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GPs buried under trusts' workload dump

NHS England adviser in talks with HEE about five-year GP training

A prominent GP and NHS England adviser has said he is in talks with education bosses about offering five-year GP training schemes.

NHS England's new care models advisor, NHS Tower Hamlets CCG chair and east London GP Sir Sam Everington said he is currently working on the project with Health Education England (HEE).

According to Dr Everington, this comes as the current training that GPs receive is 'not fit for the future', with only '11%' of medical training taking place in primary care.

He told delegates at a King's Fund conference that the UK needs to 'completely review the training that doctors do', which in some ways has not moved on for 30 years.

Dr Everington said training was 'not fit for purpose now', 'let alone... for the future', adding: 'So I have a project going with the HEE where we’re going to offer doctors, newly qualified, the opportunity to spend five years in general practice.'

As it stands, GP trainees need to spend just 18 months of their training in a general practice setting, as part of a three-year postgraduate training scheme.

But Dr Everington said that going forward GP training will be focused ‘much more on the holistic approach to healthcare and on the back of that what will be also different is we will train our own GPs’.

He added: 'If I looked at an orthopaedic surgeon and said to them: I’m going to spend three and a half years training you in general practice and one and a half years in hospital, what would they say? So why have we accepted a scenario where we allow our hospitals to train our GPs?’ 

An HEE spokesperson said: Health Education England is always looking for innovative ideas to improve local recruitment to general practice. As we outlined in our draft workforce strategy, it is our intention to investigate options around GP training in the future.’

Last week, HEE revealed that it has recruited a record number of doctors to GP training after the first intake this year.

But HEE chief executive Professor Ian Cumming also unveiled data showing 40% of GPs who completed training five years ago are no longer in substantive employment or working as long-term locums.

He argued that given the amount of money NHS spends training GPs, something had to change to improve the situation including how people are trained and kept on.

The RCGP had planned for four-year GP training to commence from 2015, before this was scuppered by ministers in 2014.

In 2017, a group of experts on the Shape of Training steering group argued instead in favour of a more flexible 'three plus one' model, which would include a one-year fellowship scheme.

The RCGP said last year it would continue lobbying for extended training and HEE backed further discussion over extending GP training to four years in its 10-year workforce plan published in December 2017.

But this all comes against the backdrop of a severe workforce shortage in general practice, with health secretary Jeremy Hunt confessing earlier this month that he is ‘struggling to deliver’ his pledge for 5,000 additional GPs by 2020.

Readers' comments (17)

  • AlanAlmond

    Do we think this will increase the supply of U.K. trained GPs or reduce it?
    Will we insist the legions of goodly GPs ‘trained over seas’ all have 5 years training?
    What’s the point in any of it really when the entire workforce will soon basically have been trained some place else?
    I’m sure the leader of the RCGP has the answer
    She’s a right wiz. Maybe we should train everyone with an app...phenomenal

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  • How much of inbred intelligence do you need to become a Sir? Zero.
    All you need is money or a pedigree.
    How much intelligence and hard work do you need to go through medical school - Unlimited.
    Yet a Sir deems that the medic out of School needs 5 years to further train as a GP. At his level of intelligence, this is justified though for people with brains, it is a crazy idea especially when we need GPs asap.

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  • The training is 5 years at the moment. I am not suggesting any lengthening of the time. My point is that 5 years should be based in general practice. We should train our GPs. This would also give enormous support to general practice that is struggling to recruit across the country while enabling junior doctors to have the option of living in one place and have the same trainer and team supporting them for 5 years. Many junior doctors, particularly those with family commitments, would value this choice. Best wishes, Sam

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  • Knowledge is Porridge

    Thanks Sam, didnt realise you included the FY1 and FY2. Very sensible suggestion.
    Also we need to push back on the fashion for "reflection", where nothing counts without some awful reflective statement. During my training I wanted to collaborate with others on building online resources for fellow trainees, but realised my efforts wouldn't count towards my ridiculous learning log which was always short of entries. Dear diary is useless for many people.
    Now I have the same sinking feeling with upcoming appraisal. Although I am enjoying my partnership vacated by a chap who couldn't face another appraisal.

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  • Great idea, but how will hospitals cope with the extra work load without GP trainees to help out? Or is the plan to drastically reduce OP referrals to hospital by training up new GPs as GPsWSIs allowing them extra time and giving them full access to traditional hospital investigations? It is all about how both primary and secondary doctors are spread in a service that can not keep pace with demand.

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  • AlanAlmond

    I didn’t appreciate the idea was to increase the time spent in general practice rather than the length of training. A good idea I guess, you’ll still need some time in hospital though if for no other reason than to understand how they work. One of the problems with some hospital specialists is their almost complete lack of experience of general practice, where as all GPs have lots of experience of hospitals. This experience benefits GPs, lack of GP experience hampers sensible hospital specialist care. how about compulsory placements of hospital specialist trainees in general practice. They need educating too, and we need the staff

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  • Another ingenious plan that will lead to nowhere. The uk never fails to amuse!

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