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Five-year GP-based training could start in 2021, says NHS England adviser

A five-year GP-based training scheme could start in 2021, as part of a pilot project in east London, an adviser to NHS England has said.

NHS England’s new care models adviser Sir Sam Everington said the trial will see students enter GP training straight out of medical school, rather than going into the current two-year hospital-based foundation training before entering GP speciality training.

The pilot will launch with seven juniors – one at each of the seven CCGs in east London, but could be rolled out nationally if successful, he said.

This comes after Pulse reported in June that Sir Sam – an east London GP – was working on a project with Health Education England to increase the time trainees spend in general practice

At the time Sir Sam said that GP training was ‘not fit for purpose’ and that the UK needed to ‘completely review the training that doctors do’.

Speaking to Pulse this week Sir Sam, who is also Tower Hamlets CCG chair, said: ‘For the moment the whole idea is to pilot it. If the pilot is successful there would be the temptation to provide it as an option nationally.

‘There’s no exact starting date. We’re hoping it’s going to be for two years’ time – 2021.’

The first CCGs set to trial the training are: Barking and Dagenham, City and Hackney, Havering, Newham, Redbridge, Tower Hamlets, and Waltham Forest

Sir Sam said: ‘The whole aim is to improve recruitment and retention. It all starts with the figure of 50% [of GP trainees] not going on to be GPs.

‘This is all about flexibility. The answer is to create greater flexibility.’

He continued: ‘It’s about bringing back the joy into training because of that flexibility and being able to develop as an individual.’

‘There are lots of potential benefits. We’re looking at three, four, five year training options,’ he added.

As part of the programme, trainees would be encouraged to stay workin in the local region for five years. But there would be flexibility if they wanted to move area or change to a different specialty, Sir Sam explained.

‘The idea is you’ll have much more training in general practice, it’s about giving confidence to general practice that we can train our own – which we know we can,’ he continued.

At the moment, medical graduates set on a career as a GP must complete a two-year foundation programme before doing a three year specialty training programme. The latter normally involves 18 months in general practice and another 18 months in hospital posts.

Previous attempts to provide long-term training in a GP setting have fallen by the wayside. The RCGP had planned for four-year GP training to start from 2015 but in 2014 the proposal was axed by ministers.

Two groups are currently working to finalise the new plan – a strategy group looking at the overarching plan such as overcoming obstacles in setting up the pilot, and an operational group focusing on the detail of the training course itself.

While HEE refused to comment on the pilot project, its executive director of education and quality Professor Wendy Reid, said: ‘HEE is always looking for innovative ideas to improve recruitment to general practice and as outlined in our draft workforce strategy, we stated we would investigate options around GP training in the future.’

In October, HEE announced it had recruited record numbers of GP trainees, surpassing their target of 3,250 for the first time.

However, a survey last year by the King’s Fund found that less than a quarter of GP trainees planned to practice full-time one year after qualifying.