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At the heart of general practice since 1960

GPs side-lined in NHS staffing plans

By Nigel Praities

A raft of clinical work is to be shifted from GPs to nurses and other healthcare workers under a new workforce strategy unveiled by NHS bosses today.

Five times as many training places are to be created for nurses and other healthcare professionals as for GPs over the next decade, under new NHS London plans.

Most of the additional 3,000 non-medical staff will work in the community, shifting care from hospitals and taking on tasks that have previously been done by GPs, such as prescribing.

The percentage of nurses working in the community is set to jump from 18 to 40% over 10 years, while the proportion of doctors working in the community will also rise, from 25 to 47%.

Dr Anne Rainsberry, deputy chief executive of NHS London, said more specialist nurses and other professionals were needed to manage long-term conditions in the community. ‘This [strategy] envisages some of the things currently done by medical staff will be done by nurse consultants.

‘This is because we will increasingly be providing care for patients with liver disease, diabetes and chronic respiratory conditions. If these patients are not well managed in the community then they will end up in hospital,' she said.

The plans are in line with Government blueprints for Lord Darzi's GP-led health centres revealed by Pulse last week – in which nurses will outnumber GPs by as much as three to one – and are likely to be followed elsewhere in the country.

There will also be more cash to train existing GPs under the plans. Professor Neil Jackson, GP dean at the London Deanery, said GPs needed to be ‘fit for purpose' so they could play a part in the future of the NHS in London.

‘This is all about creating the right climate for GPs to take advantage of these new commissioning models and develop their own careers,' he said.

But Dr Chaand Nagpaul, GPC negotiator and GP in Stanmore, said the targets had not been developed with ‘meaningful dialogue' with GPs in London,

‘We need to guard against falling into the trap of rushing headlong into achieving staffing levels that have not been developed through any meaningful analysis of needs,' he said.

NHS London plans: a summary

- Plans to train 600 new GPs and 3,000 advanced practitioners (including nurses, midwives, paramedics, healthcare scientists and allied health professionals)

- Role of healthcare assistants to be expanded

- More opportunities for existing GPs to receive training to be clinical leaders or develop specialist interests

Shifting skillmix: Nurses set top take on more work from GPs Shifting skillmix: Nurses set top take on more work from GPs

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