GP shortfall projected at 15k by 2036 as workforce plan sets out training overhaul

The GP shortfall will grow to 15,000 FTEs by 2036 without measures such as boosting GP training places, NHS England has said in its newly published long-term workforce plan.

As announced yesterday, the plan has committed to increasing GP specialty training places by 50% to 6,000 by 2031/32.

The full plan reveals that the first 500 extra places will become available from September 2025.

It went on to highlight the need to grow GP specialty training places by 45-60% by 2033, which will come from a ‘a bigger pool of doctors’ resulting from the pledged doubling of undergraduate medical school places.

The 15-year plan will be backed by a £2.4bn investment from the Government ‘to fund additional education and training places over five years on top of existing funding commitments’, NHS England said.

NHS England, with backing from the Government, has also committed to ensuring that all foundation doctors have at least one four-month placement in general practice by 2030/31, and GPs in training will be able to spend their full three years in primary care settings.

The long-awaited plan also stated an intention to reduce the number of years required for a medical degree from five or six years to four years in order to ‘bring people into the workforce more efficiently’.

The projections for the future GP shortfall took into account ‘some boost in GP numbers as a result of interventions in recent years’ but found that the estimated growth over the long term ‘fails to keep up with expected demand’.

NHS England has calculated demand using the 2015 ratio of patients to qualified GPs, while also taking into consideration the new measures in the recent primary care recovery plan.

The plan also highlighted the need to expand physical estates to enable supervision to take place, and put a focus on primary care ‘where insufficient physical space across an ageing estate limits GPs’ ability to increase training placements’.

However, the specific measure required to tackle this are ‘outside the scope’ of the plan, and will need ‘continued, sustained investment in the primary care estate’.

Other ambitions announced in the plan include:

• Providing 22% of all training for clinical staff through apprenticeship routes by 2031/32, up from 7% today;
• More medical school places in areas with the greatest shortages;
• Reducing reliance on international recruitment, with 9-10.5% of the NHS workforce recruited from overseas in 15 years’ time, compared to nearly a quarter now.

The BMA’s representative body chair and workforce lead Dr Latifa Patel raised concerns that NHS England’s projections have ‘not been independently verified in their entirety’ as promised by the Chancellor last year, meaning it will be ‘difficult to have confidence’ that the plan will ‘achieve its goals’.

Dr Patel also said: ‘While the plan acknowledges the need for expansion in foundation and specialty training placements and infrastructure commensurate with the growth in undergraduate medical training, we don’t yet have a credible path to get there.

‘Approaches such as medical apprenticeships and accelerated degrees are also untested, so we have concerns about their role in addressing the crisis.’

She also said that while an increase in GP numbers and junior doctors spending more time in general practice are ‘much-needed’, the plan does not make it clear ‘how they will be supervised given how stretched our colleagues working in practices are’.

Prime Minister Rishi Sunak said: ‘On the 75th anniversary of our health service, this government is making the largest single expansion in NHS education and training in its history. This is a plan for investment and a plan for reform.

‘In the coming years we will train twice the number of doctors and an extra 24,000 more nurses a year, helping to cut waiting lists and improve patient care. And we will do more to retain our brilliant NHS staff and reform the way the health system works to ensure it is fit for the future.

‘This is something no other government has done and will be one of the most significant commitments I will make as Prime Minister – acting as the cornerstone for our vision for a better, more modern healthcare system and putting the NHS on a sure footing for the long term.’

Chancellor Jeremy Hunt said: ‘Today marks an unprecedented investment to train thousands more NHS staff and deliver more doctors, nurses and healthcare staff in the community than ever before – taking us above current average staffing levels across the OECD. 

‘Our plan will end the reliance on expensive agency staff, while cutting waiting lists in the coming years and building an NHS which can match up to the scale of tomorrow’s challenges.’

But chief executive of Londonwide LMCs Dr Michelle Drage said: ‘Reducing GP training time is a false economy, as newly qualified GPs will need more support from experience colleagues, drawing them away from patient care.

‘And the expectation that GPs have the time to supervise growing numbers of pharmacists, physiotherapists and other roles which have been worked into the general practice team over recent years is unrealistic,’ she added.

Increase required in GP training intake by year: