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No guarantee GP trainers safe from budget cuts, says HEE chief

Exclusive Training bosses cannot guarantee that there will be no cuts to the funding of GP trainers, following the news that Health Education England has to make swingeing savings.

But, speaking in an exclusive interview at the Pulse Live conference in London yesterday, HEE chief executive Professor Ian Cumming said there would be reduced funding for 'back office' functions only, and that the rationale was so that money can be put 'back into the front line'.

But while he guaranteed that therefore GP trainees would not be facing any reduction in funding, he said he could not say the same for GP trainers.

He told conference delegates: 'Now that I can’t guarantee, because we need to look at what we’re doing, how efficiently we’re doing it and whether or not whether or not there’s any scope for doing that better.'

He added: 'But our key job is to produce doctors of the highest possible quality with the best possible training that we can. We aren’t going to sacrifice that.'

Mr Cumming further suggested that the news that the HEE budget is to be cut by 30% had been misunderstood by some people.

He said that the money HEE recieves to run the organisation was reduced by 25% in last year's spending review, which he said 'is the right thing to do' to improve efficiency to be able to 'put as much money as we can into our frontline activities'.  

But HEE is also looking to make savings worth 30% in its educational support division, which supports the back office functions around recruiting trainees into training programs.

He said: 'It isn't 30% out of HEE budget. It is 30% out of how much money we spend as a back office function and as a support function to see how we can make that more efficient.'

But he reassured GPs that there would be no cuts to GP training.

He said: 'If we fill the 3,250 GP training slots, we will spend £50m more on GP training than we did last year. So we're certainly not taking money out of frontline training.'

HEE is responsible for hitting the Government's target of putting an extra 5,000 GPs in the workforce by 2020. The organisation failed to meet their target of training 3,250 GPs per year by 2016.

But Mr Cumming said there needs to be a focus on retention as well as training because just training an increasing number of GPs is a 'very inefficient way of trying to maintain the workforce'. 

He said: 'What we need to do is to make sure that we're keeping the highly skilled, highly trained workforce that we've got and that we're bringing in additional workforce to allow us to grow overall because ... if we're losing more and more GPs we can't simply train more and more.'

Meeting the 5,000 GP target 

In 2014, health secretary Jeremy Hunt announced the Conservative Party’s plans to ‘train and retain’ an extra 5,000 GPs by 2020.

However a Pulse investigation found that the DH will likely miss their target by more than half as the Government is on track to increase its primary care workforce by just 2,100, unless there are significant changes to the number of GPs joining and leaving the workforce.

In response, the DH said the 5,000 GPs would include doctors in training, watering down the promise by giving the Government three more years to hit their target.

To help make boost workforce numbers, Jeremy Hunt announced a £100m plan to make the NHS 'self-sufficient' by making doctors work in the NHS for four years after qualifying and increasing the number of medical school places by 'up to a quarter'.

But the GP workforce fell by 96 GPs in the last year, despite 'golden handshake' schemes offering GPs £20,000 to work in some rural, remote or deprived parts of England.

NHS England also launched an overseas recruitment scheme worth £20m to bring 500 GPs over from Europe by 2020. GPs from Lithuania, Bulgaria, Poland and Spain are due to arrive in Lincolnshire and Essex next month, with more going to Hull later in the year.

Readers' comments (13)

  • "But Mr Cumming said there needs to be a focus on retention"
    So which deanery has the best retention rate?
    A deanery is an autonomous institution answerable to noone.
    A deanery has academic standards,retention is not an academic standard,they would not know what he is talking about,would not recognise it as an issue,do not have records with regard to this,have never been asked to audit it
    Whatever Mr Cumming thinks he is talking about would be incomprehensible to a deanery,and he is paying them

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  • Vinci Ho

    Observation as an 'outsider' since I am not a trainer(ever):
    (1) At least , he was honest about 'no guarantees' and the real picture of losing more than what you are giving birth everyday , hence the issue of retention.
    (2) Reduced funding only for 'back office' : have you ever played this game called Jenga? Every block you remove from the tower increases the risk of a total collapse for your opponent(hence, beaten in the game) if you just 'survive' this round.
    (3) Capita claimed they could deliver a 25% cheaper back office support for all GPs . So history is repeating almost instantaneously.
    (4) Still in the subject of education: look at what state schools now have to do to raise funds for survival and the morale amongst teachers . But I suppose the government does not really care much other than preparing for article 50......... and opposition(s) are pathetic..........

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  • It's done on the cheap as it is . Any reduction in trainers grants or supplementation of GPR salaries will be the end of in practice GP training . I simply will not be able to persuade my partners that is is worthwhile. HMG are trying to destroy GP

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  • Back office functions sounds like underemployed secretaries being sacked. It is not this at all-the Deanery admin has already been cut to the bone. What back office means is TPDs, GP tutors and all the hierarchy above.And it is 25% of this. What he is saying is that they are not cutting GP Registrars salaries which also come out of the HEE budget. Did you all gather that from his statement? Because it doesn't look obvious to me. And how about "the money HEE recieves to run the organisation was reduced by 25% in last year's spending review, which he said 'is the right thing to do'" - the right thing to do????!!! Well I suppose you could say it's a point of view.

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  • I agree with Dr Hatfull. Cut trainer's grants and many of us will cease to train GPs as it will simply not be a viable prospect. Good luck to Jeremy Hunt with finding new GPs when there is no one to train the few actually want to do this job. The reduction in training numbers will lead to more stress on the current workforce and even less retention of current staff.

    Sadly, the endpoint of all this is very predictable.

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  • Excellent news, GP Training should be stopped completely to save trauma to future doctors. There are many better career options.

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  • and if it is "the right thing to do" why not put it up on the HEE website?

    https://hee.nhs.uk/

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  • of course the Titanic sank because it was "the right thing to do"

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  • One of the grand plans is to reduce teaching: HEE do not understand why GP trainees have so much educational time and so many one to one tutorials.

    They want gp trainees to move away fro the expensive training structure and start chipping away at that aspect.

    Plan is group tutorials and reduced time at deanery teaching.

    Unfortunately several deaneries are already entertaining the idea.

    Although I am not a fan of the GP training structure the next set of HEE plans are farcical. And yes e-portfolio in untouchable!

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  • Sadly, some practices are reliant on trainees to cope with workload so not everyone will be able to say no if trainers grants are cut.
    However, if this happens I hope the BMA + RCGP push for reduced expectancy on trainers to provide 2 hours protected teaching per week etc. Sadly I expect we will be asked to do the same/more with less funding just like everything else.

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