’s something the BMA has to look at.’
An NHS England spokesperson said: ‘We know there have been some unacceptable delays in this process. NHS England has been working closely with Capita to urgently improve services and where necessary, intervening to accelerate progress.’
A Capita spokesperson claimed: ‘The robust and timely processing of performer list applications remains a key priority for us and we have recently recruited additional staff into the performers list team. Capita is working across the stakeholder community to ensure all parties are fully involved in the process and supporting the supply of all outstanding information in order to complete the process.’
It comes after a whistleblower said that Capita primary care support centres are staffed by temporary agency staff on low wages, with some lacking even basic computer skills. NHS England vowed in May last year that it would ‘hold Capita to account’ for the array of problems GPs have endured since Capita took on the responsibility for providing primary care support services.
The GPC has called for compensation for GP practices for the issues they have had to deal with.
Although health ministers said they had directed Capita to ‘consider’ this it has not yet materialised.
Meanwhile, The South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is cutting its paramedic home visiting service from the end of March, leaving GPs to take on more visits themselves. SECAmb has been subcontracting paramedics to practices across the southeast to take on home visits. But GP leaders said the ‘excellent service’ is being suspended because the trust received an inadequate Care Quality Commission (CQC) rating for not answering 999 calls within the five-second target.
After a routine inspection last September, the ambulance service was noted as ‘the worst performing trust nationally’ for failing to answer 999 calls on time. The report said: ‘Trust performance was as low as 95% within 80 seconds during March 2016.’
It added that between April 2015 and March 2016, 67.3% of emergency calls received a response within eight minutes – worse than the 75% national target. The CQC report said this meant SECAmb was the fifth worst performing, out of 11 ambulance trusts in England, for emergency response times to life threatening situations during this period.
Dr John Allingham, medical secretary of Kent Local Medical Committee (LMC), said the service was struggling to hit the targets with GPs ‘stealing their paramedics’. He said: ‘There aren’t enough paramedics either and we’re all fishing in the same pond, so the paramedics that run the 999 ambulances are the same ones that do our home visits for us; the paramedic practitioners.’
By subcontracting paramedics from the ambulance trust, practices do not have to handle sickness or holiday cover, while vehicles and equipment are also supplied by the trust.
He added: ‘In an area like I work in, in Dover, our town couldn’t support enough paramedics to provide a cover that would meet things like sickness and maternity leave, so every time someone goes home sick or goes on holiday there would be no one on duty.’
He continued that the service was ‘very good at avoiding admissions’ and cutting the service ‘means more after evening surgery visits and going home late’. Last November NHS England recommended Clinical Commissioning Groups (CCGs) introduce a local enhanced service to incentivise GPs to do more urgent home visits, where there isn’t a system already in place.
Dr Allingham, however, said he had not heard any talk of introducing such a LES in Kent. A spokesperson for the South East Coast Ambulance Service NHS Foundation Trust said: ‘Unfortunately, due to capacity and the demand placed on the Trust’s services, we were unable to extend this contract.’
They added that the contract was only ‘for a pilot period’ and due to finish at the end of March.