GP redundancies: sending the wrong message

News that 11 salaried GPs at a surgery in Surrey have been offered redundancy1 has sent shockwaves through medical students and junior doctors. Drivers for redundancy included “new ways of working” (patient demand for virtual appointments) and recruitment of additional roles reimbursement scheme (ARRS) practitioners such as physician associates, clinical pharmacists, and paramedics.23 These professionals are quicker to train and easier for surgeries to employ thanks to government funded reimbursement.3Redundancies undermine the status and value of GPs and risk reducing the quality of patient care. ARRS professionals receive significantly less clinical training than GPs and thrive where medicine is protocol driven and transactional—such as when consultations result in a prescription or referral. Without a proved increase in overall effectiveness (rather than just access), replacing GPs with ARRS practitioners is likely to increase tests, second opinions, referrals, and re-presentations. This will not serve patients with complex, psychosocial, or medically unexplained symptoms….
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