GP Retention Working Group: report and recommendations

6. Crosscutting Recommendations

These are recommendations that cut across General Practice, and that would make a positive impact on GP Retention:

1. Scottish Government should work with partners to establish a General Practitioner Career Development Pathway. This might include career case studies which set out the options, the availability of training and development opportunities, and postgraduate qualifications which support personal and professional development. This should build on the work already established by NES for GPs completing GPST, and from SRMC in the context of remote and rural working.

2. Scottish Government should work with stakeholders to further map and scope opportunities for fellowship schemes at all career stages, recognising the benefits of investment in additional learning opportunities for GPs, to support general practice to deliver increasingly complex community-based care to an ageing population with increasing multi-morbidity and widening inequalities. Fellowship schemes are required which meet the needs of the population across rural, urban, and offer health equity. Further consideration should also be given to how Fellowships are publicised to all GPs, given that they are provided both nationally, and locally by Health Boards.

3. Scottish Government should work with NES and other stakeholders to redesign the current range of retention initiatives available to GPs at every stage of their career, to make sure they are meeting the needs of the profession.

6.1 Early Career Recommendations:

4. Scottish Government should work with partners to establish a comprehensive support package for early career GPs who have just completed their GP Specialty training. This would include:

• developing peer support networks across Scotland by building on existing approaches.
• Establishing leadership development opportunities.
• Access to QI training.
• Fellowship opportunities which focus on developing the key clinical and leadership skills required, that will offer development opportunities for early career GPs in a supported environment to continue developing their skills as an Expert Medical Generalist, as part of their role as a GP.
• Developing a package of mentoring and coaching. This will be focused on supporting GPs in the early stages of their career.
• Support in developing skills to take on Partnership.

5. Scottish Government should work with NES to explore the challenges and specific needs that International Medical Graduates (IMGs) face when moving to Scotland. Anecdotal evidence suggests that there is more that could be done in terms of practical support with settling in Scotland, as well as in terms of support around visa application and establishing a career in Scotland. This might include installing an IMG Champion within each Health Board, encouraging peer support networks, as well as harnessing existing support for international recruitment within territorial and national Health Boards. Consideration should also be given to establishing an enhanced induction programme

6.2 Mid-Career Recommendations

6. Scottish Government should work with partners to establish a range of supports for Mid-Career GPs to continue to develop their career as a GP across a range of relevant areas, including leadership, management, enhanced clinical skills, teaching and training. This includes:

• Explore how flexible working options might be developed for GPs at mid-career. This needs to include the impact this has on broader delivery, and how this can be managed. These could include:

i. Term time contracts

ii. Flexi- hours

• Explore Fellowship development opportunities that enable mid-career GPs to enhance their skills in other specialisms as they continue to develop as an EMG. All Fellowships to be clearly advertised in a single place to make it easier for GPs to know what is available to them.
• Enabling readily available access to leadership training for GPs who may be thinking about Partnership, but also access to mentoring and peer support from highly motivated and experienced GP Partners in a supported environment.

6.3 Late Career Recommendations

7. Scottish Government should commit to exploring with key partners ways to enable late career GPs to maintain and share their knowledge and experience in ways that support their needs and requirements. Later career GPs are well positioned to support:

• Mentoring and coaching
• Development of MDT
• Teaching