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GP training cuts necessary to allow HEE to 'develop physician associates'

Cuts to the health education budget, which have led to training programmes for GPs and trainees being scaled back, were a trade-off to allow the development of physician associates, training bosses have said.

Health Education England (HEE) said that the 30% cuts to its running costs, first revealed by Pulse, had come as it had to prioritise objectives like developing the non-medical workforce over ‘training support’.

The Government has pledged to train 1,000 physician associates by 2020, who under GP supervision will take medical history, order investigations and make diagnoses, and in future may even prescribe medicines, relieving GP workload.

At the HEE monthly board meeting today, finance director Steve Clarke said: 'We decided we needed to make reductions in education support so we could afford… programmes like developing physician associates, and the nursing associate programme.

'All that good stuff, the education support [funding] goes back to that.'

This comes as Pulse revealed last week that budget cuts are affecting training available for qualified GPs and trainees.

HEE has repeatedly said it is focusing on reducing its adminstrative and organisational costs in order to ‘divert all possible resources’ to frontline services and trainee salaries.

Also at today's meeting, HEE revealed that although there was some take-up to the voluntary redundancy scheme, some compulsory redundancies would likely follow.

HEE chief executive Professor Ian Cumming said: 'I’m not pretending we’re going to have zero redundancies but every person we have to force out of their job – well that’s not a position I want to have happen.’

The board was also told that forced redundancies could not be rushed because 'compulsory redudancies can be challenged so they do need to be robust'.

And it noted that there was concern over the loss of jobs as well as the impact on education support, with a 'record breaking' 1,500 submissions to a consultation about the cuts.

Slides shown to the board said ‘strong staff views were expressed about the Volunteering for Redundancy scheme’.

HEE said in a statement attributed to Professor Cummings: 'As with all of the ALBs [Department of Health arms-length bodies], we are seeking to reduce our overall running costs.

'The changes will allow us to enhance and improve our delivery, freeing up resources to concentrate on our priority areas of work, while doing everything we can to avoid compulsory redundancies. We are consulting staff on the proposals and this process is on-going.'

RCGP chair Professor Helen Stokes-Lampard said: 'The College is open to widening the skill-mix in general practice, and working with allied health professionals, including physician associates – and we’re incredibly grateful for the work that all members of the healthcare team do to support us in delivering the best patient care possible.

'But one must not be a substitute for the other - and training for one profession must not come at the expense of another.'

Note:This article was amended on 21 June 2017 to correct an earlier version which stated HEE was required to make 30% cuts to its overall budget, the reduction applies to its running costs - such as educational support -  the majority of its budget is spent on trainees' placements and salaries.

What are the effects of HEE budget cuts?

HEE has been asked to cut 30% of its running budget, which Pulse revealed was resulting in a voluntary redundancy programme open to GP trainers.

Last week, Pulse revealed that budget squeezes in Wessex meant loss of a gold-standard CPD programme, while full-day training sessions for trainees have been scaled back to half-days.

In Bristol local GP education supervisors explained they had not been allowed to advertise for a replacement for one of their team and now their first-year trainees were being taught by a third-year GP trainee.

And, speaking at the Pulse Live conference in March, Professor Cumming said that he could 'not guarantee' there would be no cuts to the funding of GP trainers.

Readers' comments (24)

  • Cobblers

    Is it me? Am I Barking? I read this with absolute disbelief. Both hands came up to my face and I let out a groan of Victor Meldrew proportions.

    The money for training of GPs is being cut to fund the training of Physicians Associates. And Physician Associates are needed because there are not enough GPs in work or in the pipeline.

    You could not make this up!


    My apologies for my intemperance, Anglo-Saxon and shouting.

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  • No no no, you've got it all wrong, just look at what goes on in the construction industry. If you run out of bricks while building a house, simply remove some from the bottom of the wall and add them to the top. Pinch a few windows from the kitchen to complete the en suite aviary. It all makes perfect sense, you'll see.

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  • @Cobblers
    Forget Victor Meldrew. Malcolm Tucker is indeed required here.
    This is mindf***ingly stupid. Jeremy Hunt and the Tories can't be far away

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  • Vinci Ho

    For those who are employees of HEE , I don't know any other choice than going onto the street , gathering outside Downing Street to protest against this weak PM.....

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  • Is this a bit like using non fire retardant bricks on the outside of a tower block,in the end a false economy.At least we should be able to say they were warned ,come on GPC warn them public ally,make them liable.

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  • Why we need training from HEE? All the retired people from pct working there for no reason. Drs give life we dont need HEE. They need us. All getting old and need dr at some point in their life. They dont want flat tyre of ambulance.

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  • AlanAlmond

    I think maybe it's because the longer term agenda is to replace GPs with cheap easily controlled physician associates ...employed by serious folk like NHS trusts or super massive mega practices. It'll all dove tail nicely with secondary care treatment pathways and help keep the silly crap out of A&E. The narrative is that the world of primary care is a pretty simple place, not requiring much training, just more 'drones on the ground' can call be sorted and controlled centrally by protocol. GPs are an unnecessary extravagance not in keeping with what's needed for the '21st Century'. How on earth this squares with the other narrative currently going round - namely primary care is set to become more and more complex as more and more hospital care is dumped there - I've no idea.
    I think this is an example of cognitive dissonance - the simultaneous existence of two contradictory view points in the same individual. But then the NHS isn't an individual hey ..if it was it'd obviously be bonkers

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  • Gps dont fight for their rights. They deserve to be replaced. Sorry to say it. Fight or flight or keep quite.

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  • Please don't listen to incompetent politicians, don't cop out you cowards

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  • Gonedoc @8.43 pm
    Here is what 'could' be the plan:
    It is part of STP. Replace GPs with physicians assistants. GPs then take on the role of hospital doctors. Everything will be protocol driven and so supposedly very easy for physicians assistants and GPs to follow. GPs will still require extra training, but who is going to pay for it and who will deliver it? As a result some hospital consultants will be made redundant. In fact that is the only real way to bring financial resources into primary care. If what I suggest is true I wonder what the Royal Colleges, with their post graduate training programmes, think about this?

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