GP returners: +1,000
HEE has told Pulse that 176 have so far registered for the GP returners’ scheme, with numbers remaining around the same for each quarter. If we assume all these will return to practice in England from abroad (a generous assumption) a total of 936 will be added to the GP workforce by 2020.
But this is not enough to counteract the potential increase in GPs applying to go abroad, and not all of them will go through with their plans – indeed, only nine GPs in the returners scheme were in full-time general practice by the end of the third quarter of 2015/16, a success rate of 8%.
Dr Colin Jacoby, now a GP in Bristol, told Pulse he had lost £60k in earnings in the six months it took him to complete the scheme, while another GP says she had been put off returning because she couldn’t support her family on the bursary.
She says: ‘I’ve decided I am not going to complete the course. I have colleagues in Sydney who were wondering if it was worth coming back. Obviously they’ve been put off by my experience.’
Perhaps HEE should follow the lead of NHS Education Scotland managers, who are flying to Australia to tempt GP émigrés to come home.
Newly trained GPs: +11,800
Health Education England has increased the number of GP training places in recent years, but is struggling to find graduates to fill them. We estimate that – assuming an attrition rate of 2-5% each year and at the end of training – that 11,763 new GPs will be trained by 2020.
There was an increase of 100 filled places last year, but this was due to a disastrous recruitment round the year before. This year, Pulse has revealed a drop in applications for GP training of 5%; that does not bode well, as this is the last year that will produce trained GPs by 2020.
Initial figures on vacancies remaining for the next round of training recruitment suggested that HEE had been successful in filling more training posts this year. However, Pulse revealed that these data contained errors.
This all means HEE has to do much more to attract medical graduates into general practice, and soon. This year, it is introducing £20,000 ‘golden hellos’ and has begun a major review of the culture and attitude to general practice in medical schools – an issue regularly highlighted by Pulse.
Expat GPs : – 3,500
Last year Pulse revealed that around 822 GPs per year were applying for a GMC ‘certificate of good standing’ that would allow them to leave the country, around 700 of which are based in England.
Not every application leads to emigration – indeed, last year, the GP Survival group told GPs to apply for a certificate as a gesture of protest at the state of the profession, without the intention to use it (these are not included in the 822 figure).
But Pulse’s investigation does show there is far more interest among UK GPs in leaving the country than there is in coming back. And since Pulse received the data from the GMC, overseas recruiters have reported an increase in interest. Meanwhile the junior doctor contract imposition also saw a spike in applications for certificates. Shadow health secretary Heidi Alexander said after the imposition that Jeremy Hunt should ‘stop behaving like a recruiting agent for Australia’.
Even if applications by GPs stayed at the 2015 level, some 3,500 could be leaving the country in the next five years.
Health Education England and the GPC have been working on a GP retainer scheme that Pulse understands is likely to see the light of day in May.
It will need to be good, as official NHS figures, obtained by Pulse under the Freedom of Information Act, reveal that around 1,700 GPs retire every year across the UK (approximately 1,400 in England). Assuming the rate remains the same – another generous assumption – this would see 7,200 GPs retiring by 2020.
But a BMA survey last year found that one-third of GPs were considering retiring within the next five years, suggesting these numbers could worsen.
GPC chair Dr Chaand Nagpaul said at the time that the survey’s figures were ‘shocking’.
Now, in an attempt to persuade older GPs to stay on by improving their work-life balance, NHS England is planning to train 160 GPs to coach colleagues in resilience. It remains to be seen whether this can make any difference.
Missing GPs: 2,900
Pulse estimates that if current trends continue, around 2,850 new GPs will still be required by 2020 to meet the 5,000 new GPs pledge, but this does not take into account any spike in junior doctors leaving the country due to the contract imposition, or older GPs deciding to retire early.