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Fears of junior doctor exodus after dramatic spike in CCPS requests

The General Medical Council (GMC) has recently been getting almost 30 times more requests from doctors seeking certificates to work abroad than normal, indicating a risk of exodus if new trainee contracts are imposed by the government, the BMA has warned.

The association has voiced the possibility of junior doctors “speaking with their feet” amidst the “outpouring of anger” over recent government decisions to impose a new contract on them despite failed negotiations.

The GMC received 1,644 requests for certificate of current professional status (CCPS) documents between 16 and 18 September, compared to a typical figure of 20 to 25 requests a day.

In the whole of last year, 4,925 doctors applied for the documents, compared to a peak of 5,153 applications in 2012. It is expected that the figure by the end of this year will break this record, since last week’s spike already took the total application number to 4,500.

Although not all doctors who request a certificate leave the UK, it is necessary to work abroad and is considered the best indicator of interest in taking up work elsewhere.

Thousands of doctors have already left in recent years to work in Australia, New Zealand, Canada and other popular destinations.

The dramatic spike in requests was recorded on the days following an NHS Employers decision to impose contracts on junior doctors despite their BMA committee refusing to re-enter negotiations.

Dr Kitty Mohan, co-chair of the junior doctors’ committee, said: “These figures should serve as a serious wake-up call to the government.

“There has been an outpouring of anger over plans to impose a new contract and there is a real risk that junior doctors will speak with their feet. To lose a large swath of doctors in the early stages of their careers would be a disaster for the NHS.”

The new contract, which will reclassify their normal working week to include Saturdays and working days up to 10pm, is perceived as a threat to patient and doctor safety. Junior doctors called the negotiations “unacceptable” and said the contract would remove “vital” safeguards that discourage employers from making them work dangerously long hours.

And although NHS Employers said the new contract will reward doctors who take on more responsibility and work ‘unsocial’ hours, it is expected that the change will result in 30% pay cuts. This is because doctors working at evenings and weekends will be paid the standard rather than a higher rate.

Despite the soaring requests for CCPS documents, a Department of Health spokesman said the figures are “not emigration data” and “do not reflect the number of doctors planning to leave the UK”. The Department suspects the unprecedented spike in applications was prompted by the BMA.

The BMA is now urging its trainee members to attend regional meetings put on by NHS Employers to explain the impact of the new contract. The events, aimed specifically at junior doctors, are free to attend but require registration. The next date will be on 28 September in London, but other meetings will be hosted Manchester, Leicester, Southampton, Leeds, Durham, Birmingham, Taunton and Oxford.

Other bodies have already voiced their support for junior doctors, with the Medical Women’s Federation saying the proposed contract would not protect medics and patients or penalise employers who overwork trainees.

The federation called the basic pay rise and reduced breaks “unjust” and incomparable to other professions as it does not acknowledge the importance of work-life balance. The new contract would also mean that their pay would be unprotected should they go on maternity leave or take time out for ill-health, disability, re-training or academic researching. They argued that, amongst other things, this could discourage women from pursuing medicine as a career – further affecting recruitment and retention issues across the NHS.

The Royal College of Paediatrics and Child Health has also defended junior doctors’ decision to reject the proposed contract, reiterating that it is “unacceptable” and saying the standards of child health services depend on the contribution of paediatric trainees working alongside consultants.

The royal college added that the removal of annual pay progression is “potentially discriminatory” as less than full-time trainees will be exposed to greater financial risk. They added that failing to penalise trusts for breaching safeguards designed to prevent employers from overworking trainees is “retrogressive”.

Despite the commotion in England, with junior doctors having previously threatened to strike over the contract proposals, both the Welsh and Scottish governments have confirmed they will not adopt the new contract – with a government spokesperson adding that their relationship with BMA Wales is “positive and constructive”.