RCGP and BMA attack Government’s ‘unintelligible’ plans for GP training shake-up

By Laura Passi

GP leaders have launched a scathing attack of the Government's proposals to reform GP education and training, and urged ministers to reconsider.

The RCGP called the plans, published in December and outlined in the white paper Liberating the NHS: Developing the Health Care Workforce, ‘unintelligible and confusing', while the BMA said the pace of change was too fast and could further fragment the NHS.

The DH consultation listed a number of proposed changes to medical education, which would see the abolition of deaniers and a move to a ‘bottom-up' system as part of the NHS reforms.

But the RCGP said it has ‘very serious concerns' regarding the redesign of the medical training structure - and also chastised the DH for leaving out vital details.

The College's response said: ‘We support the principle of seeking to improve quality and efficiency, but believe that reform should be evidence-based, and tested by rigorous evaluation … many of the proposals in this paper do not meet these standards, are likely to result in negative consequences for the future healthcare workforce, particularly in primary care, and ultimately may lead to poorer outcomes for patients.'

'Many of our members, including senior experts in the field of medical education, have found aspects of this paper unintelligible and confusing,' they added.

The DH plans call for the establishment of ‘local healthcare provider skills networks', to oversee the commissioning and delivery of education and training at a local level. These groups will in turn be overseen by a new statutory board called the Health Education England Board, which will be responsible for allocating money to local groups and holding them to account.

BMA chair Dr Hamish Meldrum said: ‘The plans for medical education and training could be very damaging to the NHS because of their lack of detail, the overly ambitious pace of change and the failure to consider effectively their impact on medical training and patient care.'

‘Moving away from a national – or, even better, a UK-wide - approach to the management of workforce planning is particularly worrying as it risks introducing a postcode lottery for medical training and ultimately patient care. At a time when so much change is planned for the NHS in England it would make more sense to build on the current system rather than embark on a revolution with hugely uncertain outcomes.'

The BMA also opposes the abolition of deaneries and believe the separation of its roles into various different organisations could undermine the quality of GP training.

Dr Tom Dolphin, co-chair of the BMA's Junior Doctor Committee, said: ‘The Government's plans will effectively abolish the postgraduate medical deaneries which provide important local scrutiny of the quality of medical training and ensure patient safety is not jeopardised by poor training.'

He added: ‘The Department of Health are going to some effort to make the skill networks into legal entities so they can form contracts with employers. As far as I can see they may as well spend that time and effort trying to make deaneries a legal entity again so that they can continue to function in the way they did before the SHAs.'

Health minister Anne Milton said: ‘Far from creating a fragmented system, we are making sure existing NHS staff and new recruits can access the best possible education and training to improve services and respond to changing patient needs. This means building on what works well in the current system, and putting a new focus on training through Health Education England.'