How the 5,000 GPs target has been watered down
Pulse tracks how the health secretary's pledge to increase the GP workforce has been continually shifting
Former health secretary Andrew Lansley announced a target of 3,250 of medical graduates going in to general practice every year - 50% of all medical graduates.
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Health secretary Jeremy Hunt first made the pledge for 5,000 extra GPs by 2020 at the Conservative Party Conference. He also suggested that the UK would be self-sufficient with regards to the GP workforce.
He promised: 'I can today confirm plans to train and retain an extra 5,000 GPs.'
The DH continued to take this line in the lead up to the 2015 general election.
Mr Hunt reiterates the target in his so-called ‘new deal’. However, in the subsequent Q&A session to the announcement of the ‘new deal’, he admits there will be ‘flexibility’ in the target due to some areas finding it difficult to recruit.
He said: ‘We’ve said that we want the overall increase in the primary care workforce to be around 10,000 of which we anticipate around half will be GPs. But we are leaving some flexibility because in some parts of the country it is very hard to recruit GPs.’
Two days later, he puts more distance between himself and the target at the Health+Care show in London, claiming that 5,000 was the ‘maximum’ the Government could hope to achieve.
Mr Hunt said: ‘I talked about recruiting 5,000 more GPs on Friday. In truth, we think that is the maximum that we would be able to increase the GP workforce by, over the next five years. Given the time it takes to train new GPs; given the potential number of people who we can persuade to come back into the profession.’
The DH says that its baseline for these targets will be the September 2015 GP workforce figures released by the Health and Social Care Information Centre (now NHS Digital).
The health secretary confirms that the target is now ‘5,000 more doctors in general practice’ when talking about his plans for the new GP contract.
This subtle shift – away from ‘5,000 extra GPs’ – is significant. The new target includes trainees, and not only fully trained GPs.
A health minister casts doubt on the Government’s ability to meet this target. Lord Prior – the former chair of the CQC – told Parliament: ‘The workforce is a serious issue. We are committed to finding 10,000 new GPs or GP equivalents in general practice by 2020 and we have increased the number of training places by 3,500 from this year and going forwards. To be honest, there is a risk whether we will be able to get that number of people into general practice. However, without that kind of workforce commitment it will be difficult to deliver our ambitions.’
Estimated changes in gp numbers by 2020
A Pulse analysis of workforce figures reveals that the promise of 5,000 extra GPs (doctors) is a long way off, as the number of GPs leaving the profession through retirement or emigration is almost equal to those coming in to the profession.
The GPC’s education, training and workforce subcommittee chair Dr Krishna Kasaraneni said: ‘The political pledge to recruit 5,000 GPs by 2020 is wholly unrealistic. Pulse’s data analysis shows how short we are likely to be.’
NHS England’s GP Forward View reiterates plans to increase GP trainee recruitment by 3,250 a year in order to ‘support net growth of 5,000 extra doctors working in general practice by 2020’.
To achieve this, it said it would start a ‘major recruitment campaign’, targeted £20,000 bursaries in areas that have found it hardest to recruit, a new retention scheme to attract GPs to stay in the profession and scheme to attract UK-trained GPs who have left general practice back into the system.
NHS Digital figures revealed that the number of full-time equivalent GPs had decreased by 221 between September 2015 – the baseline for the 5,000 extra GPs target – and March 2017, meaning the Government had to increase the workforce by 5,221. It had also decreased by 36 in the first year since the GP Forward View.
NHS England chief executive Simon Stevens announces that the overseas recruitment scheme is to be quadrupled, with an aim to recruit 2,000 GPs from overseas, up from the 500 specified in the GP Forward View.
He admits: ‘The conclusion we’ve come to is that in order to increase the likelihood of being able to have 5,000 more doctors in general practice, we are going to need… a significantly expanded industrial scale international recruitment programme. We intend to launch that in the autumn.'
NHS Digital figures reveal there are now 350 fewer GPs than in September 2015, the baseline for the 5,000 target.
He says that this isn’t to meet the 5,000 target, and that NHS England want as many GPs in the system as they can get…
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…however, it emerges in the procurement note to recruitment agencies interested in finding these overseas GPs that the ‘2,000 to 3,000 of those 5,000 GPs [specified in the target] may be recruited from overseas’.