A Pulse analysis of the NHS workforce report reveals that we need to double the general practice training capacity in five years, and treble it by 2033. This is how we arrived at the figures
Our intention was to provide a rough estimate of how many months’ worth of training GP practices in England would need to provide in the years 2020-2037.
We used months as a unit to show overall training demand in order to easily compare estimated capacity in 2020 with projected capacity in 2033.
We mapped out each cohort of medical school years intake, starting from 2011. With a linear training progression – ie, five years medical school, two years foundation programme and three years specialty training) – the 2011 medical school cohort completed their third year GP specialty training in 2020.
We then applied the changes in England in the NHS Long Term Workforce Plan to the figures:
- A doubling of medical school places by 2031 (p129, table 1)
- An increase in the number of GP specialty training places from 4,000 in 2022 to 6,000 by 2031 (p129, table 1)
- An intention that ‘we will ensure that all foundation doctors can have at least one four-month placement in general practice by 2030/31’ (p81, paragraph 38)
- A pledge to ‘increase training and supervision capacity in primary care so GPs in training can spend the full three years of their training in primary care settings’ (p81, paragraph 38)
When we say ‘2016’ intake below, this refers to the year they started or will start this particular stage of education or training (ie, GP speciality training intake of 2019 refers to those starting GPST in 2019).
Medical students
Figures
We needed figures for medical schools from the 2016 intake onwards, as they are the earliest ones to be potentially spending any time in a general practice setting in 2020, the first year we are measuring training capacity (presuming linear career progression).
The NHS Long Term Workforce Plan showed there to be 7,500 medical school places in England in 2022 (p129, table 1), which also gave projections from 2024. This had been increased by 1,500 in 2018 (p41, paragraph 8).
For years 2029 and 2030, we presumed incremental changes to reach the final target of 15,000 by 2031.
Months spent in general practice
There are no set figures or data on the amount of time students spend in general practice as this changes depending on medical school.
For the purposes of this exercise, we used a format popular in medical schools of three months spent in general practice in the third year, and one month in the fifth year. This was applied to every year, including future years.
Foundation year
Figures
We needed figures for FY intake from 2019 onwards, as they are the earliest ones to be potentially spending any time in a general practice setting in 2020 (presuming linear career progression).
Details of FY places in England are incomplete, so we made a number of assumptions.
There was a full national breakdown of the 2019 foundation year intake (2019 Recruitment Stats and Facts Report, p20, table 1.19) and the 2020 intake (2020 Recruitment Stats and Facts Report, p41, table 4.27) giving us official figures.
For 2021 (UKFP 2021 Allocation Statement, March 2021) and 2022 (UKFP 2021 Allocation Statement, 10 March 2021), we had UK-wide figures. HEE was unable to provide a national breakdown by the time of publication, so to the UK-wide figures, we estimated around 80.55% were in England, based on the 2019 and 2020 figures.
There are no figures yet available for 2023. The NHS Long Term Workforce Plan doesn’t include projections for 2024 onward. It says: ‘Assumes proportional increase in postgraduate training (foundation training) and specialty training including the potential to further increase GP trainee places’ (page 130).
To calculate numbers for 2023 onwards, we applied the imperfect measure of medical school numbers divided by 0.907 (the proportion from 2022, which was unaffected by Covid).
Months spent in general practice
Figures provided to Pulse by Health Education England (now NHS England) revealed that around 55% of FY trainees spend a four-month placement in general practice.
We incrementally increased this percentage from 2024, before reaching 100% by 2030.
GP specialty training
Figures
We needed figures for GP speciality training from 2018 onwards, as they are the earliest ones to be potentially spending any time in a general practice setting in 2020 (presuming linear career progression).
Figures from 2018 to 2021 can be found on the Health Education England Hub (which also includes figures from the devolved nations, but these weren’t included in our analysis).
From 2022 onwards, we used figures and projections from the NHS Long Term Workforce Plan (p129, table 1).
We applied incremental changes for 2029 and 2030.
Months spent in general practice
We assumed GP specialty trainees of all years spending six months in general practice per year (RCGP guidance, par 11, says ideally specialty programmes include at least 18 months in general practice). We incrementally increased this from 2024 until we reached 100% in 2030.
Our analysis can be found here.
