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GPs buried under trusts' workload dump

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)

  • @2:00
    no the cSA is not fair. there are not two examiners for each station. the feedback is poor and there is a persistent refusal to allow the stations' recordings to be seen by candidates. Why is that? How on earth an anyone deem that to be fair for the candidate - how can you properly appeal without video evidence?

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  • The CSA is a poor excuse for an exam.

    I think focusing on the pass rates was always a mistake. The reason it fails as an exam is that it is not relevant to medical practice. Its a subjective test based on linguistic theory. It is devoid of clinical content and only tests communications skills as applied to a very narrow part of the population.

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  • Oh dear, number of registrars who thinks they are being exploited is astounding.

    Whilst there is no doubt there may be small number of practices/trainers who abuse their trainee, many mistake genuine change in general practice work load (which should be reflected in the training, after all this is what you are training for!) and exploitations. I advice the registrars to compare themselves with their secondary care counterparts. I've been qualified as GP for 5 years and enjoyed nights/weekends/bank holidays off (ok, I do often do paper work but that's my choice). My med school friend who i a senior registrar now is about to become a consultant - still doing unsociable hours. I don't hear him crying foul for being exploited.......

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  • Yes well if training practices continue to exploit gp registrars then what does one expect....Trainees should do all the home visits because 'its a great learning experience', here have loads of blood tests to do in your lunch time because 'its a great learning experience' , we will fill all your appointments before anyone else and give you the most complicated patients because your a trainee and there to be exploited

    Well am glad f2s have seen sense, trainees are trainees not free labour for practices to exploit

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  • As a GP Reg I have no intention of anything other than locum gp work at present. Should general practice continue to deteriorate I will return to hospital medicine alreay holding one cct, with a very useful generalist skill set lacked by my hospital colleagues.

    I'm in this for the long haul and I'm not going to be messed around.

    You will find many of my colleagues feel the same, or plan to take their training and leave the uk. So although the places in some areas may be filled, be very wary when assuming this will translate into future uk gps.

    We will vote with our feet. We are not stupid and will not join a sinking ship just because it's assumed we would...

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  • "We will vote with our feet. We are not stupid and will not join a sinking ship just because it's assumed we would... "

    The irony is that, if there were more like you, we wouldn't be in this mess to begin with. Good luck - and look after yourself and your family first and foremost.

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  • This is very depressing. From an OOH point of view, we already have problems with rising defence fees, changes in the make up of the workforce and driving down of costs from CCGs I am not usually so pessimistic as I have tended to scoff at previous 'the end is nigh statements' but I think we will look back on the last year as the beginning of the end of GP led primary care.
    The consequences are immense. I have just got back from a conference of European OOHs organisations and the Danes were telling me that in Copenhagen (as opposed to the rest of the country) they have bypassed GPs in OOHs and have nurse triage with hospital care. No surprise ... rising costs, more admission, overinvestigations and reduced patient satisfaction and a government desperate to back track. Will our leaders ever learn?

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  • "Will our leaders ever learn?"

    They will learn when the same thing happens here.

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  • stop complaining about a crisis - there isn't one !

    the government has done a great job of reducing GDP spend on healthcare whilst increasing the use of the service - more for less ! we should be proud to be part of that achievement.

    if there is such a crisis then explain how the many FME drs that I have met who want to be GPs are being turned away or failed on CSA? or candidates who apply for a post are 'not-suitable'. I think GP Partners are talking up a crisis and are just out for more money. If there was a crisis why are we not seeing practices going under or dissapearing. Why are GP numbers not falling? where are theses thousands of GPs who are retiring?

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  • "stop complaining about a crisis - there isn't one ! "

    Tell that to 1500 patients who were removed from a list recently reported in this newspaper. As Dr Baker says: “General practice as we know it is now under severe threat of extinction."

    If there was a crisis why are we not seeing practices going under or disappearing?

    They are about to in London - try googling MPEG...

    Why are GP numbers not falling?

    They are: "The proportion of family doctors serving every 100,000 people has also dropped, from 70 in 2009/10 to 66.5 now" Dr Chand commenting in GPonline

    Combine the above with an ageing patient demographic, falling funding to primary care and a looming GP retirement bulge and I think we might just have a problem. Now where did I leave those rose tinted spectacles...

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