Securing the future GP workforce

GP taking blood pressure

The GP Taskforce, a Health Education England (HEE) sponsored group, has submitted its final report Securing the Future GP Workforce - Delivering the Mandate on GP Expansion.

The taskforce was established by Medical Education England (HEE’s predecessor organisation) and the Department of Health to recommend how the target of 3,250 new GP trainees each year in England could be reached by 2015.

GP recruitment has remained at around 2,700 for the past four years, which means a cumulative shortfall is building as existing GPs leave the profession or approach retirement. The report identifies blocks to progress and key factors affecting the overall size of the GP workforce, namely retention and retirement rates.

It is estimated that general practice delivers around 90 per cent of NHS contacts meaning even a slight patient shift from primary to secondary care would put unmanageable pressure on the system.

There will be a clear impact on employers as the number of training posts in hospital based specialties is reduced to account for the increase in GP numbers. The reduction in specialty training numbers would be consistent with government policy to shift care away from hospitals, but the report acknowledges:

“This will require an extremely sensitive and coordinated approach, within appropriate time scales, to enable the reconfiguration of specialty training programmes to maintain quality placements and service delivery. The scale of the service reconfiguration needed cannot be under-estimated, but we believe is necessary to ensure an overall NHS medical workforce with the right numbers in the right places, capable of meeting the developing needs of the population.”

It could be reasonably anticipated that this reconfiguration would mean work that would have historically been carried out by specialty trainees will need to undertaken by SAS doctors and the increasing number of consultants. 

The report recommendations

A summary of the key recommendations which Health Education England will now consider are below.

  • A professionally-led marketing strategy to promote general practice to a wide-range of audiences starting as early as school/college leavers.
  • The re-commissioning of the GP workload survey along with a more effective vacancy survey.
  • An interim target of 3,050 GP ST1 entry points for 2014 (an increase of 250), with a corresponding decrease of 250 hospital specialty training numbers and the final target of 3,250 GP training ST1 entry points achieved by 2015, requiring a further increase of 200 GP numbers and corresponding reduction of 200 hospital specialty training numbers.
  • Long-term target reviewed following the NHS England Review of Primary Care, along with the long-term target for hospital specialty numbers. HEE will need to review whether further increases in GP trainees or further decreases in hospital specialty trainees should be made.
  • Consideration given to prioritising expansion in under-doctored areas, or incentivising trainees to train in under-doctored areas. A longer-term plan is also needed for this problem.
  • Local Education and Training Boards should review the capacity of their existing educational infrastructure to support further GP expansion.
  • Research undertaken to identify why doctors leave general practice early and the barriers to them returning. Nationally funded induction and refresher (returner) and retainer schemes make good economic and strategic sense, and need to be refocused to support workforce provision and development in under resourced areas.
  • The system must design and develop specific schemes to support GPs' approaching retirement age to encourage ongoing engagement in the GP workforce.
The report and recommendations can be read in full on the Health Education England website.

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