Posted by: Nigel Praities Editor's Blog16 June 2014
I am usually quite level-headed, but now I am angry. Hopping mad. Furious.
What has me in such turmoil? I will tell you. The disastrous recent GP training places figures.
As Pulse revealed on Friday, up to 40% of places are unfilled in some parts of the UK. It is not the case in all areas; I have been told that in Kent they are filling their GP training places quite happily. But in other areas they are looking at yawning gaps.
In one area the local education and training board (LETB) has even had to offer a ‘pre-GP training year’ for unsuccessful candidates to plug gaps in secondary care, due to the looming shortfall in GP trainees.
It is not as if the warning lights were not flashing. Pulse reported earlier this year a 15% drop in applications to GP training, there have been studies showing only quarter of medical graduates rate general practice as first choice and the row over the CSA must have had an effect on applications from non-white groups.
But let me remind you that this is at a time when the Government is telling Health Education England that is should be increasing the number of GPs to 3,250 new GPs a year by 2016. This has already been quietly put back a year from the original planned implementation of 2015, but these figures show that we are going backwards rather than forwards.
If we are going to get anywhere near the NHS that NHS England, Jeremy Hunt and others say we need, it is vital that the number of GPs is increased. Practices cannot provide more preventative medicine, greater access and take on more work from secondary care unless there are more GP bums on consultation room seats. It is as simple as that.
In many areas of the country we are already seeing a recruitment and retention crisis, with practices struggling to cope with patient-to-GP ratios of 8,000. The demographics of the GP workforce mean that this problem is only going to get worse before it gets better and if we cannot call on a large pool of fresh (not burnout) GPs from postgraduate training then where will we be?
HEE really needs to get a grip. Training practices need better support, and the marketing of GP training to postgraduates must be looked at. The much-delayed GP workforce planning report must be published. Radical solutions, perhaps including capping other specialities or paying off student loan debt for GP trainees, should be considered.
None of this is rocket science, but there is precious little sign of anything happening soon. It is like being a bystander watching a car hit a brick wall in slow motion. And it makes me furious that no one seems to be doing anything to stop it.
There is perhaps one silver lining. When the GP workforce becomes a steaming, crumpled mess, the powers-that-be will have to listen.