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Training bosses introduce further round of GP trainee recruitment in 'desperate' bid to plug shortfalls

Exclusive: Health education managers are running an unprecedented third recruitment round for GP trainees in the autumn as part of a ‘knee-jerk’ bid to fill the gaping hole in trainee numbers, Pulse can reveal.

This is the first time that graduates have been given a third chance to apply for GP training posts, and comes after Pulse revealed that as many as 40% of training places were going unfilled in some parts of the country.

The GPC said that the plan for a third round of intake is a ‘knee-jerk, short-term’ solution and that there are few graduates remaining who could fill the places.

The announcement of the third round comes as Health Education England said it was running a ‘pre-GP’ year spent in hospitals for trainees who failed to pass the assessment stage for GP training, while the GPC accused HEE of ‘burying’ a report on a long-term strategy for increasing GP recruitment.

The Department of Health mandate for HEE requires them to ensure 3,250 graduates enter general practice every year by 2016, which in itself represented a one year extension to the original deadline, after a surprise 15% drop in applications meant they were unlikely to achieve the 2015 target.

Pulse revealed that HEE was way short of its figures this year, with only 2,564 of positions filled in England, representing 87% of those training posts available, which is a decrease onthe 2,764 positions filled in August 2013.

A spokesperson for HEE said: ‘We are holding a third round of GP recruitment this year. It is the first time this has been done and is part of a range of measures we are taking to help increase the number of GP trainees in line with our mandate target to provide 3,250 places by 2016.’

‘Other measures include a review of the GP recruitment process, development of a pre-GP year for prospective applicants and careers advice for foundation doctors and medical students.’

Dr Beth McCarron-Nash, a GPC negotiator and a GP in Cornwall, told Pulse that standards shouldn’t be allowed to slip in order to plug gaps in recruitment, and that a Government drive to promote general practice was needed.

She said: ‘What we want is quality general practitioners, and we need to make sure that what we do is we continue with the same high standards necessary to actually recruit into general practice.’

‘My concern, obviously, is that to me this smacks of desperation. And actually it’s not the way to solve the recruitment crisis we have in general practice, they need to think about addressing the problem and this will not address that.’

‘It is a knee-jerk, short-term, inadequate solution to a much bigger problem. We need to start addressing the reasons why people no longer want to train as a GP, and why – once they do – a significant number are leaving.’

Dr Krishna Kasaraneni, chair of the GPC trainee subcommittee told Pulse he had his doubts about the scheme’s effectiveness, as there was no surplus of medical students waiting to choose a speciality.

Dr Kasaraneni said: ‘If it works, fantastic, but somehow I don’t think it will. My understanding of it is that all the specialty placements are filled, but I think psychiatry and general practice are significantly under-recruited. If you look at the sheer numbers, general practice is by far the worst.’

‘And if there’s no interest already in the normal rounds, there’s not going to be that many people who are out of sync who decide to go for the third in the middle of the year.’

‘Since 2007 when modernising medical career s happened, general practice hasn’t had a third round… I don’t think it will work, but they can try.’

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  • Krishna Kasaraneni

Readers' comments (43)

  • You GPs have been beautifully stitched up. For years the Govt and its dogs in the press vilify GPs thus creating a public mood against GPs, Then strangle general practice with lack of funds and over-work on rubbish bureaucracy. Patients wait ages for appt which they have now been trained to blame on GPs, not the Govt. So there is a public mood for a change, no public sympathy with closing practices, the nice Govt steps in to replace your failed practice and its greedy GPs with lots of triage nurses so there are appts available now and the triage nurse refers you straight to hospital which is what the patient really wanted anyway regardless of its appropriateness, hey presto the public is pleased that general practice is gone.
    Just watch, that is what will happen with the practice in Bristol that has announced it is closing.

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  • 12.30 I agree GPs have been stitched up very successfully by the government. I don't remember this degree of vitriol when the dentists were partially privatized. What is worrying is how little resistance there has been from our leadership who seem to have been complicit in MMC/CQC/revalidation/CCG reforms which makes one wonder how many people are working from the inside on the privatization by stealth plot. It remains to be seen whether there will be large suburban areas devoid of primary care as the loss of GPs will at first be confined to geographically isolated regions and poor boroughs where recruitment has been historically problematic and patients don't have a voice. Obviously flogging off the remnants of primary care services in the regional cities will only be possible if there are enough doctors of whatever ilk to fill the gaps but this is unproven and experiments with nurse led care and polyclinics have to date proven costly to implement.

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  • They don't want more GPs or Nurses - they want physician's assistants and HCAs to drive the wage cost down.

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  • I think we have been stitched up, just as the practice manager has very astutely suggested...however I do think GPs themselves are partially responsible for the situation that they are in;

    The new contract was never going to go down well with the public, giving up OOH and a higher salary has generated the impression that the tax payer has been hugely ripped off! Instead the negotiations should have focused more on reducing patient demand, more public awareness about self limiting conditions, tackling the medicalisation of social problems and other provisions such as the issuing of sink lines taken away from Primary care.
    The RCGP had previously done very little from a PR point if view to counter the Daily wails vitriol, but I'm glad that Maureen Baker is now more proactive at this.

    Finally, had I known that a lot of a GP partner's time is spent doing admin, QOF and also having to take on the added financial responsibility of staff sick payments etc I would have reconsidered my application into GP. I became a doctor to see patients, not to be a number crunching administrator dealing with social problems that have no remedy that we can offer.

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  • Fundamentally you cannot replace GPs with trained nurses and practitioners, no matter how much you want it to, this will never work or be accepted in an industrialized society and is likely to inflate costs further in the long run (see 111/Darzi-centres).

    People forget that the 2004 contract was introduced the last time GPs were on there knees and chaos beckoned but a cash fix was only ever going to go part way to fixing primary care. This time it's worse because we have financial problems, a workforce crisis and regulatory failure. There really is no easy way out and I doubt Mr Branson and chums can do it all.

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  • remember there is a niche for nurse practitioners etc but it is just that. They can be a useful adjunct thats all

    Look at the USA, Physician Assistants were pushed and they have a limited use, but have they taken over no. In many ways because of the rising costs they are looking to support primary care ( via insurance companies) to try and reduce cost

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  • I'm glad that Maureen Baker is now more proactive at this

    What are you smoking, she's been behind the story every time. Notice how she's not available to the media on weekends. Look at her performance on the daily politics - unable to correct simple factual errors.

    I assume she has strengths - dealing with the media is not one of them

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  • Of course it will be more expensive to have nurses referring everything to hospital, but that is the plan!
    Who stands to make a lot of payment by results income from lots of referrals? The hospital. Who expects to increase the size of his/her dept due to all the extra referrals, and thereby gain more salary and prestige? The hospital consultant. Who is in pole position to talk to the CCG and offer to take over the failing practice? The hospital that will be referring to itself. Who dominates the BMA? Hospital consultants. Which doctors does the Secretary of State or DoH listen to most of all, if any? Hospital doctors. Which doctors does Jeremy Hunt come into contact with regularly when he does a hospital shift? Hospital doctors. Which GPs does JH do a shift with? None, never.
    They are all telling JH and DoH how bad GP is and how they could run it much more cheaply whilst omitting to mention the other side of the coin that the hospital bill will go up by several multiples of the saving on GP.

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  • It would be quite interesting if hospitals took over primary care because it would end the internal market that our governments have been so obsessed with. If it did happen I think doctors would have a more unified voice and become much more powerful so I doubt the DOH would actually allow it.

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  • locumGP @ 2.49
    The take-over of primary care by hospitals has already been happening and DoH certainly isn't blocking it.

    http://www.gponline.com/hospitals-primary-care/article/1229322

    http://www.hsj.co.uk/primary-care/leading-foundation-trusts-explore-moves-into-primary-care/5066280.article

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