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GP training practice funding set for reform as DH looks to address unfair variations

The Department of Health is reviewing the way it funds practices that offer training placements in an attempt to address unfair regional variations, Pulse has learned. 

Health Education England board papers reveal that it and the DH are looking to run a pilot in GP practices to identify clinical time and resource costs associated with offering training.

They told Pulse that a ‘fairer funding system’ was required, and they are working with the BMA, RCGP and medical schools to develop one. 

But the pilot has not yet got off the ground because education bosses have been unable to identify practices to submit their data, claiming that practices have requested payment to complete the data collection.

HEE said that paying practices would set a ‘dangerous precedent’ – a claim criticised as ‘utter nonsense’ by the GPC.

The GPC has been pushing to set national standards for placement funding, but GPC leaders said the DH would need to recompense practices to take part in any pilot, which will be ‘time consuming’.

A statement from the DH and HEE to Pulse said: ‘We need a fair funding system for all GP trainees, including support tailored to postgraduates’ stage of training.

’We are working with Department of Health, the BMA, RCGP and the medical schools to establish how that new system should work.’

But in its performance report to the February meeting, HEE said that the development of the new system has stalled.

It said: ’This is a joint project with the DH and although support has been provided in identifying GP practices to participate in the pilot, the practices identified have not submitted cost data to the required timescales.

‘Indications are that they expect to be paid £1,000 per practice to participate. This would set a dangerous precedent if HEE pays primary care for data that secondary care provides at no cost to HEE or the DH.’

Dr Krishna Kasaraneni, chair of the GPC’s education, training and workforce committee, told Pulse that information will need to be collected before making recommendations about how the tariff will work. 

He said: ‘At the moment it’s a national sort of tariff, but the question that wants answering from this is how much does it cost to train a medical student, or a junior doctor, or a GP trainee in general practice?’

But he said that practices should be reimbursed for providing the information, as they receive far less in funding for training than secondary care.

Dr Kasaraneni added: ’As soon as I read that it would set a ”dangerous precedent” I saw red. This is utter nonsense.

‘The level of information that’s needed to make sense of this pilot, it’s quite granular data required and each practice will have to spend a signficiant amount of time looking through this document and feeding back. You’ll need to pull someone out of doing their normal day job to do this.’

The focus on training practices

training trainer practice  PPL

training trainer practice PPL

training trainer practice PPL

The review of the training tariff is the latest attempt to reform the treatment of training practices.

In 2014, the GPC called for an overhaul of undergraduate GP placement funding, which varies nationally and does not cover the cost of making premises available for teaching.

The result is that undergraduates have limited opportunity to get high-quality exposure to general practice, and were less likely to choose it as a specialty.

And improvement of training practices’ premises was one of the priorities of NHS England’s joint 10-point plan for GP workforce

The plan is a key measure in tackling the ongoing GP workforce crisis and delivering the Government’s pre-election pledge of an extra 5,000 GPs by 2020.


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