Where can returning doctors add most value?
Doctors returning to practice will have variable competence and confidence. Trusts should ensure they have appropriate induction, training and clinical supervision, just as for existing staff being redeployed to optimise staff and patient safety. See NHS England and NHS Improvement's guidance on deploying our people safely.
Over 7,000 returning doctors have made themselves available and only 2,000 of these have so far been deployed in trusts and in Nightingale hospitals. Even if trusts see no immediate need for additional medical support to meet the COVID-19 surge, there will be a need for additional staff when normal services are stood up again. Trusts are advised to bring these additional staff on board as soon as possible so they can be allocated, trained and embedded in effective teams.
Supporting information and guidance for employers on how to carry out risk assessments, particularly for vulnerable groups in order to understand and mitigate specific risks staff members may face, is now available.
The guidance below has been prepared by the Medical Director for Professional Leadership and Clinical Effectiveness.
- Consultants and other doctors with ITU/anaesthetic/airway experience in the last three years are best placed in critical care.
- Consultants who are ex-medical directors or clinical directors or who have undertaken other senior leadership roles can perform senior co-ordinating roles in trusts or Nightingale hospitals.
- Consultants and other doctors in other specialties with recent clinical experience can join their specialty teams to replace those who are absent or who have been redeployed into acute services. If not needed in these roles, they can be deployed in ward teams to replace those who have been redeployed to the acute COVID-19 service.
- GPs returning to practice will need to be on the performers’ list to work in primary care. They may be able to contribute to the NHS 111 service or may be allocated to support practices in restoring some of the routine long-term condition management work or contribute to contacting shielded patients or those recovering from COVID-19 infection.
- Doctors who are not registered, who are more than three years out of practice, or who lack confidence to return directly to practice, may be allocated as Medical Support Workers. They would work under the supervision of a registered doctor. This role is being implemented in both secondary and primary care. In hospitals, medical support workers can be part of ward teams fulfilling duties such as scribe, ward co-ordinator, liaising with other teams, or undertaking basic clinical tasks. In primary care, medical support workers can be part of the wider primary care team in a similar way to physician associates. They cannot prescribe, nor carry out other duties only permissible for registered doctors. Some medical support workers, if they gain GMC registration and access the educational support that is being developed, may be able to move on to more senior ward team roles.
- Doctors able/willing only to work remotely: (includes all over 65s, plus many who cannot work face to face due to co-morbidity or caring responsibilities). Opportunities for remote working include:
provide remote OPD clinics for trusts
- provide remote consultations in primary care
- support, supervision or mentorship for colleagues who are working in the acute service
- remote medical student or training grade doctor tutorials and/or educational supervision to replace colleagues who are working full-time clinically at present
- remote work for NHS 111
- provide audit support to trusts
- provide liaison roles between ITUs and patients’ families.
- For a number of doctors returning in most of the above categories, they may also be able to fulfil a role in education and training, especially if they have experience of the English medical education system. Those expressing interest in this can be assessed by the regional HEE Dean or their deputy for their suitability for such a role.
Note that some regions are setting up non-COVID-19 sites to restart elective work. Such sites may be suitable to deploy doctors who are not suitable to work in COVID-19 services.
A small proportion of doctors who have offered to return to work during this emergency may be found to be unsuitable or may change their minds about working. These doctors should not be criticised but should be thanked for their offer to help and released. It is a worrying time for many, especially older doctors and those with dependants.
Advice and FAQs for doctors who are returning to work is available from NHS England and NHS Improvement's document, Redeploying your secondary care medical workforce safely (PDF).
Health Education England (HEE) published a paper on 15 April, setting out a process for HEE’s national and regional teams to facilitate medical workforce planning and deployment in support of service delivery in other regions across England. Access the paper in the medical and dental training updates section of HEE's COVID-19 overview web page.
As with other staff returning to practice, the costs of salaries and related expenses can be reimbursed through the agreed financial process for COVID-19. Access NHS Employers staff terms and conditions guidance, FAQs and specific medical and dental workforce issues.
For more information, access the workforce supply and deployment guidance pages and guidance on the minimum training requirements for all returning staff.