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RCGP chair-elect: PCNs will struggle to recruit additional staff

Exclusive: Primary care networks will face a ‘big challenge’ in achieving the GP Forward View target to recruit 5,000 additional general practice staff, according to the RCGP’s incoming chair Professor Martin Marshall.

In an interview with Pulse, Professor Marshall, who takes over as RCGP chair from 23 November, said it will be a ‘big challenge’ to hire the additional PCN staff, given the existing struggles faced with recruiting 5,000 GPs.

The 2016 GP Forward View stated a minimum of 5,000 other non-GP staff will be recruited by 2020/21, including 3,000 mental health therapists and 1,500 pharmacists by 2020.

Some networks are already finding it difficult to recruit the 5,000 additional staff part of networks, particularly the initial social prescribers and pharmacists, he also revealed.

In his first interview since being elected the new chair, Professor Marshall also said general practice needs to be ‘talked up’ and made more ’attractive and stimulating’ in order to improve the profession.

NHS England recently said CCGs should redistribute unused funding for hiring additional staff elsewhere.

However, some network leads are warning that they are having problems recruiting these staff.

Professor Marshall said: ‘I think that’s going to be a big challenge because we know how difficult it is to get these 5,000 additional GPs.

‘We’ve got 5,000 other general practice staff being recruited, focusing initially on pharmacists and social prescribers, but then progressively looking at mental health and other health professionals as well, and some PCNs even now are finding it difficult to recruit those.’

NHS England unveiled plans in January to provide networks with 1,000 social prescribing link workers by April 2021.

However, Professor Marshall, who was elected as the new RCGP chair earlier in July, said the biggest challenge with recruitment for primary care networks was achieving NHS England’s goal of ‘in all parts of the country.’

He said: ‘I’m sure we’ll get to the 5,000 [non-GP practice staff] because we’re already halfway there in terms of the numbers that are going there, but whether we’ll have enough people across the country in all parts of the country, I think is an open question.

‘I think the biggest challenge for us though is to not pretend that one model fits everywhere in the country.’

Professor Marshall gave the example of the varying models of general practice in east London and Devon, where the community in east London benefits from a multidisciplinary team but the traditional method of general practice in Devon still operates ‘perfectly well.’

‘Where I work in east London, so the big, multicultural, largely social deprived community, having a big health centre with a multidisciplinary team, close integration between services, it works really well.

‘But I used to work down in Devon and I’ve still got a lot of friends down in Devon. I was a partner down in Devon for the first ten or 12 years of my career, and the traditional model of general practice works perfectly well there and there’s no need to change it if it works well. It’s something about flexibility across the country depending on what the needs are.’

Professor Marshall added the potential for networks to move workload away from frontline GPs is ‘entirely dependent’ on the space they are given to develop. He told Pulse that NHS England was ‘doing the right thing’ in not mandating a set of responsibilities for PCNs, as they should be given ‘time and space to develop.’

He added that the potential to reduce GP workload is ‘significant’ but that delivering on that was ‘entirely dependent’ on how much space networks are given to achieve it.

He continued: ‘I think NHS England are doing the right thing in standing back from PCNs in not mandating a whole set of new responsibilities. I hope that they stick with that because the biggest danger I see is, every time there’s a new function I hear people saying, “PCNs will deal with that,” and that isn’t going to be the case. They’ve got to be given time and space to develop.’

Professor Marshall also told Pulse that PCNs should be allowed space in order to form relationships which previously have not existed. 

He said: ‘I see some parts of the country where the PCNs are building on structures and governance and relationships that have gone before and they’re really flying and really doing amazing work.

‘Others that are struggling, where perhaps the relationships are new, perhaps they might not have worked with each other in the past but they’re starting to do so now, and they’ll be much slower to deliver.’

Earlier this year, new NHS contract documents said networks ‘should include’ community pharmacies, optometrists and dental providers.

NHS England recently scrapped plans to set up a £3m network accelerator programme, after GPs warned it would widen the inequality gap across the country.

Last year, the RCGP called for a social prescriber in every practice to combat an ‘epidemic of loneliness’