Table 3 Panellist median scores for policies and strategies deemed ‘appropriate’ or ‘inappropriate’ after accounting for panel consensus

For implementation at national/ regional level (n = 6)

1

In order to assess ‘at-risk of GP shortages’ status in a commissioning/planning area and taking into account confidentiality GP practices should be able to self-register their organisation’s ‘at-risk’ status.

8

2

GP practices identified as being ‘at-risk’ of GP shortages should be provided with a toolkit to manage recruitment and retention.

8.5

3

New incentive and support packages should be available to GPs and other organisations setting up new practices or new ways of working in under-doctored areas.

7.5

4

There should be a publicity campaign focussing on managing expectations of patients in line with the resources and constraints of GP-based primary care services.

9

5

GP practices identified as being ‘at-risk of GP shortages’ should be managed with an appropriate and sensitive supportive arrangement – for (i) optional implementation.

8 ^b

6

GP practices identified as being ‘at-risk of GP shortages’ should be allocated a specialist team for managing recruitment and retention – for (i) optional implementation.

9 ^b

For implementation at GP practice level (n = 4)

7

GPs who are returning to work after a period of absence or after a career break should have access to ‘Health and Wellbeing programmes’ to help them manage their re-entry into the workforce – for (i) optional implementation.

8.5 ^b

8

GPs who are returning to work after a period of absence or after a career break should have access to schemes that have a range of routes and options that can be combined in a personal package for re-entry.

9

9

GPs who are returning to work after a period of absence or after a career break should have access to schemes that use a mix of online education and face-to-face meetings to ensure timely access to induction and refresher courses.

9

10

GP practices should implement strategically planned exits for retiring GPs.

7

For implementation at GP level (n = 14)

11

Peer support initiatives should be made available to GPs aimed specifically at health and well-being - for (i) GPs who are not reaching retirement age.

8.5 ^b

12

GPs should have access to their own specialised health care service to ensure a quick and confidential occupational healthcare service – for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

9, 9, 9 ^b

13

A structured programme of training and support should be made available to all GPs in their first 5 years following qualification as an independent GP to help them establish healthy, productive careers – for (i) optional implementation.

7 ^b

14

GPs should consider portfolio working as part of their career pathway and this should be optional - for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

9, 7, 7 ^b

14

GPs should consider portfolio working as part of their career pathway and this should be compulsory - for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

1, 1, 1 ^b

15

Career support should be available to GPs to enable portfolio opportunities to be identified and taken up in a strategic way to inform their future ambitions - for (i) all GPs, or (ii) GPs not reaching retirement.

8, 7.5 ^b

16

Incentives and support packages should be available for those GPs developing portfolio careers who are linking their portfolio activities to specialisms/areas that are directly beneficial to local clinical priorities - for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

8, 8.5, 8.5 ^b

17

Where a strong case can be made that there is a financial risk directly relating to the work of the practice (e.g. ownership of premises), GPs should have access to schemes to reduce financial burden (e.g. buy back schemes for premises) – for (i) all GPs or (ii) GPs reaching retirement and who could take their pensions

9, 9 ^b

18

There should be an agreed maximum in the number of consultations that a GP should be allowed to conduct in a working day in order to protect patient safety as well as the health of the GP - for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

9, 9, 9 ^b

19

There should be contractual changes to encourage longer consultations where appropriate - for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

9, 9, 9 ^b

20

The working hours of GPs should routinely include fully-funded, dedicated time to accommodate the full range of roles (administrative, clinical, training, management, CPD, business undertaken as part of care professional activity – for (i) all GPs or (ii) GPs reaching retirement and who could take their pensions.

9, 9, 9 ^b

21

Contracts based on specified programmed activities should be available to GPs to work across several GP practices and on other health related activities – for (i) all GPs, (ii) GPs reaching retirement and who could take their pensions, or (iii) GPs not reaching retirement.

7, 8, 8 ^b

Specifically regarding GPs who are reaching retirement and who could take their pensions on exit

22

For such GPs a comprehensive flexible careers scheme should be introduced with a view to supporting annualised hours, part-time working, and/or ad-hoc contributions to direct patient care.

9

23

For such GPs there should be financial incentives for such GPs who have maintained a prolonged/sustained period of direct patient care.

8.5

24

The annual appraisal and revalidation process should be reviewed with a view to streamlining and simplifying the process - for (i) GPs who have not encountered any concerns in the previous revalidation/appraisal processes, or (ii) GPs who would like to work with a specified and limited scope of practice.

8.5, 8.5 ^b