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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)

  • The solution to attract new GPs and retain existing ones is to make the conditions better than they are now. Forcing people into jobs that they don't want to do won't help the crisis - they will simply leave at the other end. Ultimately, this will filter down to medical school applications and the best potential entrants will realise what a hostile environment Medicine provides - they will simply go and do something else.

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  • So they are essentially forcing many doctors to choose GP as a vocation indirectly and as a eminent Professor one said "GP is a most difficult job to do well and easiest job to do badly". People forced into General Practice woul more likely to have burn out as General Practice tends to have high levels of uncertainity compared to other specialities and hence if psychometrically not suited to some doctors who would shine in some specialities but not in others. Why not make general Practice more attractive!

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  • You can take a horse to water but you can't make it drink! Especially when it is a stinking sludge pile! Why not invest in some "flood defence" and "environmental conservation" and educate the public about being responsible with the land and it's resources. That way you'll have clear waters lapping gently at a shore lined with an array of wildlife eager to drink...... This is a bullying government threatening to bully people into jobs they do not desire. Patients will be worse off for being treated by someone who wishes they weren't there. FFS just stop attacking and build up UK general practice into what it should and could be

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  • I am counting down the days to retirement now - had one career then retrained as GP. In the space of 12 months both my jobs will be taken over by social enterprises and I spend my time wading through drivel from managers. very relieved neither child wants to do medicine - they have managed to put some of their classmates off too,

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  • The short term boost in GP numbers will be more than countered by newly trained GPs leaving as they feel forced to do something they do not want to do. A profession which has to force people against their will will be even less attractive when filled with miserable resentful people.
    In addition, denying specialist training after 7 years to those who started out with an aim to do something specific will make medicine a less attractive option for all entrants to medical school. Those that can will go abroad for further training after F2.

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  • The better option would be to make hospital medicine as equally crap as general practice to even things up....

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  • Don't worry, they are doing their best to make medicine crap for everyone!

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  • They want to bring down the whole NHS and lay it at the door of GPs who were trained but "couldn't be bothered"! Yet again it's the "lazy GPs!!!...." Whilst the f2s will emigrate also no one in their right mind will remain a UK doc. Good luck Joe public, don't forget to switch off the lights when youre the last ones to leave!

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  • The conditions of work must improve or the financial reward to compensate for the difficulty of the task must increase . For an administration that proclaims the advantages of a free market economy it is being wilfully obtuse.

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  • The numbers of trainees are revised almost every year and the trainee numbers depend on projected demand for that speciality. It has never been a open market in that respect ,that you can choose to train in whatever specilaity you want to train in. Prior to Calma the cut off point was at Senior Registrar trianing .Since Calman a trainee once recruited into a speciality subject to satisfactory asessments proceeds to end of training.This is not a exact science so no guarantee that there would be a post at end of training . However there is little point in training if there is not a reasonable prospect of empoyment in NHS at end

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