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Gold, incentives and meh

Almost 40% of GP training places unfilled in some areas of UK

Exclusive The proportion of GP training places filled in certain parts of the UK as fallen as low as 62% in some areas, calling into serious doubt the Government’s plans to meet targets to increase the GP workforce.

The figures for the August 2014 intake - described by the GPC as ‘the worst ever’ - reveal that 2,564 of positions have been filled in England, representing 87% of those available, which is a decrease on the 2,764 positions filled in August 2013.

This could cause major problems for the Government in achieving its target of training 3,250 new GPs a year by 2016, which itself was put back a year from the original planned implementation of 2015.

However, GP leaders said the biggest concern was the vast differences between regions, with the popular regions filling all places, but areas where workforce recruitment problems are at their most acute, such as the East Midlands, the Northern region and Merseyside, have fill rates of 62%, 71% and 72% respectively.

The East Midlands local education and training board (LETB) has even been forced into offering a ‘pre-GP training year’ within secondary care, which has been introduced because the shortfall of GP training posts has left gaps in service provision, the GPC has said.

This comes amid a workforce crisis that has seen practices being forced into offering ‘golden hellos’ to recruit partners, and a high percentage of shifts going unfilled.

Pulse revealed earlier this year that the number of graduates applying for training positions decreased by 15% from last year.

Dr Richard Vautrey, deputy chair of the GPC, said: ‘These figures are deeply concerning and represent a serious threat to the delivery of effective GP services to patients. They show that we are experiencing serious shortfalls in the number of doctors choosing to train to become GPs, which will ultimately mean fewer GPs entering the workforce across large parts of the UK, most worryingly in already under doctored areas such as the North and the Midlands.’

He added that this could lead to a gap in service between the south and north of England.

He said: ‘This worrying shortage of GPs will only exacerbate this crisis and could leave us in a situation where there are simply not enough GPs to cope with the number of patients coming through the door. The imbalance in filled posts between the north and south of England could also mean that we are seeing the opening up of a division in the standard of care patients get in different parts of the country.’

Dr Krishna Kasaraneni, chair of the GPC GP trainees subcommittee, said: ‘There are the worst figures we have ever seen in GP recruitment since everything was standardised in 2007. What is worrying is that despite us flagging the issue on a regular basis, not enough has been done to encourage young doctors to go into GP training.’

The East Midlands LETB has advertised a ‘Pre-GP Project’, a one year role which involves filling in shifts in hospital rotas for candidates who failed to achieve the required standard for GP training spots in the assessment round.

But Dr Kasaraneni criticised the plans. He said: ‘This is not like any other GP training we have seen. This is nothing but a rota filling gap, that has nothing to do with GP training.’

A Health Education England spokesperson said: ‘The number of GP training posts has been increased in 2014 to support our Mandate requirement. We are doing further work to improve the number of applications and fill rate to support that Mandate target to provide a total of 3,250 GP training places. This work includes a review of the GP recruitment process, development of a pre-GP year for prospective applicants and careers advice for foundation doctors and medical students.’

In the devolved nations, Scotland has filled 89% of posts, Wales 90% and Northern Ireland has filled 64 of its 65 training posts.

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Readers' comments (65)

  • What about all the specialist trainees who get "juiced" out of the ST bottleneck? They'll come our way most likely. We need a model where GP's can enter sub-specialist training to vary our weeks/develop skills and make some extra dough. Pure GP day in,week in,month in,year in and decade in coupled with current climate can lead to the sad stories we have read further up this column.

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  • Question:Are the posters' negative comments on Pulse a true reflection of views of GPs out there?

    I don't think so.Those who are satisfied are less likely to post.I suspect it's the same small bunch of people who always come to this site to moan and groan giving a skewed representation.I meet loads of GPs who encourage their children to go into medicine including General Practice.Now why would they do that if the situation was that dire?Perhaps that's the reason why the public turns a blind eye to the naysayers.Dr Ivan Benett from Manchester illustrates this well when he writes in his recent response to the BMJ:

    "Comments in the GP magazines are full of people moaning about how hard their lives are these days, although personally I can't remember when it was better"

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  • Anonymous | GP Partner | 13 June 2014 6:20pm

    Dr Ivan Bennett is on the CCG in Manchester. How your logic can relate his views to represent the coal face GP is laughable.

    I'm also worried that people like you and him simply do not see the gathering storm that is primary care. If being a GP is so great, then why are so few of our doctors entering training? The statistics do not add up.

    I dont know what kind of circles you travel in, but it doesnt represent the GP partners I see everyday, a good portion of them about to burn out.

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  • Question: to 6.20pm

    Was it the contented majority who all voted for Dr Una Coales then?

    Although I am interested to hear why you are still so contented with your lot?

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  • Dear Anon 6.20 I hope you are right and that most Gp's are happy with their lot. If you're wrong then the situation will deteriorate rapidly and we will see increasing numbers of practice failures. All will be clear in 12- 15 months . Fingers crossed .

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  • So it's clear. The vacancy rate is everyone else's fault. Nothing to do with practices/GPs and what they offer

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  • What a ridiculous notion that a pre-GP year will do anything but fill secondary care rota gaps. As a GP Registrar many of the hospital posts my colleagues and I undertook were for blatant service provision with no primary care relevance which was made worse by 6 month posts in place of the previous 4 month placements.

    Furthermore the very inflexible rotations and deanery did not allow swaps so often we repeated posts that we had already done in FY1 & FY2. In my
    own personal training scheme I did 6 months acute medicine followed by 6 months respiratory medicine instead of valuable Paeds/ENT/dermatology etc.

    It seems GP's are abused from the beginning of their training career and now facing bleak prospects on completion of training. Even consultants and staff did not bother to teach with the same enthusiasm once you were known as 'the GP trainee'. Now we wonder why we are in the position we are in.
    We need to sort this mess out starting from GP training schemes and not make our GP trainees feel like rota filler fodder!!

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  • It is not Westminister we need to complain to. Are we that bad a profession that doctors working in it are so suicidal. What is the GPC
    doing? Do we not need a stronger Union? These guys are hopeless.

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  • It's not just hospital where GPSTs are used as 'rota fodder', you'll find in a few practices that GP registrars are assigned to look after the care/nursing homes (usually the sole doctor); apparently part of a 'learning experience' (read as partner's work avoidance). It's a Shame really as the lack of interest of senior partners denies the most vulnerable patients the opportunity to be cared for by the most experienced clinicians, a scandal quite frankly.

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  • I have now passed AKT and CSA and am applying for GP jobs. I need my prospective employer to sponsor my tier 2 visa (my deanery had sponsored my tier 2 visa for the last three yearsof GP training). I find lots of jobs advertised but GP Practices seem to be unaware of people like me who need visas to remain in the UK and work as GPs. Although there is a GP shortage, my options seem to be quite limited!

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