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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)

  • You wouldn't see the hospital consultants putting up with seeing their training budgets removed to train some health care assistants on the ward instead!

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  • leave this doomed system before it takes it with you

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  • Definitely a bigger working plan in the pipeline. Really, really...truely exciting new changes and very, very, very, very interesting!

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  • It is the very type of consultations (that others can do so easily) that give us the time to get to know our patients, their histories and their family connections. It has been the ability to put the pieces in the jigsaw (than any experienced GP will tell you) that give the whole picture, and teh family doctor service that has been the envy of the world. It is only by addressing the root causes of illness that we can treat it. We are reaping the rewards of the rule of analgesic ladder being applied in a 10min consultation by multiple clinicians.
    Anyone can do our job if they do our training and learn to think about the lists of differentials, think outside the box and applying knowledge of family histories. Anything else short-changes our patients and significant diagnoses are missed repeatedly. We are moving out of our comfort zones with the devolution of secondary care into the community. We need longer to see patients and deal with their multimorbidity - fewer GPs to make way for PAs who only deal with the simple stuff and have to keep interupting us to discuss cases will not achieve the high quality general practice I would like to have available to me in my old age

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