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A faulty production line

Have we run out of possible solutions to the workforce crisis?

Editor’s blog

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This week saw the publication of the long-awaited report on the NHS’s long-term workforce strategy. To be honest, it was bit of a damp squib for GPs. There was the push to make pensions more flexible - although accountants soon questioned how successful this would be.  

There were another couple of ideas - a new fellowship scheme for newly qualified GPs, and a commitment to promote the potential for working portfolio careers for GPs. I can’t criticise this - I said much the same last year

Yet the interim report seemed to kick the can down the road, promising that there will be more on GP recruitment strategy when the final report is published. 

I fear we may be getting to the point where one of these radical measures will be on the table

I can’t accuse NHS England of not understanding the problem, or not trying solutions. There have been plenty: international GP recruitment, incentives for GPs to stay on or return to practice, marketing campaigns geared towards medical graduates, etc. In fairness, they have managed to increase the number of GP trainees to record numbers. 

But let’s face it, all these solutions are having minimal impact as last week’s updated figures on workforce showed - even those trainees are not guaranteed to stay on, and won’t be ready for a while anyhow. 

It may be that there are no solutions left that we can do in the current environment. It will need radical changes - some I am comfortable with, others I am not. For example: huge investment, which seems obvious, but is not going to happen in the current environment; a cap on workload, which has its problems; charging for care, which is highly undesirable; or ditching the partnership model, which would carry the risk of removing everything that is good about general practice. 

I fear we may be getting to the point where one of these radical measures (and I don’t mean extra investment) will be on the table. 

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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Readers' comments (7)

  • please-delete-this-fucking-profile-i-cant-delete-it-in-my-account-settings

    you can only remain engaged in the debate if you somehow believe somebody is listening, that your ideas and arguments will have some kind of impact and you are contributing in a meaningful way to a great struggle that will (nay has to) save the day ...but i think the reality is general practice is lost and has been for some time. The drowning of general practice is coming, the end is inevitable, we have passed the point of no return. The 'radical measures' you allude to aren't valiant attempts to bring it back, they are simply sad stages in the extinguishing of light. general practice slipped below the surface some time ago, we experience it's hand slip across our fingers as it moves off into the depths. once you accept the inevitability, the pain of the struggle disappears.
    and what we'll get instead?

    anyone's guess but certainly floating, likely made of plastic and mass produced.

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    This isn't new.....I keep coming back to stopping the ambulance chasers and squeezing the money from he solicitors pockets back into the NHS. We spent £24 per patient per year on litigation in the NHS- if there was a statute of limitations, automatic layouts for harm and only the worst cases went to court we could invest more in health care and likely reduce the litigation further by having more resources to deal with it...currently we are going the wrong way. I also suggest that tax reform here is needed to stop Amazon and other online retailers haemorrhaging the cash out of the UK. You are right, what we need is an injection of cash...... nothing else is really going to make a difference....networks further spread out our already thin time......the issue for us is that the solutions are not possible within general practice hence why I feel we need the public to put pressure on the government of the day to invoke the change we need to save general practice and the NHS if we still want it..... its fundamental as to why I dont believe our leaders current approach will get us anywhere.......

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  • The Coroner criticizes a GP for reviewing in 2 weeks rather than 1 week, per NICE guidelines. It is impossible in real life to follow all nice guidelines unless we spend 16+ hours per day and see 60+ patients. Ergo, it is impossible to be a GP. You will get complained about and a single complaint can stop your career, land you in jail for Manslaughter. I would have become a GP now and I will leave next year.

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  • Sorry, I would not become a GP today

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  • There is an obvious change that would help a lot.
    Why are you not mentioning the restrictions on which doctors can work in general practice?

    Any doctor can work in emergency departments or even in neurosurgery but only Gp trainees or fully qualified gps are allowed to do our job. If we like New Zealand or Denmark for example allowed other doctors to work in general practice then we would have more bums on seats in the short term and some of them would stay surely.

    What’s not to like? Unless you are the RCGP etc.

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  • As per All for one the scenario doesnt make sense. Unyielding demand, which we cannot say no to because of fear of litigation, on an all you can eat contract. Only variable that keeps changing id GP's working harder and harder for less and less.

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  • charging for care, which is highly undesirable ----- to whom exactly?

    You do know care is not 'free' Jaimie. Not to taxpayers, not even to the country as a whole, as a state run comprehensive healthcare system shrinks the economy.
    I hope you also know that a private healthcare insurance policy for you would likely cost less than your tax contribution to the NHS annually.

    Injection of cash? the type the NHS has been getting EVERY YEAR for DECADES? Despite our growing national debt?? You might be happy mortgaging MY kids' futures, but do you have kids of your own?

    The problem is the socialist idea of universal comprehensive healthcare. As with most (maybe all) state-run bodies, they all grow into monsters, they are not driven by competition, and they do more harm than good. Yes a radical solution is the ONLY solution. Tailoring back what is available on the NHS to the original emergency treatment +/- primary care access is the bare minimum. How to do it? Libertarianism.

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