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Hospitals seizing control of GP training

Exclusive: GPs are set to lose control over training and professional development under Government plans to replace postgraduate deaneries with local education and training boards (LETBs), a Pulse investigation reveals.

The boards – not due to take over from deaneries until April 2013 – are already being set up by powerful acute trusts, with GP leaders warning of a strong secondary care bias and only token GP representation.

The LETBs – which will be handed a £5bn budget – are being introduced to replace the education functions of SHAs, which currently host deaneries but will be abolished under the NHS reforms.

The Department of Health is currently setting up a new body, Health Education England, to run the boards, with 10 to 15 expected across England and three in London, which are already established.

Pulse has learned that the interim board in Yorkshire and the Humber will have 28 members including six trust chief executives, but only four GPs. Currently the Yorkshire and Humber postgraduate deanery is overseen by two GPs and two hospital specialists in dean and deputy dean roles.

A discussion document on the interim board for the South London region showed it will have 26 members, including four chief executives of acute and mental health trusts and several academics – but only two GP representatives from CCGs and two from local practices. In comparison, three of the 12 members of the London Deanery's senior leadership team are currently GPs.

The North Central/North East London LETB was set up ‘under the auspices' of the giant academic health science centre University College London Partners, minutes of the governing body of UCL Hospitals Foundation Trust reveal. The interim LETB will be chaired by Professor David Fish, managing director of UCL Partners.

In his report to the governing body, Sir Robert Naylor, chief executive of the UCL NHS Foundation Trust, said: ‘I have also been invited to become a member, which is important to enable UCLH to exercise strong influence.'

Professor Bill Irish, chair of the General Practice National Recruitment Office, told Pulse: ‘The boards are dominated by large secondary acute trusts with no strong representation from GPs. These are powerful lobbies within trusts and SHAs.'

Dr Chaand Nagpaul, GPC negotiator, said: ‘CCGs need to be mindful of proper GP representation on these boards. Deaneries will retain their functions but will become part of the boards, with a dilution of GP presence weakening the whole infrastructure of GP education.'

Dr Michelle Drage, chief executive of Londonwide LMCs, added: ‘These bodies are being set up by trust chief executives. We want LMC representation – otherwise we fear the culture of GP training could be lost.'

While some deanery and SHA staff will be transferred to the new boards under TUPE, the discussion paper for the interim South London board also

suggests it will implement 15% cuts in operational and management costs this year, with redundancies in deanery staff.

A DH spokesperson said: ‘GPs will continue to input into education and training in the new arrangements and be represented at both local and national level. The LETBs are required to derive their membership from the full range of healthcare providers so that acute, mental health, community and primary care services are represented.'

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