In October, the NHS announced plans to boost the GP workforce ahead of winter. A key part of this plan is the recruitment of over 1000 GP assistants to help GPs reduce the amount of time they spend on administrative tasks and basic clinical duties.
The move is supported by the Royal College of GPs (RCGP). However, the chair, Professor Martin Marshall, emphasised the importance of appropriate training for GP assistants and stressed that “they are not a substitute for GPs or other clinical staff, and they must not be expected to work beyond their levels of competence”.
GPs will be ultimately responsible for training GP assistants and for the work that they do, so appropriate indemnity cover is essential.
What is the role of a GP assistant?
The role of GP assistant (or Medical Assistant) was developed to relieve the administrative burden on GPs and enable them to focus on patients’ clinical needs.
The GP assistant job description may include:
- Sorting and prioritising clinical post
- Extracting information from clinical letters that needs coding
- Arranging appointments, referrals, tests
- Preparing patients for GP appointments
- Dipping urine, taking blood pressure, electrocardiograms, phlebotomy
- Completing basic (non-opinion) forms
- Explaining treatment procedures to patients
- Helping the GP liaise with outside agencies
- Supporting immunisations and wound care.
Practices can choose how to deploy GP assistants within the outlines of the job description and competency framework. In some practices, the role is purely administrative; in others, it combines administrative and basic clinical tasks.
How do GP assistants benefit practices?
Following a successful pilot of the GP assistant role in the North West of England, Health Education England (HEE) implemented a national programme in 2019. By 2021, over 350 GP assistants had completed training. Feedback from GP practices and staff was positive, suggesting that adoption of the role may benefit practices by:
- Improving patient access
- Enabling highly qualified staff to focus on patients with more complex conditions
- Improving patient flow, increasing efficiency, reducing waiting times
- Supporting patient experiences by reiterating information from the GP
- Enhancing GP retention and job satisfaction
- Reducing the time spent by GPs on correspondence
- Creating financial savings.
Feedback also showed benefits for the staff members who trained for the GP assistant role, with the new career pathway providing increased job satisfaction, a formal qualification, and sometimes a stepping stone to further clinical training.
Training for GP assistants
GP assistants receive on-job training and development led by GP mentors, in line with the national competency framework. Staff who undergo training may also seek accreditation, for which they must generate a portfolio of evidence.
A formal accreditation programme is available to provide guidance and support throughout the process, which is based on a framework of 5 clinical and non-clinical domains:
- Care certificate (clinical)
- Clinical (clinical)
- Communications (non-clinical)
- Administration (non-clinical)
- Managing health records (non-clinical).
Trainees complete each training domain through an on-line learning portal, with support from a GP mentor who signs off the trainee’s evidence of competency. Training may be supplemented with external courses in topics such as phlebotomy if that is not delivered in the practice.
The training provider will verify the submitted evidence and give certification. Overall, the training should take 6–9 months to complete. HEE expects to expand the accredited programme with additional places in 2023.
The push to recruit GP assistants
The Additional Roles Reimbursement Scheme (ARRS) for 2022/23 now includes funding for four GP assistants per primary care network (PCN). PCNs can recruit to the role, predominantly through trainee positions, and claim reimbursement for salaries and some on-costs (maximum reimbursable amount at Agenda for Change band 4). Practices can also recruit GP assistant staff directly, either externally or from their existing staff team.
Dr Amanda Doyle, NHS England national directory of primary and community care, said: “Giving patients timely and convenient access to GPs and primary care is vital, especially during winter, which is why we are introducing brand new roles and giving GPs more flexibility to create teams that best meet the needs of their local population”.
GPs are responsible for overseeing the GP assistant role
GPs are responsible for the guidance and supervision of GP assistants and the services they perform under the NHS contract. In the document, Frequently Asked Questions: General Practice Assistants, HEE states that “the GP assistant’s primary mentor should always be a GP, who may draw on support from other health professionals in the practice/PCN.”
Other health professionals who support training must be appropriately trained and qualified themselves, with full endorsement by the GP practice team following a risk assessment, for indemnity/insurance purposes. A secondary mentor may also support and sign off training in the non-clinical domains of the accredited course. However, the GP mentor maintains overall accountability and any concerns must be relayed to them.
If you are recruiting or mentoring a GP assistant and have questions about your medico-legal responsibilities or indemnity, please c