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Independents' Day

'Train non-GPs to fill vacancies'

By Helen Crump

More nurses and medical care practitioners should be trained to fill GP vacancies, an LMC is arguing.

Avon LMC has said replacing all leaving GPs with another GP and not using skillmix is 'neither feasible nor desirable' for the future.

The comments have been triggered by research the LMC conducted in Bristol, North Somerset and South Gloucestershire. It found that although the region required the same number of GPs to be trained year on year until 2010, it was 'not a viable option' to ignore skillmix.

Avon LMC concluded: 'Given the current trends in working practice, replacement of GP with GP to meet current and predicted demand is neither economically feasible nor desirable.'

The LMC has called for the introduction of courses to boost training places for medical care practitioners because there was a lack of evidence that there are enough nurses wanting to fill these roles.

Relying on physician assistants, who are trained abroad, to fill the gap 'is not considered a strategic move for the long-term', it said.

The report advocated 'golden handcuffs' for GP and medical care practitioner trainees to tie them into jobs in the area after qualifying in order to cover the cost of training.

Steve Mercer, Avon LMC chief executive, said GPs needed to 'consider more radical workforce options'.

When GP shortages began to bite, unpopular areas would be likely to face private tenders and independent companies would be likely to consider skillmix models, he added.

Mr Mercer said: 'It's going to be a skillmix model anyway so why don't we grasp the nettle?'

But the LMCs findings were questioned by GPs in the region, who argued that lesser-qualified staff could not replace doctors.

Dr Stefan Cembrowicz, a GP in Bristol, doubted whether the the medical care practitioner role would offer any more than nurse practitioners: 'The evidence is nurse practitioners are not any more cost-effective than GPs because they take more time and have a lesser range of roles than a GP can manage.'

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