Under the new system family GPs will be handed responsibility for commissioning out-of-hours care (currently Primary Care Trusts (PCTs) hold responsibility for commissioning), however a return to the old out-of-hours system whereby GPs had to be on call to provide 24-7 out-of-hours care has been ruled out. Rather, General Practitioners in local groups or PBC clusters will either commission services or provide them if they wish through co-operatives.
Responding to the announcement the Recruitment and Employment Confederation’s (REC) Director of External Relations, Tom Hadley said “Whoever holds budgetary responsibility, the key is to ensure that patients receive the right levels of care. Locum doctors and other temporary staff provide crucial front line services and their contribution must not be marginalised, especially as working time rules now place strict limits on individual GP working hours. Despite the focus on new rota systems, specialised recruitment agencies will continue to provide a cost effective means of ensuring that the right staff are in the right place at the right time.”
English Language Ability
The proposed changes follow the case of Dr Daniel Ubani, a German doctor who prescribed David Gray, a 70 year old patient, with a fatal overdose while delivering out-of-hours care. On the case Mr Lansley said there is a need to ensure that overseas doctors have the right language skills to work in the UK.
Currently overseas doctors are split into two categories, doctors from European Economic Area (EEA) Countries and doctors from outside of the EEA (non EEA doctors). The General Medical Council (GMC) has rigorous systems in place for non EEA nationals including a two part PLAB test to ensure doctors hold satisfactory medical qualifications and language skills. However, the GMC are unable to enforce the same system for EEA nationals due to the right to free movement and employment within the EEA. The responsibility for language checks therefore rests with NHS Trusts.
Commenting on the English Language issue, Mr Hadley went on to say “There is scope to review the GMC’s ability to take language skills into account when registering doctors from other European countries. However there will always be a need for an effective assessment process at Trust level and for other vetting procedures to take place with regards to CRBs, references and ID checks. The REC Medical Group will continue to emphasise the positive role that specialised locum agencies play in ensuring that all doctors have the necessary skills and credentials before they are placed on site.”
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