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GPs to be offered incentives to delay retirement under £10m strategy to solve workforce crisis

Experienced GPs will be incentivised to stay practising - or return after a career break - under a major £10m workforce plan launched by NHS England today.

A major marketing campaign on the ‘positive aspects’ of general practice will be launched to persuade more medical graduates to become GPs and incentives to encourage returners and trainees to work in underdoctored areas will also be introduced.

GPs will be incentivised to either stay in practice or return from a career break by offering older GPs the option of a portfolio career or payments to mentor less experienced GPs.

The plans are designed to counter a growing workforce crisis. Pulse revealed last year that GP vacancy rates had quadrupled over two years and the RCGP has highlighted a need for 10,000 more GPs by 2020.

NHS England says the money, which will be reallocated from the Government’s £1bn general practice infrastructure fund, will also create a new national retainer scheme and set up ‘training hubs’ to allow practice staff to extend their skills.

The ‘10 point plan’ has been designed together with Health Education England (HEE), the GPC and RCGP.

But the GPC warned that it did not go far enough to tackle the rising workload that is leading to ‘tens of thousands’ of GPs planning to retire and a rise in emigration.

Although the plan does include piloting schemes to introduce new grades of general practice support staff to support GPs, including physician associates, medical assistants, clinical pharmacists and advanced practitioners (including nursing staff).

The plan includes several of the recommendations from the GP Taskforce report published in July 2014, such as for example the marketing campaign, funding of a new returner scheme, focusing incentives to GPs willing to work in under-doctored areas and offering flexible career paths for older GPs.

However it also omits several recommendations, including a proposal to make exposure to general practice mandatory for trainees in all medical specialties or decommissioning other specialty training posts to pay for more GP posts.

The RCGP said it will kick off the general practice marketing campaign with 16 roadshow events aimed at medical graduates and starting in Kent next week (28 January).

It comes as almost 40% of GP training places were unfilled in parts of England last year.

Dr Krishna Kasaraneni, chair of the GPC’s education and training subcommittee, welcomed the plan, but said it was not a ‘magic solution’ and the £10m funding should be recurrent.

He said: ‘It is a long-term plan, which is positive. And it does have potential to deliver gains in areas like recruitment, induction and returner schemes a lot sooner, but quite a lot of these proposals are essentially looking ahead to the future.

‘While NHS England and HEE have acknowledged the situation, we recognise that this plan alone isn’t going to yield immediate returns, cut down waiting times for GP appointments or provide better access.’

‘I think [the plan] is rightfully focused on the under-doctored areas but by that it doesn’t mean that the rest of the country doesn’t have workforce problems. You have to treat the worst problem first, in a way, which is what this paper is aimed at.’

NHS England chief executive Simon Stevens said: ‘We need greater investment in GP services, extending to community nursing, pharmacy and eye care services. This £10m will kick start a range of initiatives to drive that forward so every community has GP services that best meets its health needs.’

RCGP chair Dr Maureen Baker said: ‘There is now a real push to put more resources into general practice and build up the GP workforce, with the “new deal” for general practice announced by NHS England in its Five Year Forward View and new funding for general practice infrastructure. As a result, the future of general practice is looking bright and GP skills have never been more in demand.’

Health secretary Jeremy Hunt said: ‘As we move more care out of hospital into the community, and continue to focus on prevention rather than cure, we need to support this with greater access to primary care. I welcome this ambitious plan which helps set a clear direction for the future of general practice, and I hope it will encourage even more young, aspiring medical students to take up careers as GPs.’

What does the 10-point plan include?

  1. A marketing campaign including a letter to all newly qualified doctors setting out positive aspects and future careers in general practice
  2. Offering GP trainees an additional ‘flexible’ year of training where they can train in a special interest, get an MBA in leadership skills or another academic pursuit
  3. Setting up ‘training hubs’ for GP practice staff to extend their skills
  4. A time-limited incentive scheme for GP trainees committing to work in an under-doctored area for at least three years, including financial support
  5. Reviewing current retainer schemes and investing in a new national scheme
  6. Offer premises funding to training practices focused on the agenda of transferring care into community settings
  7. Reviewing how to incentivise experienced GPs to remain in practice, for examples via a funded mentorship scheme or offer portfolio careers
  8. Piloting new general practice support staff to take workload off GPs, such as physician associates, medical assistants, clinical pharmacists and advanced practitioners (including nursing staff)
  9. Making it easer to return to practice after working overseas or taking a career break, via a new clearer induction and returner scheme
  10. Offering financial incentives to returners opting to go work in under-doctored areas and reviewing the value of the performers list in its current form

Read the full plan here.


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Readers' comments (89)

  • Too little to late.
    None of this addresses the core issues of why GPs are emigrating in their droves. Top down autocratic management that requires total obedience to the system, a vitriolic media used by the government to manipulate patient opinion, lack of professional autonomy and satisfaction, one sided contract impositions made at a whim without regard and evidence are a few of the reasons why a career in general practice isn't attractive. Add to the mix poor pay and working conditions, the CQC, GMC and all the other detestable acronyms as well as the fact that GP skills are in high demand abroad where all the above don't exist, you realise that all the suggestions above are nothing more than short term bribes. This will change nothing..........

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  • @1.25am

    Could not agree more

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  • Una Coales. Retired NHS GP.

    Perhaps the RCGP could add to the list allowing A Cambridge University UK grad a formal appeal as he was failed in one CSA station by 1/9 when he has stated to the college he has evidence corroborated by a Prof that the exam finding card for a 'dizzy' station was incorrect. Why he had to repay £1600 to resit the exam and pass? If a station has an incorrect exam finding card, how many other GP trainees were also failed at this station? Surely, the right to a formal appeal should be offered any GP trainee who has sat and failed a CSA station?

    Perhaps the RCGP could provide deaneries with better educational resources for the AKT and CSA exam, as clearly what is offered is not enough if an Imperial College med grad ST3 GP trainee wrote me a few days ago to ask for help as he failed both his AKT and CSA exam by a few points and is now on a 6 month extension before he is released if he can never pass.

    This exam which was introduced in 2007 has caused so much stress and distress in GP trainees and has led to the release of 100s of GP trainees at the end of their NHS GP training at a time when the NHS is in crisis.

    As for GP partners, they left because of lack of autonomy, top heavy bureaucracy, mind numbing useless revalidation, incessant tick boxing audits and exercises set by NHSE/DOH, cuts to running a practice, media disrespect and bashing, patient overdemand for non paying consultations, GMC/CQC scrutiny, high risk of mental distress from a GMC complaint and no compensation if exonerated.

    Who in their right minds would want to be a state NHS GP? You cannot now pave the mouths with gold of noble, moral, ethical, good GPs whose goodwill has now been spent. They are not greedy bankers, but kind, caring souls who only asked to be left alone to get on with their charitable work of healing.

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  • Sighhhhh...what next? A letter to all CSA kickouts , with a grovelling apology, stating that if all can forgiven and they are willing to come back, they can join duty asap without re sitting the CSA ever again ? Letters to GP emigrants in Oz stating that they can slip into a vacancy of their choice with a 10K golden helooooo and no need for to sit CSA, work as a minion for 6 months for a few bob etc and letters to the Indian subcontinent stating that the first 6000 applicants with a mere 12 montsh GP expoerience will get jobs with no PLAB exam etc. I smell something and it vaguely reeks of desperation.

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  • How about stopping the removal of seniority if you wish to keep senior GPs!

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  • The Capital Market will always prevail.

    Quite frankly so long as work conditions, work load and pay etc is so bad and pay + work load and conditions are better elsewhere, Doctors will continue to retire early and emigrate in droves.

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  • They need to look at and appreciate why this is happening, not throw more money at the problem with yet more top-down, ivory towers ideas. How about a really radical approach - actually ask working GPs what would have to change to make them stay and then work on a solution? Ask the demoralised workforce what has gone so wrong that they are no longer able to recommend general practice to medical students.

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  • All this GP partner wants is more money.

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  • Cant see any of that changing my mind. Half of it comes across as what we want in the community rather than helping GPs.
    Increasing the numbers of non-GP staff doesn't help - still need paying as well as supervising as well as defence subs.

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  • @ 9:10 - GP registrar- Sorry dear, this GP wants more money to be able to provide a service...not for his own pocket. If you can't understand that, you probably should leave this GP Training.
    Most of us are struggling to provide services due to cuts. The money is essentital for this purpose. Most of us have accepted drastic cuts in our earning and are still here. It's when you can't provide services, you start considering the futility of your sacrifice in terms of family life, suffering services and the last thing in the queue is your material status. If all GPs primarily thought about was getting more money for their pockets, there wouldn't be GPs left. But you have to highlight this in forums to raise awareness of our dumb policy makers that cuts will lead to a disaster.
    I hope you can appreciate this or review whether you want to join the party. Best wishes

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