Every doctor will also be required to undergo an annual appraisal to ensure they are keeping up to date.

BBC: Variations in care targeted

Doctors will also be expected to devote approximately five days a year to improving their skills and keeping up to date on the latest medical advances.

BBC: GPs to promise next day appointments

That means that the top people often have to spend more time managing the business than keeping up to date with their business and advising their clients.

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