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Pilots of four-year training to plug gaps in GP workforce



GP four-year training pilot schemes will be funded by local education managers to partly solve recruitment problems in under-doctored areas.

The RCGP said regional deaneries are setting aside funds to run an additional year of GP training with the aim to equip trainees with advanced skills needed but without removing them from the workforce.

Pulse revealed in February last year that proposals for a fourth year of training were delayed by ministers, who said they would not respond to proposals until 2015.

The college said it hoped that the pilots would demonstrate to the Government that a fourth year of training is necessary and should be funded nationwide.

Health Education England confirmed it would be looking at expanding the number of four-year training schemes in areas struggling to attract trainees, but said that further details were yet to be finalised.

But Health Education South West is already trialling the scheme on a small scale, the RCGP said, with the aim of developing leadership and change management skills in areas such as end-of-life care or schemes supporting troubled families, whilst still practising as a GP.

The local is currently putting through eight trainees for a fourth year out of some 100 on the course.

RCGP vice chair of professional development Professor Amanda Howe said that while these are no replacement for national funding for a fourth year of training, she hoped the pilots will ‘model’ to the Government what a fourth year may add.

She said: ‘They are just models of what it could do if it was funded, and the sort of outputs that we would get. Mature, more critical leaders coming into the system at an earlier stage, rather than young doctors having to wing it.’

GP leaders have warned that any roll out of four-year training would have to be staggered to prevent a shortfall of GPs in the areas where the extra year came into effect.

But Professor Howe said that this way you could solve two problems at once.

She said: ‘[These LETBs] are not putting this money aside for the areas where they’re oversubscribed. [This shows that] you can be offering that extra year in areas of real need, so that those young doctors – who are usually very good clinically and very keen – will be delivering for those populations while getting their fourth year of training.’

But she added that the pilot scheme on its own was no replacement for full funding of a fourth year of GP training nationally.

She said: ‘These kind of innovative opportunities won’t train all the GPs to do what four-year training would have done.’

Asked whether GPs should be paid for by practices, professor Howe added: ‘It’s never been our position that [a salaried fourth year] should be paid for by practices.Other doctors in training don’t get that… [These] people are still being trained [and] that should be part of the training budget of the NHS, to give – what is now a complex specialty – enough time.’

The GPC has also been pushing for increased funding for GP training places in medical education to convince more trainees to take up the role in the wake of acute shortage of applicants for general practice.