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Gold, incentives and meh

What can be done to solve the GP recruitment crisis?

Three GPs consider what needs to be done to solve the GP workforce crisis

‘Make general practice more attractive’

dr Krishna Kasaraneni

The constant criticism of GPs in the media does us no favours. The public and the NHS need, and deserve, more GPs and the perpetual GP bashing needs to stop immediately if we are to avoid a severe shortage in the very near future.

There is also a misconception about what general practice is about and what GPs actually do. It needs to be promoted as a positive career choice rather than a ‘back-up’ if nothing else works out.

Even with greater efforts around recruitment, this will only offer a long-term solution – especially with plans to extend GP training to four years.

Dr Krishna Kasaraneni, chair of the GPC trainees subcommittee

‘Remove barriers for returners’

Dr Maureen baker - online

We put up huge barriers to people who we have trained at great taxpayer expense and we positively prohibit these doctors from picking up their careers again in UK general practice.

I query the appropriateness of these routes onto the performers’ list. What we’re proposing is to work with others, to agree a set of principles around safe, proportionate return to general practice.

Someone who has been working in general practice in, say, Australia for three years has needs in terms of supported return that are likely to be very different from someone who has been out of practice completely for eight or nine years.

We could potentially have a short-term surge in the general practice workforce just by getting the best out of the potential for returners.

Dr Maureen Baker, chair of the RCGP

‘Fix the leaky bucket’

Dr Beth McCarron-Nash online

The evidence shows we’re training more GPs but many are choosing to work part-time because of the issues of burnout, many are going abroad and practices are finding it very difficult to forward-plan because funding is so uncertain. It’s a perfect storm for a recruitment and retention crisis.

We need to focus on the ‘leaky bucket’ – there is no point pouring more in at the top when so much is seeping out of the bottom. Many GPs are considering retiring early or working part-time in order to cope with stress.

We need a national workforce solution. At the moment the policy is to devolve workforce planning right down to the [local education training boards] and local priorities – but since that national resource structure has been subsumed within local budgets, funding is only happening in a piecemeal fashion.

Dr Beth McCarron-Nash, GPC negotiator and a GP in Cornwall

Read the full investigation: Are we at risk of running out of GPs?

Readers' comments (30)

  • I completely agree with Dr McCarron-Nash. I have the capacity to work more but not under the current system, i feel i would burn out! Am currently planning my exit strategy. If working in General Practice improved then i think we would have many GPs happy to increase their working hours and less of a need to train larger numbers of GPs. Its not rocket science to acknowledge this situation is the same for many .........but no-one seems to be listening!

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  • Senior partner announced retirement 2 years early
    ( stress and work load) next oldest has just cut his hours ( same reason)
    Leaves only 2 full timers one who has just informed me he has asked accountants to look at reducing hours for him
    I will follow ... It is now virtually insanity to work
    9 clinical shifts with all the stress and work load.
    What's the point of heading to an early grave.

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  • anybody thought about sorting out the csa. expensive exam that a lot of trainees have lost faith in?

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  • keep gp training to 3 years

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  • Bob Hodges

    Why bother with 3 years at all? After all it's such an easy job that just the certificate is enough isn't it?

    Round of golf follwed by light-hearted pub quiz in the club house would do the trick - diplomas all round!!

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  • here are some ideas ...

    1. increase costs of being a doctor (fees / living expenses) to say £250,000 real term debt
    2. increase length of training to say 4 years
    3. increase age to retirement to say 70
    4. increase pension contributions to say 15%
    5. have a real term cut in income by 10-20%
    6. force gps into 24hr day 7 day a week (coming soon) responsibility / blame for patient care
    7. show no compassion to ill drs
    8. bully female gps to make them feel guilty for going part time or wanting families
    9. allow GMC to bully doctors who are guilty until proven innocent
    10. have a union and college which does 'jack for you' at a hefty cost
    11. make the job as risky as possible
    12. increase yearly costs of being a gp (MDU, GMC fees)
    13. get the blame for everything in society
    14. stop those who actually want to be GPs (imgs) by having an unfair examination process.
    15. force those that want to do hospital medicine into GPVTS.
    16. transfer the whole service to federation and salaried posts (coming soon) thereby destroying the whole point of being a GP and in short destroying the profession.
    17. do nothing to tackle demand

    basically increase the sticks and remove the carrots

    that should do it - i can see them queuing up now!

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  • Hear, Hear, to all the above.
    just record an extra voice saying same!

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  • Bob Hodges

    Indeed.

    Floggings WILL continue until moral improves.

    Class rant! Respect.

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  • i agree with 10:37's post, that's your recruitment problem in a nutshell

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  • Anonymous 10.37am has it in a nutshell.
    Although it has to be a coconut shell to contain all of the negative forces against GPs at the moment.
    Still, it is all part of the long game to get rid of the traditional GP so that the private companies can come in and take what they want.
    The government [for some reason] does not worry about how horribly expensive a reduced service will be simply because the service which [strangely] still runs on goodwill, will no longer be able to call on that.

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  • Bob Hodges

    For an extra £20 per person per year, the whole of GP could be radically upgraded. That would bring in £120,000 to my 6000 patient practice.

    The vast majority would be spent employing new staff and a new partner if we coulf find one.

    TWENTY QUID PER YEAR!

    By trying to claw back a couple of quid per patient per year thye are ensuring the whole thing will collapse.

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  • Where is the attraction of General Practice? When you look at your hospital colleagues who are treated as equals; sure you may be at the bottom but no one thinks of you as a "longterm servant" you do your time and move up unlike those Partners who have abused the salaried GPs . Yes they talk about the generous BMA contract but hardly a single salaried post is given that in its fullness. Of course the Partners are working harder than those slacking no prospect salaried colleagues... choke! choke! ...but the reality is just not true. The junior doctors look at this model and turn away. Partners versus Salaried has filtered into reality and the job looks fixed/poorly paid and unglamourous not so the consultant. Is anyone surprised????

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  • Well done 10.37. This is the most accurate assessment of current General Practice I've read in a long while. Shame our Union, Professional Bodies and Representatives in CCGs are a bunch of deluded wannabe politicians and too many of our colleagues are obsessed with their public image or held ransom by their fear of being branded 'non-caring'.
    General Practice is doomed.

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  • I've already commented (but lost in your web!). BUT I'd remind you all that BMA was in league with political parties, didn't represent doctors (yes, it was lied to and confused by hot-air 'carrots' of GP responsibility). Doctors reps must take some blame for the disaster of the current NHS, and its supporters in Westminster, the media and the greedy biguns in USA. It's time to fight for our NHS! Decent. Democratic. Skilled. Cheapish. Effective.

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  • Unfortunately it will take time to change in present scenario and there will be many who have ejected or are in ejection mode from present day General Practice. Of course fewer GPs give good care to increasing and increasingly elderly population as our enlightened politicians will tell you and earning salaries which is a dream so should be published for the public. I do miss my golf course and nice lunches not to forget the yachting I used to do everyday as my previous practice was next to th beach- sorry just kidding to Jeremy and his pals

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  • 10.37
    I agree entirely, the most accurate list of issues I have seen too.
    Why don't you apply to be our new representative on the GPC or start a new union which would actually represent grass-root GPs views?
    The well meaning drive to increase standards and reduce costs without any consideration for the human beings involved has destroyed general practice. Add to this the less well meaning determination to give general practice to private companies and we are truly sunk.
    I get the impression that a large number of GPs left in December ( like me) and even more will leave in April.

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  • PS...
    Things are MUCH worse now than in 2003.

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  • 10.37- How wonderful - Here's a few more.
    40 + consultations a day at £ 3.00 take home. Tendering, federating, competing. CQC inspections that wish for disposable sygmo cuffs. Not one person would stay if they did not have a family or mortgage or debt.

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  • Up to 30% of GP appointments are musculoskeletal conditions such as neck and back pain. The experts in this field are physiotherapists who can now prescribe medications. Meet the demand of patients and address the crisis in insufficient numbers of GPs by making physio's the first point of contact in GP surgeries. Simple.

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  • It's funny, everything pointing to a shortage of GPs, but whenever I try and negotiate for some straightforward services ('flu immunisations, health checks,) to be commissioned from community pharmacies to reduce demand on GP workload I always have a battle on my hands- I can only presume that things can't be that bad after all!

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