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Desperate bid to fill training places falls flat as 12% of GP posts remain unfilled

Exclusive Only 124 additional medical graduates have signed up for GP training posts as part of an unprecedented third recruitment round designed to ease the training crisis, Pulse has learned.

The figures from Health Education England reveal that this year’s final intake is 2,688 – which is 88% of the total places available, and represents a 2.7% decrease on the number of posts filled in 2013.

It also remains well below HEE’s target of 3,250 trainees per year entering general practice by 2016 – which, itself, was postponed from the original target date of August 2015.

GP leaders said that HEE were going to stuggle to meet its targets unless root problems are addressed.

The figures also reveal that some areas still have 30% shortfall in places taken up, but this does represent an improvement on the summer figures of a 40% shortfall in some areas.

It comes after a major report into how to boost GP numbers commissioned by ministers recommended in July that hospital specialist training places should be radically cut back to make way for a rapid expansion in GP recruits, an incentive scheme for trainees to go to deprived areas and a national funding scheme to help GPs return to general practice.

HEE announced it would hold a third round of recruitment for GP training posts in July this year, after it filled only 2,564 training positions – 87% of those available. As many as 40% of training positions were left unfilled in some areas of the country.

HEE’s decision to hold a third recruitment round was met with scepticism by GP leaders, who described the measure as a ‘knee-jerk, short-term’ solution, and argued that that not enough graduates would be left to plug the shortfall.

Concerns were also raised about the quality of applications that would be made during a third round, with fears that standards would slip in the rush to plug the shortfall.

The latest figures reveal that Health Education East Midlands and Health Education North East have both filled only 70% of training places available, while Health Education Yorkshire and the Humber still has one in four posts unfilled.

Other proposed measures announced by HEE included a review of the GP recruitment process, the development of a ‘pre-GP’ year for prospective applicants and careers advice for foundation doctors and medical students.

It comes as the profession is in the middle of a recruitment crisis, with many practices considering closure because they are unable to recruit GPs, while other areas are offering increasingly greater incentives in a bid to attract partners and salaried doctors.

Dr Beth McCarron-Nash, a GPC negotiator, said that the target of 3,250 places by 2016 was unlikely to be met.

She said: ‘I’m not surprised: having another recruitment round when they had failed to recruit in the second round was never going to be a solution. Unless they address the fundamental problems that general practice faces – which are not just about recruitment, but also retention  – then we’re not going to get anywhere close to [NHS England chief executive] Simon Steven’s plan for more GPs.

‘They need to address the urgency of this situation and actually start investing in core general practice and making it an attractive career. Unless they address the issues of workflow, patient demand, and funding stability, we will not reverse from this unfortunate place.

‘HEE are going to struggle to fill 3,250 places annually unless the root cause of the problem is addressed. Even if they do manage to recruit more young doctors into general practice, we still need to ensure that the quality of training and the quality of trainees remains high and that we don’t end up diluting that quality.’

Dr Krishna Kasaraneni, chair of the GPC education and training subcommittee, said: ‘These latest recruitment figures, which show that round three recruitment has not made an impact on the number of trainee vacancies, confirm the BMA’s repeatedly stated view that we are facing a serious shortfall in the number of GPs entering the NHS.   

‘This shortfall is going to put increasing stress on a service that is already struggling to cope with increasing numbers of GPs who are retiring early. A recent BMA survey showed that three out of ten existing GPs were actively planning an early exit from the NHS because of unsustainable workload and falling resources: factors which are also clearly putting off medical graduates from choosing a career in general practice.’ 

A spokesperson for Health Education England said: ‘We have increased GP training posts in 2014 to support our Mandate requirement to provide a total of 3,250 posts by 2016. We are doing further work to improve the number of applications and fill rate and looking at innovative programmes to improve recruitment into GP training.’

Fill rates

HE East Midlands 261 184 70.50%
HE East of England 305 283 92.79%
HE Kent, Surrey and Sussex 247 234 94.74%
HE North East 180 126 70.00%
HE North West 442 358 81.00%
HE South West 265 248 93.58%
HE Thames Valley 110 107 97.27%
HE Wessex 142 133 93.66%
HE West Midlands 345 335 97.10%
HE Yorkshire and the Humber 329 246 74.77%
London Recruitment (LSS) 441 434 98.41%
Grand Total 3067 2688 87.64%