Early career GP partner Dr Heather Ryan suggests how practices can attract GPs to join as partners during or just after training

In the midst of the current GP recruitment and retention crisis, many practices are struggling to attract new GPs. Although salaried doctors are a valuable asset to any practice, and locum GPs do a fantastic job in providing flexible cover, there are many benefits to recruiting a partner. 

There is a perception that young doctors do not aspire to partnership, but the reality is more nuanced. Few trainees enter partnership straight out of training. However, research has shown that many trainees expect to enter a partnership by five years post-CCT. Practices would be wise to consider this demographic when recruiting.

Having elected to join a partnership straight out of training myself, I viewed many surgeries before finding the perfect fit. Practices differed in their approach to recruitment, and particularly in their attitude to recruiting someone straight out of training.

Drawing on my experiences, here are 10 points you may wish to consider to help you attract a trainee or newly qualified GP to your partnership.

1 Don’t rule out a trainee applicant 

More than once during my job search, I encountered a practice manager who simply could not believe that a GP trainee was interested in a partnership. One assumed I had misread the advert. If you assume a trainee or newly qualified GP will not be interested in the partnership, you may find it becomes a self-fulfilling prophecy. Although not all will want partnership, and not all will have the skills you are looking for in your next partner, keep an open mind, and ensure that the rest of your team do the same.

2 Show flexibility in the roles you offer

Applicants immediately feel more positive about a practice if its emphasis is on finding the best candidate and offering a package that is right for them. If your circumstances allow it, suggest in your advert that you will consider either a partner or a salaried GP, part-time or full-time, to increase the pool of candidates. Given the problems with recruitment – a recent Pulse survey showed 18% of surgeries had failed to recruit in the past 12 months, and the average time taken to recruit a GP partner had risen to 7.4 months – it makes sense to cast the net as widely as you can.¹

Even if you want a partner, considering a salaried GP or a ‘salaried with a view’ may attract somebody who will consider partnership once they know the practice. This is particularly attractive to trainees and newly qualified GPs, who may not feel ready for partnership immediately, but may be keen to take a job where the option is open further down the line.

3 Be open about finances

Although it may feel difficult disclosing your earnings to somebody who may not end up joining your partnership, it will probably make the recruitment process run more smoothly. Don’t worry if you draw less than the surgery down the road: job-hunters will be considering a wide range of factors, including work-life balance and how well they gel with the team, and only the unwise would choose a job they would otherwise hate for the sake of an extra £10k a year.

That said, there is no need to share your full accounts with candidates
before you actually make an offer, but you should be transparent about drawings and, if relevant, the cost of buying in. Make the financial offer as attractive as you can afford, with a short time to parity, and fair pay during any initial salaried mutual assessment period.

Some trainees may be deterred by the idea of ‘buying in’, given that finances can be tight early in a career. However, savvy GP trainees will be aware of the large increases in rents and service charges currently hitting practices, so equally don’t be afraid to promote the benefits of owning your premises.

4 Be honest about your working pattern

When I was job-hunting, some practices were at great pains to reassure me that all of the doctors left the building by 5pm on a normal day and 6.30pm on the dot on a duty day. Yet there were plenty of cars in their staff car park at 7pm, and a glance at their appointment screen showed a gruelling schedule with barely enough unfilled time from 8.30am until 5pm to have a toilet break, let alone do paperwork. Any doctor who has reached the end of GP training will understand that primary care is a busy place, and they won’t be expecting a break for a gin and tonic and a round of golf between morning and afternoon sessions. If what you are describing sounds too good to be true, a wise applicant will assume that it is.

5 Advertise for a ‘mover and shaker’ to show you are open to change

What a trainee or newly qualified GP may lack in experience, they are likely to compensate for in enthusiasm. Furthermore, having rotated around various hospitals and GP surgeries during their training, they should bring new and innovative ideas to your practice. In a stable partnership, where you have all been working together for a while, a fresh perspective can be very helpful. Avoid giving the impression that you are set in your ways and make it clear that you are open to trying new things. If you advertise for an innovative partner to help you shape the future of the practice, you are likely to attract a dynamic individual who will prove to be an asset to your team.

6 Get your team in order

GP workload is growing every year, and the promised 5,000 extra GPs are yet to materialise. There is, quite simply, more work in primary care than can be done by the current number of GPs in the time available.

Having effective support staff, and delegating work to them that can be done by non-GPs, will make your surgery more attractive to new recruits as well as improving your work-life balance. With training, documents can be screened by administrative staff, and only letters that need action by a doctor put in GPs’ trays. Practice-based pharmacists can perform medication reviews and lighten the burden of medicines reauthorisation. Trainees and newly qualified GPs will have observed such models of working in their training practices, and may want to help you implement change if you do not already have systems in place for workload delegation.

7 Have a vision for the future and don’t be afraid to share it

GPs are a cynical bunch: we are wary of anything that sounds like management jargon, and there is sometimes a perception that clinical work is the only work that counts. But a savvy trainee who is considering partnership will understand that GP partners are running a business too, and you can’t deliver a good, sustainable clinical service unless the numbers stack up. Many surgeries are choosing to merge or expand in order to reap the benefits of working at scale.

The primary care landscape is changing, and potential partners will want to understand your strategy for navigating these uncertain times. Be prepared to answer questions about specific issues such as whether you plan to remain at your current size, how you’ll tackle the move towards seven-day working and where you stand on expanding skill mix using allied healthcare professionals like physician associates or paramedic practitioners.

8 Get the advert right

I visited one surgery on the basis of an advert for a partner that specifically stated they would consider a newly qualified GP. However, the partners insisted they had only ever advertised for a salaried GP. While you will want to present your surgery and vacancy in the best possible light, if your advert isn’t accurate, you will just end up wasting everyone’s time. And if you don’t feel an applicant would be a good fit, for whatever reason, try to give constructive but honest feedback.

9 Encourage outside interests to enrich your partnership

While partners must meet their partnership obligations first, do try to be open minded about the benefits that outside interests can bring. GP trainees in particular will be wary of the risks of burnout.

A portfolio career is a great prophylaxis against this – a varied and enjoyable career will be more sustainable than one focused on non-stop service provision. This in turn will have benefits for your team – for example, GPs who perform additional clinical roles such as sports medicine can bring that expertise to the practice and help you reduce your referral rate. A budding medical politician will bring the benefit of their connections and ensure your surgery is outward looking.

10 Ensure any GP trainees in your practice are exposed to the non-clinical side of general practice

It is increasingly recognised that GP training is too short; the ST3 year, in particular, can feel like a desperate race to tick all the portfolio boxes and master the dreaded CSA before the ARCP deadline. It is hardly surprising that trainers and programme directors focus on clinical topics. However, organisational matters such as resource allocation and workload management are mentioned prominently in the ePortfolio assessment criteria, often as descriptors of an excellent trainee, so it is within the remit of the MRCGP to talk to trainees about financial and contractual issues. If trainees have a good grasp of these topics, they are more likely to feel more ready for partnership.

Dr Heather Ryan is a GP partner in Derbyshire, having joined the partnership directly after qualifying

This article was originally published in Pulse magazine in August 2017; last reviewed: July 2019

References

1. Kaffash J. Beyond partnership: how trainees will reshape the profession

2 Kaffash J. One in five practices abandons recruitment due to ‘staggering’ shortage of GPs. Pulse; 12 May 2017.