The NHS People Plan and subsequent NHSE/I letter of 11 August to primary care leads discuss the development of more flexible ways of working in the NHS.

The people plan suggests a need for ‘GP practices and primary care networks to offer more flexible roles to salaried GPs and support the establishment of banks of GPs working flexibly in local systems’ and the primary care letter states, ‘systems and CCGs [clinical commissioning groups] will want to … work with PCNs [primary care networks] to create highly flexible GP salaried roles for those who previously thought that only a career as a locum could offer them the flexibility they need’.

So, it feels clear there is a top-down drive to encourage more flexible working and try and move the large locum workforce into more salaried roles. But how will this work in practice? And, importantly, will our diverse cohort of locum colleagues who have chosen to not take on salaried roles for many varied and real reasons want to take on permanent salaried roles, however ‘flexible’ they are?

Following the paucity of work for locums during COVID-19, many may now be contemplating a more secure salaried role and personally, writing as a happily employed salaried GP in a great practice, I would suggest that if you find the right position or workplace it can be a great move.

However, as a committee we are aware some colleagues are simply unable to change their jobs in this way owing to personal situations (such as caring responsibilities or personal health issues) and the sessional committee is lobbying hard to ensure locum colleagues are not disadvantaged by unfair terms and conditions or pay rates that may be offered through these ‘locum banks’. We are also working to understand how PCN locum banks may function and we will update when there is further information.

With the nationwide shift we are seeing towards more virtual consultations and different patterns of working (including the ability for GPs to now undertake some sessions away from practice bases) now may be an ideal time for practices to consider offering job plans that sit outside of the ‘norm’, and for those looking for a more flexible salaried role to consider negotiating different ways of working with practices.

Looking to the future, it is likely that rather than a case of ‘all change’, we will see a more hybrid transition combining new and traditional ways of working, which will enable the continuity of care so valuable in general practice. It will be essential to consolidate what we’ve learned about digital consulting and develop other models that offer effective and appropriate care for our technologically savvy patients and those without the means or confidence to access virtual interactions. We wait to see what shifts in flexible working patterns for GPs may develop alongside this.

It certainly feels an exciting time for innovative and novel ways of GP working to be created.

Nicki Kemp is a BMA sessional GPs committee executive member.

Do take a look at the BMA resources available that may help you when negotiating contracts. We would suggest using the BMA contract checker service when considering and agreeing any offered contract.
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