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Senior consultants could finish career in general practice, says education lead



The chief executive of Health Education England has suggested that hospital physicians could be encouraged to spend the last few years before retirement in general practice to help solve workforce problems.  

Speaking before the Commons Health Committee, Professor Ian Cumming said he would like to see the performers list reformed so physicians who want to ’work on a much more structured basis’ could work in primary care. 

He also told MPs that 676 trainees have applied for this year’s third GP training recruitment round, compared with just 100 applicants at the same stage last year. 

Professor Cumming suggested that the increase might be attributable to the ’controversial’ marketing campaign it is currently running – ‘Nothing general about general practice’.

He said that they are unclear about how many of these 676 applications will be accepted, but the figures are a marked improvement on last year when HEE took the ’unprecedented’ step of a third round, which fell flat with 12% of places left unfilled nationally.

Pulse revealed earlier this year that some areas were left with 40% of positions left unfilled, with around 380 of the 2,950 nationwide posts left unfilled. Professor Cumming admitted that applicants are still preferring London and the South East, to the detriment of areas such as the East Midlands and the North East.

Professor Cumming also said that practices had to do more to take on medical students and trainees, adding that it was ‘fundamentally wrong’ that some practices, including ’super practices’, had decided they would no longer take undergraduate trainees. 

He also attacked the NHS’s ‘invention’ of health and safety regulations, which he claims block young people from doing work experience in practices or hospitals.

This was the first meeting of committee’s enquiry into primary care and focused on the Primary Care Workforce Commission’s (PCWC) ‘The future of primary care: creating teams for tomorrow’ report, which highlighted the benefits of practices to recruit paramedics and admin assistants.

Also in attendance were lead author of the report, former GP and professor of health services research at the University of Cambridge Martin Roland, and Greg Allen, managing director at the Centre for Workforce Intelligence.

Professor Cumming also told the committee that:

  • HEE has commissioned a review into undergraduate medical education to ’encourage people to be GPs, and embed more of the training in the community’, which will also look at remuneration for GP practices taking on students;
  • The RCGP is developing a costed plan for implementing the recommendations in the PCWC report, which will be presented at their session with the committee;
  • HEE hopes to see physician associates to be regulated and given powers to order x-rays and prescribe independently. Pulse has already shown the Department of Health was reviewing the implementation of prescribing;

Giving the example of a senior hospital physician who’s responsibility for working nights meant they were ‘likely to retire in their mid to late fifties because they can’t cope any longer’, Professor Cumming said: ‘In my personal opinion, that individual, if we could keep them and use them in primary care, would be an absolutely invaluable resource to a big practice.

‘They could work on a much more structured basis, Monday to Friday, nine to five. They could work alongside GPs, help manage the flow of patients into secondary care, reduce that and help take people out of hospital earlier.

‘So why doesn’t that happen at the moment? One of the reasons is that the performers list gets in the way, they can’t get onto it.’

On the increase in third round applications, Professor Cumming suggested the rise might be attributable to HEE’s recently launched ‘Nothing general about general practice’ promotional campaign, which was criticised for focusing on the administrative aspects of being a GP.

He told MPs: ‘We’re running a campaign at the moment, it’s controversial in some sectors, but it’s a marketing campaign called ”Nothing general about general practice”.

‘It’s to try and encourage young people to consider general practice, and we have seen 676 people apply for round three training. Whether or not there’s a direct link, we don’t know yet.’

‘But 676 applications for round three, when we consider last year we were in the area of 100, is a very, very, significant increase in levels of interest. How many of those turn into actual posts being filled, we don’t yet know.’

Professor Cumming also spoke strongly about the need to make GP practices take on more trainees in spite of current workload pressures.

He told MPs: ‘It’s difficult at the moment because GPs are under a lot of pressure and asking them to take more trainees, be they physician associates, or nurses, paramedics or whatever, is a challenge.

‘But we have to do it. Because if we don’t do it we’ll never get out of the workforce difficulties we have.’