GP trainers need to be paid more in order to achieve the planned expansion of training places, NHS England has said in its submission to the doctors’ pay review body.
Last year, the NHS long-term workforce plan pledged to increase GP training places in England by 50% to 6,000 by 2031, but GPs expressed concerns about the infrastructure needed to fulfil the plan, while a Pulse analysis revealed that achieving these ambitions would require a doubling of training capacity in five years.
In its submission to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), NHSE highlighted that the current ‘balance of workload to remuneration’ is the ‘main reason’ GPs and practices are ‘deciding not to join the training community’.
It said GP trainer workload has ‘intensified’ as primary care roles and GP specialty training places have expanded, adding: ‘A shortage of educators and supervisors will hinder efforts to expand GP numbers.’
Even before the workforce plan announced the expansion, GP had told Pulse that the increase in the sessional workforce has contributed to a lack of trainers, and that physical space within practices is another significant barrier.
And a report by the GMC last year revealed that GP trainers are at more risk of burnout than the average for all other specialties.
The RCGP also found that 66% of GP practice staff say limited space is making it difficult to train new GPs, while 75% find that it restricts the number of trainee GPs they can take on.
NHS England’s submission to the DDRB has drawn on this evidence, recognising the pressure GP trainers are under and that a ‘significant expansion’ of training placement capacity is needed.
It said: ‘The expansion of roles across primary care and the increase of GPST places has intensified the role of GP trainers and their workload.
‘Consistent feedback in every region is that the balance of workload to remuneration is the main reason for practices and doctors deciding not to join the training community.
‘Without additional increase in remuneration to retain those in the role and incentivise others to join, the existing issues with training and GP expansion will be compounded.’
GP trainers are included in the Department of Health and Social Care’s GP educator pay scale, and NHS England expects that any uplift to this scale will ‘automatically’ apply to them.
The document also outlined NHS England’s aims to use ‘blended learning placements’ as a ‘reform and capacity building’ initiative.
On GP contractor pay, NHSE advised the DDRB that within the settlement from Treasury, funding is only available for a 2% GP pay uplift.
The national commissioner warned the DDRB against recommending pay uplifts beyond this funding settlement as this would ‘put further pressure’ on the NHS budget.
Last month, a report by the public spending watchdog concluded that NHSE’s workforce ambitions are based on ‘significant’ substitution of fully-qualified GPs with trainees and SAS doctors.
The long-term workforce plan projected only a 4% increase in fully-qualified GPs between 2021 and 2036, compared to a 49% growth in consultants.
The report found that NHSE’s projected supply growth in general practice ‘consists mainly of trainee GPs’, who accounted for 93%, as well as ‘making increased use of specialist and associate specialist (SAS) doctors in primary care’.
GP leaders have also raised concerns about the increase in supervisor workload associated with the expansion of ‘additional’ roles such as physician associates.
The updated PCN contract for 2024/25 included a new clause which said GP supervisors must be ‘satisfied’ there is appropriate governance when PAs see undifferentiated patients.
The BMA’s GP Committee England warned that the ‘time and skills’ required for GP supervision of these roles takes them ‘away from their patients’.
Pulse recently revealed that a record number of doctors applied for initial allocation GP specialty training places this year but the vast majority face rejection.
READERS' COMMENTS [4]
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In one article NHSE recommends GP pay should not be increased above 2% because of pressure on the NHS budget, then in another article they recommend GP trainer pay be increased.
What is this – joined up stupidity..
The Educator pay scales in this article are for GP training programme directors and above, paid usually pro-rata anything upwards of 1 session.
This is not the same as GP trainers in practices (at the bottom of the page) who are currently paid at £9794 per annum before tax.
How on earth did G.Ps. manage before they were ”trained” ?
NHSE does not want to increase GP pay>2%, and want more trainers so they can supervise the PA , ANP, FCP, MHP etcetera….