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Health minister rejects request for compulsory GP training placement

The government will not commit to ensuring 100% of trainee doctors receive at least one placement in general practice as part of their foundation training, health minister Dr Daniel Poulter has said.

Responding to a ministerial question from fellow Conservative MP Charlotte Leslie, who asked if the secretary of state for health ‘will instruct Health Education England to make a placement in general practice compulsory for all F1 and F2 trainee doctors.’

Dr Poulter said:  ‘No.’

He added: ‘In England, all foundation schools are expected to work with Health Education England by way of meeting the recommendations set out in Broadening the Foundation Programme’, including that at least 80% of foundation doctors should undertake a community or integrated placement from August 2015.’

The Broadening the Foundation Programme guidance, released earlier this year by HEE, also recommends that all foundation doctors ‘undertake a community placement or an integrated placement from August 2017’

Chair of the GPC education, training and workforce subcommittee Dr Krishna Kasaraneni told Pulse that Dr Poulter’s comments were ‘disappointing’ and that an experience working in general practice at foundation level would help hospital doctors understand holistic patient care and improve communication with GPs.

He said: ‘It is very, very disappointing for someone to say, blank “no” to that without thinking how much there is to gain by it.’

‘Because all GP trainees have time in hospitals, and they have a rough idea of how things work. But hospital trainees don’t spend time in general practice, and … what it will help with, is for them to understand where the patients come from, and how are they managed in primary care.’

‘You can look at that holistic care approach and use that to communicate with GPs, what you can ask the GP to do and what you can do yourself.’

Dr Kasaraneni added that community placements in other settings, like urgent care, were not a substitute either and should also include some exposure to general practice.

He said: ‘As a doctor in foundation placement some taster time, not a full placement, in general practice will be very valuable for the NHS, the individual trainees, and most importantly for the patients.’

The GP taskforce report recommended that the proportion of general practice posts in foundation programmes should be increased, ‘ensuring that 100% of foundation doctors have exposure to general practice or community based experience’. And the GPC recently annouced they would campaign for fair funding for GP placements in undergraduate training.

Readers' comments (8)

  • Took Early Retirement

    Just as well; there aren't enough training practices, and, no offence to our F2 colleagues, but they are, on balance a drain on practice time and resources.

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  • John, I agree but maybe that sacrifice could be worth it in the long term if improves the empathy of those who go on to be future specialists?

    Also, you never know it might put them all off GP forcing the system to implode and reset for the better - the cynic in me wonders whether this is why it's been refused!

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  • @john
    I agree having an F2 is a lot more work than having a more senior trainee, but that is a reason for making sure practices are appropriately funded for having trainees - rather than not offering them the opportunity to experience General Practice.

    I am a partner and love it. At the end of medschool i would have put General Practice towards the bottom of my potential career choices. It all changed because I had a good GP F2 job sandwiched between my two surgical jobs.

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  • Took Early Retirement

    I have no problem with F2's and F1's coming to the practice. Indeed, I used to have students on a regular basis. Regarding the latter, we were paid well, I would say, but then we were good to them too, and made sure we had "proper" teaching sessions, with a timetable, and each partner having 3-4 appointments blocked out so they could either teach/discuss the case without feeling hassled and then also let the student see patients on their own, reporting then back to the partner, again, without falling behind.

    With FY2's we found (IIRC) that the training grant was no more than with a reg but they needed far more supervision, reviewing every patient with them for 6m. We then found we were always pushed for time, and it generally didn't work out as well. Though they were always nice people.

    God bless 'em, I know we need them, but we need to be properly resourced to do it, as you say. A double training grant for their 6m would probably be about right.

    I expect the morons in the DoH! cannot understand why a junior in hospital will share their supervisor with 15 others, and in GP it is basically usually 1:1. I'd say the quality of training is BETTER in GP. (Someone will flame me!)

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  • Why ? If you want more gps surely it's important to egg them in early to see the truth of how amazingly wonderful GP is so they can make an informed choice

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  • Dr Poulter is right in saying 'No'.
    Low morale is highly infectious - if you force these youngsters into general practice rotations - you might scare the daylights out of them and they may never venture again into GP.
    Let things calm down and either stabilize or improve - that may be the time to offer them the opportunity to participate in GP tasters. Without compulsion that is - because human nature resents compulsion.

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  • at current rates perhaps limiting foundation places is a good idea to reduce how many potential trainess are put off by general practice....

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  • It wouldn't surprise me if everyone had a taste in general practice that the applications were full training scheme would fall!
    Saying no compulsary training has probably done more for recruitment!

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