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Senior consultants could finish career in general practice, says education lead

The chief executive of Health Education England has suggested that hospital physicians could be encouraged to spend the last few years before retirement in general practice to help solve workforce problems.  

Speaking before the Commons Health Committee, Professor Ian Cumming said he would like to see the performers list reformed so physicians who want to ’work on a much more structured basis’ could work in primary care. 

He also told MPs that 676 trainees have applied for this year’s third GP training recruitment round, compared with just 100 applicants at the same stage last year. 

Professor Cumming suggested that the increase might be attributable to the ’controversial’ marketing campaign it is currently running - ‘Nothing general about general practice’.

He said that they are unclear about how many of these 676 applications will be accepted, but the figures are a marked improvement on last year when HEE took the ’unprecedented’ step of a third round, which fell flat with 12% of places left unfilled nationally.

Pulse revealed earlier this year that some areas were left with 40% of positions left unfilled, with around 380 of the 2,950 nationwide posts left unfilled. Professor Cumming admitted that applicants are still preferring London and the South East, to the detriment of areas such as the East Midlands and the North East.

Professor Cumming also said that practices had to do more to take on medical students and trainees, adding that it was ‘fundamentally wrong’ that some practices, including ’super practices’, had decided they would no longer take undergraduate trainees. 

He also attacked the NHS’s ‘invention’ of health and safety regulations, which he claims block young people from doing work experience in practices or hospitals.

This was the first meeting of committee’s enquiry into primary care and focused on the Primary Care Workforce Commission’s (PCWC) ‘The future of primary care: creating teams for tomorrow’ report, which highlighted the benefits of practices to recruit paramedics and admin assistants.

Also in attendance were lead author of the report, former GP and professor of health services research at the University of Cambridge Martin Roland, and Greg Allen, managing director at the Centre for Workforce Intelligence.

Professor Cumming also told the committee that:

  • HEE has commissioned a review into undergraduate medical education to ’encourage people to be GPs, and embed more of the training in the community’, which will also look at remuneration for GP practices taking on students;
  • The RCGP is developing a costed plan for implementing the recommendations in the PCWC report, which will be presented at their session with the committee;
  • HEE hopes to see physician associates to be regulated and given powers to order x-rays and prescribe independently. Pulse has already shown the Department of Health was reviewing the implementation of prescribing;

Giving the example of a senior hospital physician who’s responsibility for working nights meant they were ‘likely to retire in their mid to late fifties because they can’t cope any longer’, Professor Cumming said: ‘In my personal opinion, that individual, if we could keep them and use them in primary care, would be an absolutely invaluable resource to a big practice.

‘They could work on a much more structured basis, Monday to Friday, nine to five. They could work alongside GPs, help manage the flow of patients into secondary care, reduce that and help take people out of hospital earlier.

‘So why doesn’t that happen at the moment? One of the reasons is that the performers list gets in the way, they can’t get onto it.’

On the increase in third round applications, Professor Cumming suggested the rise might be attributable to HEE’s recently launched ‘Nothing general about general practice’ promotional campaign, which was criticised for focusing on the administrative aspects of being a GP.

He told MPs: ‘We’re running a campaign at the moment, it’s controversial in some sectors, but it’s a marketing campaign called ”Nothing general about general practice”.

‘It’s to try and encourage young people to consider general practice, and we have seen 676 people apply for round three training. Whether or not there’s a direct link, we don’t know yet.’

‘But 676 applications for round three, when we consider last year we were in the area of 100, is a very, very, significant increase in levels of interest. How many of those turn into actual posts being filled, we don’t yet know.’

Professor Cumming also spoke strongly about the need to make GP practices take on more trainees in spite of current workload pressures.

He told MPs: ‘It’s difficult at the moment because GPs are under a lot of pressure and asking them to take more trainees, be they physician associates, or nurses, paramedics or whatever, is a challenge.

‘But we have to do it. Because if we don’t do it we’ll never get out of the workforce difficulties we have.’

Readers' comments (80)

  • That's marvellous news.All this talk of a "crisis" was hot air after all.

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  • Education lead and you think that "senior hospital physicians can take on salaried roles in general practice before retirement"- hard to think of a more uninformed or disparaging view.

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  • I remember decades ago when consultants and registrars did OOH, they are fine in there own field but outside that in GP land caused problems.

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  • This suggestion denigrates the specialism of General Practice.
    I assume that hospital consultants will have an abbreviated training ,as all hospital consultants now practice in a very narrow area of medicine!
    Perhaps their training could be in areas of the country where they are most needed like the Welsh valleys and Teeside.
    Feedback please.

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  • Is this a process of turning a silk purse into a pig,s ear?

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  • Sadly this is very poorly thought through.
    It creates the impression that anyone who is "senior" can do general practice.
    The fact that general practice can simply be provided by "about to retire" and "doctors who can't cope with their current post" consultants is appaling and insulting.
    Do you have any awareness how stressful primary care is - this move could finish them off!!!
    Also what will the quality for patients be? We are working hard to ensure a reduction in inequalities in primary care and this will potentially worsening the situation.
    Also to state that these consultants would be able to fall into a 9to5 job in primary care simply doesn't recognise the fact that primary care works 0800 to 1830 and beyond and Saturdays!!! How does this new resource fit into the reality of that?

    There are however some positives here.
    If there are senior and specialised consultants ready to "fall" into primary care this could address some of the commissioning challenges regarding shifts of care etc...

    Some windows of opportunities are here but this should only be used as an approach if these senior consultants are fully trained to work in one of the most complex, challenging environments which is indeed primary care...

    Work this one through a bit harder and there might be something in it... Possibly... Maybe.... Hmmmmmm

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  • How offensive and condescending to GPs. What makes Professor Cumming think that the skills of senior hospital consultants are any more transferable to General Practice than the other way round? As a GP, I specialise in the general, the management of uncertainty and undifferentiated illness - in a population of patients with whom I have built up a trusted relationship. The good Professor's attitude smacks of the old 'GP as failed consultant' myth - just plain wrong.

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  • So burnt-out old farts like me can move into general practice for a cushy life until retirement? No, it sounds bollocks to me as well!

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  • LOL - and maybe senior GPs can return the favour by doing part-time neurosurgery before we retire!

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  • Crazy out of touch suggestion. "The retired opthalmologist will see you now about your period problems." We force the trainees to pass CSA/AKT etc for good reason.

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