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A faulty production line

GP training figures are a complete car crash

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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.


Readers' comments (11)


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  • Paying of student loan or debt for GP trainees may help the numbers training in General Practice. It still won't encourage them to be GP partners- and why should they! More of us are planning to leave or at least resign and do locum work to control workload.

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  • I think the problem is you're assuming they want a service 'delivered' by GPs. They don't - far too expensive. They want a service 'led' by GPs, which is not the same thing.
    The really scary bit, is that nurse numbers are doing a similar nose-dive, albeit that many want out of the acute sector now.
    If you want to know where to watch, it will be the accreditation and formalisation of HCAs to create a cheap technical workforce who will be systematised to give them more formality and credibility, but with it will come a far broader role.
    The overall aim - an integrated Primary Care team, led by GPs, but with a clear separation of clinical leadership, service delivery and ownership.

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  • Una Coales. Retired NHS GP.

    Thank you Nigel and Pulse for summarising the GP recruitment crisis eloquently. Alas government is keen to close the NHS and that starts with GPs. It is a shame they are not allowing NHS GPs to survive financially by offering private services alongside state NHS in NHS surgeries. Instead APMS will have the monopoly on provision of healthcare with GPs as salaried workers.

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  • Nhsfatcat

    Changing the target date is so they can promise more places after the election duping the public into believing a GP crisis will be avoided if they can get in and their plans be taken forward.
    And in other news Pope still Catholic.

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  • I hope HEE dont make a short sighted move to try and suck in GP trainees.

    Recruitment is one thing, but retention power is far more important.

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  • as for 'daily fail and ignorant bigot.'.it is such an evil cancer spreading lies and disinformation like that other purulent gutter trash 'news of the world' was it should also be closed down.

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  • Tom Caldwell

    where GP training figures differ from a car crash is that a whole load of resource is thrown at a car crash and none at general practice. :)

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  • I am so glad that I have left GP. Years ago it was the norm that GPs had to be encouraged to retire. Now colleagues are leaving well before retirement age. It's a consequence of years and years of harassment of GPs by government of every shade. The rot started with Kennneth Clarke and the joke of fund holding. Labour were not much better with the bean counting culture. Now we have a Jeremy Hunt who has made it clear in the past that he wants to demolish the NHS. I am distressed that GP recruitment is apparently collapsing but am not in the least surprised. In my opinion (and for the benefit of the lawyers I could be wrong) the Nasty party agenda is to run down the NHS so that Group 4, Stobarts or Virgin can make a financial killing.

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  • Reading the comments for this blog and the original pulse article makes depressing reading. Having suicidal GP partners is an indictment of the current system which exploits the goodwill of all NHS staff at the expense of their health.
    The UK GP training system is excellent and is the reason why UK GPs with CCT/MRCGP can work in Australia without any exams. Only a few GP training systems are recognised (Ireland,Singapore,Canada) in Australia. Changing the CSA may devalue the training.
    Being a GP can be rewarding and satisfying however the UK may not be the best place to practice, as my wife found after moving to Australia, following 20 years in the NHS. This has been my experience with all the UK GPs helps make the move. More clinicial freedom and a better quality of life. NHS management should look to Australia as a guide to running the NHS of the future.

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