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HEE to push for five-year GP training pilots in every deanery area

Exclusive Every deanery area should run a pilot for five-year GP specialty training, Health Education England's head of primary care has told Pulse in an exclusive interview.

Professor Simon Gregory, HEE's deputy medical director of primary and integrated care, said he would ‘ideally’ like to set up a five-year training pilot in every deanery area following the pilot set to be trialled in Tower Hamlets.

This will include the current three-year training but will be solely in general practice, and trainees will 'automatically' be enrolled in a two-year fellowship at the end of it.

The RCGP has been pushing for extended GP training for years, but has previously been knocked back in its attempts to extend training to four years. 

However, Professor Gregory told Pulse that he plans to rollout extended training. He said: ‘Our plan is to have 13 or 14 pilots. Ideally, I'd like one in every deanery area, I'm having discussions on those at the moment. This is really exciting.’

He added: 'Why do you train people for 18 months in a hospital?  Often, they're not even learning much about general practice, they're providing service in the hospital, but that's the way it's currently funded.'

Health Education England splits into 13 regions for specialty training.

Professor Gregory said that spending five years in one area allows more likelihood for trainees to 'fall in love' with the area and ‘have an affinity’ for it.

He also said the extended training is advantageous to the area as trainees can ‘adapt’ to the needs of the local population.

He said: ‘These days people go into medicine but by the time they've qualified, they're often in relationships. They don't want to be moving around the country. The chance of a job that's five years long in one area, that means that you can take out rent and not have to move every six months like my daughters had to do.

‘It wins for the doctor themselves, but it wins for the area. If we take that one in Tower Hamlets, that means they can adapt the training programme to what Tower Hamlets needs but also I think if people are there for five years, they're more likely to fall in love with the area and have an affinity for it.’

He continued: ‘There's going to be seven people starting next year in FY2 [in Tower Hamlets]. They're going to do a year of FY2 in the community. They'll do three years of GP training and then the fellowships automatically at the end of it.’

NHS England recently announced the rollout of voluntary two-year fellowships for newly qualified GPs by March 2020.

NHS Tower Hamlets CCG chair Sir Sam Everington said: 'In some ways, I’m not surprised because the feedback I’ve got from so many people is "we want it here too".

'There’s a whole raft of rationale behind it. There’s recruitment and retention, which is key, but also the strength of the training. We think this will greatly improve the training the doctors get because of the continuity.'

Sir Sam said there is no fixed idea of how many trainees will join the pilot until they advertise.

He said: 'It’s going to go ahead, but we’re not quite sure when it’s going to start, probably February or August next year. There are still some things to be sorted out. There’s lots of enthusiasm to get started as soon as possible but there are practical things – but we’re racing ahead.

‘We don’t know how many there will be until we go out and advertise. But certainly, wherever I’ve been speaking, there’s a lot of interest from trainees.

‘There’s a massive attraction of being in one place for five years, so you don’t need to be moving every four to six months. And secondly, you get the continuity of – I would call it – being with a family for five years.'

Readers' comments (16)

  • way I see it, there's no problem with the duration of training. Learning doesn't stop after qualifying. There's a problem with unrealistic ludicrous standards of RCGP assessments, which give trainees a skewed view of real practice. Turning them into protocol droids, portfolio social workers, anything but GPs. Of cause we also live, and practice, in the age when it is incredibly difficult to act as good doctor. Much easier, and safer from medico-legal prospective, to follow a policy, guideline, protocol.

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  • More time in hospital. Agree that's where u learn about all the things your ruling out in GP but rarely seeing. Why not 3 in specialties 2 in GP. Doing psych derm paeds gynae general medicine maybe ENT or palliative med then GP

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  • I agree with others about specialty placements, you have to a good doctor before you can become a good GP.
    The agenda is about keeping doctors in work, as they nearly all leave practice after completing their protected training. The best way to achieve that target is to extend training to 35 years.

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  • No way - 5yrs too long, stick to 3 please

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  • DrRubbishBin

    I think 5 years is too long. I doubt i would have become a GP if the training was 5 years, I'd have opted for a hospital speciality. Learning is continuous as a GP, you really can never know enough. What you need is the ability to spot when someone is unwell and know when to ask for help when you encounter something you don't know how to deal with. That doesn't take 5 years. I think this is about getting more trainees to staff hospital rota's, it also strokes the egos of people who organise training and set exams. I don't believe it is necessary. We aren't suffering a crisis of competence in general practice, we're suffering a crisis of numbers. This won't help that.

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  • i totally agree Harry. it may be cheap labour/ service provision plan in community.
    It is less painful when a trainee get released from training at 3 yrs than 5yrs! Not to mention few extensions for more csa trials or maternity/ paternity, ill health in between that may extend training period.
    -hospital training is very important , because this is what a trainee will fall back to when rcgp releases them from training, the 500 trainees who failed can at least work confidently in ED or acute medicine.

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