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GPs buried under trusts' workload dump

Non-GP training posts 'could be capped' under radical plan to boost GP numbers

Exclusive Health education chiefs are set to consider capping the number of trainees entering non-GP specialties under radical plans being considered by advisers to alleviate the GP recruitment crisis.

Pulse has learnt that an advisory group set up by Health Education England to help meet its mandate to boost the proportion of medical graduates going into general practice to 50%, is looking at limiting the number of trainee posts for hospital doctors and other non-GP specialties.

The move comes as a Pulse investigation revealed the extent of the workforce crisis. Data from 8,088 GP practices in England, collected by the Health and Social Care Information Centre, shows that – excluding locum support – 149 practices had more than 4,000 patients per FTE GP and 75 were coping with more than 5,000 per GP.

Growing concerns about the shortage of GPs back in 2012 led former health secretary Andrew Lansley to set out a plan to increase the proportion of trainees going into general practice by 20% to ensure half of all trainees become GPs by 2015. But progress has been slow, with deaneries only increasing the number of GP trainees recruited last year by 95, compared with a target of 3,250 a year.

Pulse understands a GP task force, chaired by Wessex Deanery postgraduate dean Dr Simon Plint, is currently working closely with the Centre for Workforce Intelligence (CFWI) to make recommendations on how to deliver on the number of national training posts required by 2015 and is due to publish its final report soon.

A source close to the task force said it was ‘looking at ways of marketing GP as a career to medical students and foundation doctors, increasing training capacity and resources, capping recruitment into other specialities and strategies to increase retention’.  

But the idea has been criticised by GP leaders who warn the plans are ‘extremely short-sighted’ as medical graduates forced to become GPs will leave.

Dr Beth McCarron-Nash, GPC lead on education and training, said: ‘If you look at the evidence a significant number [are leaving] very early on after qualification – and that is a big concern. I think capping of other specialties and forcing doctors into general practice is extremely short-sighted because they’ll just leave.’

She added: ‘We need to make sure general practice is an attractive career option so we get the brightest young doctors who want to be GPs, and ensure GPs of the future are there for the right reasons.’

Dr Krishna Kasaraneni, chair of the GPC training subcommittee and a member of the BMA Junior Doctors Committee, agreed that medical graduates should be motivated rather than forced to join general practice.

Dr Kasaraneni said: ‘I don’t want anyone to be forced into general practice, they need to be encouraged to pursue that as an option. It’s not that hospitals are over-filled with consultants – we still need doctors in both primary and secondary care, but we need more GPs and any innovative way of making it happen we are open to.’

A spokesperson for HEE would not comment on the plan to cap specialities, but said: ‘We are anticipating a requirement in our refreshed mandate to report later this year on training requirements for the GP workforce and the information in the taskforce report will be one of the resources we look at as part of that wider work.’

Information from the CFWI report into the GP workforce last year showed there was a doubling in the number of hospital consultants trained between 1995 and 2011 and a 50% rise in other non-GP specialists, compared with only a 30% rise in the number of GPs.

Investigation: Are we running out of GPs?

A Pulse investigation has found that 21 practices across parts of London, the North and the Midlands are facing as extreme a situation as one area in North-East Essex, where NHS England has stepped in to help with recruitment, with one full-time GP serving more than 8,000 patients.

Click here to read the full investigation.

GP density map - large - online

Readers' comments (40)

  • Once again all anonymous except one response. If for some strange reason a health minister did read Pulse then they wouldn't pay any attention to responses because they wouldn't know who to contact about their opinion anyway.

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  • GPs need to be careful. if there is a shortage of GPs in the future and practices are unable to cope, its a good excuse for the DH to offer GP contracts to private companies. Now you might say (anonymously of course) that the private sector will struggle even more than the GPs based on the current contract, but what is offered will not be the same. No NHS Pension, No rent reimbursement, No IT costs covered, etc. Salaried GPs paid by a private company.

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  • Bob Hodges

    The flaw in your logic there Brian is the assumption that private companies would not only be able to find enough appropriately trained GPs (who current lack of existence is threatening the service) to deliver primary care, they'd also be able to employ them at a fraction of the cost.

    It don't make no sense!

    The more likely alternative is widespread collapse of the service in large areas with huge electoral consequences, unless there's industrial scale Gerrymandering, followed by a free market in GP skills and labour resulting is services rendered to the highest bidder.

    Do you think I'll be seeing patient for a fiver a pop for Serco or CareUK?

    Flesh will be denominated in KILOS not pounds!

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  • Vinci Ho

    Vinci Ho | 03 February 2014 8:42pm
    Typical right winged bullying government --
    What about blocking girls going into medical schools or women becoming GPs because politicians were moaning female doctors being a burden of NHS? Ba***rd

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  • Hey, I thought the submission to the pay review body was that there was no problem with recruitment or retention, so no increase in pay - in fact , cut wages = GPs earn too much and play too much golf. I think we are getting our Kers in a twist over nothing. There are lots of unemployed GPs playing lots of golf. FORE ! is right.

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  • And employed ones playing lots of golf as well.Fore!!

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  • Brian Austen - how would giving GP contracts to private companies increase the number of GPs available? I've heard this strange assertion before, the suggestion that if you made all GPs salaried and forced them to work 'efficiently' for less money on crappy contracts with no NHS pension suddenly you'd solve the work force crisis and they'd be GPs everywhere clamouring to work in areas of need on a sunday….how does arranging health care provision for the benefit for shareholders in private companies increase the avalibale GP workforce?…greater efficiency perhaps? …more use of nurse prescribers?... I don't know ...perhaps you could explain

    On another tack I personally post anonymously because I'm not at the end of my career and need to remain in a job..which I suspect is the case for many others...not rocket science really - congratulations on not being in this position but not every body is... had this not occurred to you??

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  • anonymous 11:00pm- be brave! why are you worried about loosing your job???? there are loads of vacancies out there... and even better ones abroad... ......best thing that could happen the profession is a mass exodus..... if one looks at the shortage in the US, Canada, Australia and New Zealand every GP in the UK could take up a post abroad....... and then we could all send the health minister a post card thanking him for inspiring us to take up a new life abroad....with a PS asking him how he is getting on in the Uk without GPs.

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  • There is no crisis just alot of hyperbole.Recruitment in any sector of the economy is cyclical and varies geographically.Vacancies in rural and inner city areas have always been the most difficult to fill.That is nothing new.Medicine remains the most popular subject for university graduates and there is only a finite capacity to absorb them all into secondary care posts.Ergo they must side step into general practice.A few may leave or emmigrate but that is proportionately a tiny figure.General practice will do just fine.

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  • "Do you feel lucky, punk ?"

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