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A faulty production line

Workforce strategy needed to prevent 'disintegration' of general practice, warns academic

General practice is in need of an urgent ‘coherent plan’ and ‘robust’ funding for workforce development to prevent ‘further disintegration’ of the profession, an academic has said.

Veronica Wilkie, professor of primary care at the Institute of Health and Society, University of Worcester, argued that preventing attrition in the GP workforce is just as important as recruiting new trainees, in an article published in the BMJ.

Trainees who witness ‘stressed and burnt-out GPs’ are unlikely to choose general practice – regardless of ‘how good the marketing at undergraduates is’, she said.

Work activity in general practice ‘as a whole’ needs to be analysed as well as workforce numbers, to reflect the impact a small change in secondary care can have ‘over and over again to the working day on a practice’, she added.

Her comments come after health secretary Jeremy Hunt recently announced the launch of an independent review to establish how many GPs need to be trained and deployed in each area in order to cope with future pressure on the service. Labour pledged to train 8,000 more GPs to boost the workforce

Professor Wilkie refers to a report published in 1950 by researcher JS Collings that described general practice as ‘appalling’ at the time, and subsequently led to new initiatives.

She claims that the current failings in primary care could represent ‘another Collings moment’, asking ‘how many reports need to be published before action is taken?’

Professor Wilkie highlights the recent publications of Health Education England’s Centre of Workforce Intelligence review and the GP Taskforce report – which both concluded that there are too few GPs and that GPs are under too much pressure to deliver healthcare safely.

She said: ‘What neither report recognises is that students and trainees who witness stressed, burnt-out GPs, who feel isolated and unsupported, are unlikely to choose general practice. This is regardless of how good the marketing at undergraduates is, or how access to flexible postgraduate training is improved. Preventing attrition in the existing workforce is as important as recruiting new trainees.

‘We need a coherent plan for workforce development in primary care, taking into account undergraduate and postgraduate training and beyond, with a robust funding plan that is flexible enough to reflect the local population’s needs but big enough to prevent further disintegration and a lack of investment.’

She added: ‘Work activity in general practice as a whole needs to be analysed — not just outpatient referrals or access — to reflect the change in complexity and the effect that a small change in all areas of secondary care can have, over and over again, to the working day on a practice.’


Readers' comments (4)

  • Vinci Ho

    'Things have their roots and branches, affairs have their end and beginning. When you know what comes first and what comes last, then you are near the Way.'
    from the book , Great Learning , ancient China.

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  • Could not agree more.

    2ry Care - 20 mins or more for ONE problem with access to all investigations

    1ry Care - 7 mins for multiple problems with limited access to investigations and 'while I am here can you also see my brother Peter etc...'

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  • It's like World Trade Centre Building 7 . We all know that the collapse is coming. There is nothing any one can do . When it comes it will be at free fall speed. Then it will never be heard of again.

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  • Collings Report Summary from March 1950:

    "The overall state of general practice is bad and still
    "The development of other medical services ... has
    resulted ... in wide departure from both the idea and
    the ideal of family doctoring"
    "Some [working conditions] are bad enough to
    require condemnation in the public interest"
    Inner city practice is "at best. . . very unsatisfactory
    and at worst a positive source of public danger"
    Rural practice is "an anachronism" and suburban
    practice a "casualty-clearing" service
    "An attempt should be made to define the function of
    general practice within... the NHS"
    "Group practice units... should be formed"

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