Is the LTA leading to a shortage of GPs?

Eric_the_half_a_bee

Why are so many GPs shutting up shop?

https://www.theguardian.com/society/2017/sep/27/gps-surgeries-shutting-brighton-family-doctors

LTA not mentioned in article, but I understand a lot of GPs are retiring early because their pensions are hitting the LTA?

TARDIS

I'm not a GP, but know a lot and have spoken to several recently about the recruitment and retention crisis.

I think the LTA if it plays a part is a very minor factor in this. It's fairly easy to retire and come back in the same role as a GP or defer pension membership. I understand it's even possible to pay in for only one month a year to retain membership rights.

The main issues are around workload. Why would you continue working 80 hour weeks when you can locum for half the hours for the not a lot less pay?
Indemnity costs have also soared: £10,000 pa is now common if you do out of hours work.

Added on top of the offloading of hospital work onto GPs with no additional resources, rising demand and expectations from patients, political interference (in what world is it sensible to force Saturday opening on a service that's struggling to provide a mon-fri service?), CQC inspections which focus on paperwork rather than quality of care...

Oh and the lure of better pay, conditions, appreciation in countries such as New Zealand, Australia and the Middle East haven't helped.

OldBeanz

With a DB pension and salary over £100k then there is a problem. The changes in responsibility (no need to be on call) brought in when Brown gave them the big pay rise means that part-time working gives a viable salary. Unexpected consequences of allowing pensions to be inherited thus squeezing their lifetime benefits and the unreformed monopoly of the BMA.

crv1963

I think that it is a multiple of factors as in the posts above. For some the LTA will be a factor for many it will be workload and work life balance.


The trouble with trying to run the NHS like a factory or production line is that in industry machines get down time for essential repair and maintenance, you can't run them at 100%, 100% of the time. Running hospitals at 100% occupancy or departments and surgeries at 100% capacity all of the time leads to exhaustion, stress, burn out and staff vote with their feet. Even more so if they are able to retire with a reasonable standard of living, why stay longer than necessary if your work is undervalued and your profession a political kicking ball?


Just my thoughts.


CRV

TARDIS

crv1963 wrote: »

The trouble with trying to run the NHS like a factory or production line is that in industry machines get down time for essential repair and maintenance, you can't run them at 100%, 100% of the time. Running hospitals at 100% occupancy or departments and surgeries at 100% capacity all of the time leads to exhaustion, stress, burn out and staff vote with their feet. Even more so if they are able to retire with a reasonable standard of living, why stay longer than necessary if your work is undervalued and your profession a political kicking ball?

Excellent point and goes some way explain why it's not just GPs leaving - loads of nurses are leaving too and very few will be anywhere near the LTA

crv1963

TARDIS wrote: »

Excellent point and goes some way explain why it's not just GPs leaving - loads of nurses are leaving too and very few will be anywhere near the LTA

I would hazard a guess that very few nurses and allied medical professionals get anywhere near the LTA.


Even though the pension scheme is good I worked clinically for years and did a stint at middle management level for 10 years before returning to direct clinical work (I have a cynical view of many of the NHS changes). Even although at one point I was earning 45k pa for a number of years, without the pension sharing order that has since reduced my actual expected pension my "pot" would have been around 500k of my lifetime allowance.


So I expect that the vast majority of clinical and ancillary staff have smaller pots and only the high flyers at very senior levels and the upper levels of the medical profession get to or near the LTA.


CRV

marlot

I know several GPs who are planning to retire at 55. The LTA is one of a number of things which is tipping them over the edge.

stoozie1

OH is a dental surgeon and will not hit the LTA, even by making substantial sipp contributions which most IFAs we've spoken to couldn't get their heads round.

I think the public perception of the earnings of a profession is often just a headline of click bait.

Completely agree about clinical pressures. Austerity measures lower morale.

justme111

austerity measures themselves would not be so bad; the worst part of it is the demand to keep pretence that the service provided is safe and of a good quality together with being constantly harangued by an endless parade of smoke screen of regulation and compliance.
Its not LTA itself , its that they have/had good dalaries that given them option to retire early and not be part of this shambles.

jamesd

TARDIS wrote: »

in what world is it sensible to force Saturday opening on a service that's struggling to provide a mon-fri service?

One where the customers work nights and week days and want to be able to get at health care when they are awake and not at work. I don't really like having appointments only available during my prime sleeping hours and it's one reason why I've been in an area for a decade without having a GP. The mon-fri service isn't just struggling, it's completely failed to serve me.

justme111

you must be lucky to be in a good health then. By the way I am sure private GPs work till about 7 pm , enquire at your local Nuffield or Bupa or whatever other private hospital , they may offer private GP services.
Of course it would be better if all was free and comprehensive and of good quality and at any time in this world but it happens only either in communist society or in a dream .