The Cameron Fund has received several recent requests from GPs on the Induction & Returner Scheme, all trying their best to return to General Practice.
Launched in May last year, the Scheme aims to safely and quickly introduce experienced UK-trained GPs back into the workforce. This was obviously a step in the right direction, offering supervised work placements which are tailored to assess competence, good medical practice and an individual’s professional capabilities. Unfortunately though, we have seen first-hand, from the GPs asking for our help, that this process is not without difficulties.
One of our applicants who was returning to the UK after three years in mainland Europe, with no clinical issues whatsoever, hit a wall of bureaucracy:
Dr Penrose* began to make enquiries about the process of return in July 2014 and was advised that he would not need to take the initial I&R exams, just a period of re-training of three to six months. On his return to the UK in December 2014, he was thinking he would be back to clinical work by late spring/early summer, however he had no idea that it would take a whole year to go through the current ‘GP Returner’ process.
Firstly, he had to wait until the new Returners Scheme started in March 2015. Then Dr Penrose was told he would need to take the exams, and the earliest sitting for the MCQ was June and the Simulated Surgery in July. Then having passed these, found indemnity cover and been accepted back on the Performer’s List, he was finally able to begin a supervised placement at the end of August.
Throughout these months Dr Penrose had relied heavily on his credit cards, while his partner had been paying the mortgage. While he had submitted his application for the I&R Scheme bursary of £2,300 a month, he experienced considerably delay in payment and he contacted the Cameron Fund in November 2015, when their financial situation had reached crisis point. The Fund were able to help with a monthly grant, until Dr Penrose was finally cleared for unsupervised work at the end December, and back working as a locum in January.
He wrote at the time: “At least I can now try and recover from the disaster that this year has been. The Cameron Fund’s support has been incredibly helpful in letting us get things turned around” and was very keen for us to…“illustrate how the Returner Scheme is ridiculously difficult”.
Other requests have been from GPs ready to start an I&R placement but unable to afford the sky-high costs of medical indemnity insurance they are being offered. This is a particular problem for GPs; hospital doctors are able to resume work with Crown Indemnity. Returning GPs deserve similar consideration, even if only for the period of the training placement.
One such case is Dr Forrest,* who received a quote of £20,206, for £10 million cover (NHS England’s current guideline figure), which included a six month run off period as the 12 month insurance offered only included claims received during the cover period – very much an example of exorbitant costs and poor commercial value.
He explained: “It is requirement to be on the Performer’s List before commencing a placement. I will not be accepted on the Performer’s List without proof of indemnity… I was declined indemnity by the traditional indemnity providers, the MDU, MPS and MDDUS. They did not give reasons but…this is not unusual following GMC sanctions”.
Prior to this Dr Forrest had been earning £500 a month, working as a clinical notes summariser on a zero hours contract, while his wife worked as a nurse. The family had received help from relatives and friends to meet mortgage repayments and clear household bills, but he also had existing debts of a business loan of £39,000 and £17,000 of legal fees (relating to his GMC hearings). The family home had already been re-mortgaged, and there was no further equity to tap into. Dr Forrest asked for a grant in excess of £20,000 (a vast sum compared to the usual grants we give).
With the relevant documents submitted to the Area Team, he was all set to begin a placement on 1 April, and had been warned that these could expire if he did not start the programme soon. The Fund agree to help Dr Forrest with a grant to cover the first two insurance instalments and offered him a ‘Retraining Loan’ towards the other eight instalments (which would require a suitable guarantor, who had sufficient resources to meet repayments in the event of default). The Royal Medical Foundation also stepped in with a grant to ‘share the load’.
As ‘The GP’s own Charity’ the Cameron Fund tries, whenever possible, to help applicants improve their situation – but there are limits to the support we can give.
If you’d like more information of the Fund’s work, please go to www.cameronfund.org.uk
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* For confidentiality reasons both the GPs names are pseudonyms