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Workforce reform stalls as deaneries train hundreds of additional hospital doctors – but just eight more GPs

Exclusive: Deaneries are failing to respond to the growing workforce crisis in general practice, creating only eight more GP training places across the UK this year.

A Pulse investigation reveals a drop in the proportion of GP trainees compared with hospital trainees across the UK, amid falling numbers of GP training places in England.

The drop in GP places comes after the Government announced in May it was targeting a 20% increase in GP training places by 2015, and as the RCGP called for 10,000 more GPs ‘just to stand still'.

The figures add to growing concern over secondary care bias in educational bodies. Information obtained by Pulse shows that the new Local Education and Training Boards (LETBs) are overwhelmingly dominated by hospitals' representatives.

Figures from the GP National Recruitment Office (GPNRO) show 3,152 offers were accepted for GP trainee positions this year across the UK, compared with 3,144 offers last year, and despite a 6% rise in applications in 2012. There was a decrease of three GP places in England compared with the previous year, with 2,693 GP training places accepted in 2012. This compared with a rise of almost 700 in hospital training places in England, with 4,725 places accepted, compared with 4,034 in 2011. This meant the proportion of GP trainees fell from 40% in 2011 to 36% in 2012.

This year's intake is the last by deaneries, with LETBs due to be authorised from October.

Of the 11 LETBs Pulse surveyed, most have stuck rigidly to the minimum requirement for authorisation that there are at least 10% of GPs on their boards. Although some have not achieved this, Kent, Surrey and Sussex LETB has only one GP representative on a shadow board of 19 members.

RCGP chair Dr Clare Gerada said the college would soon be publishing a 10-year strategy recommending an increase in GP numbers: ‘We've estimated that we need 10,000 GPs over the next 10 years just to stand still, which equates to about one more GP per practice.'

Professor Bill Irish, chair of the GPNRO and director of GP education at Severn Deanery, said the new figures were a concern as hospital specialists were already being overproduced by 60%. He said: ‘People on boards are not going to support a cut to hospital specialties, which would be a cut to their own income streams. LETBs are configured in such a way that there are vested interests, and we need a strong voice for primary care.'

Dr Barry Lewis, chair of the Committee of General Practice Education Directors, pointed to a lack of high quality applicants, but he added: ‘There are potential blockers [such as] funding restrictions and potentially the current lack of adequate GP representation on LETBs in many parts of England.'

Dr Nigel Watson, chief executive of Wessex LMC and the GP representative for Wessex LETB, said training boards needed a radical change of mindset. He said: ‘I went to a board meeting and a hospital chief said "You're a GP – why are you here?" '

A DH spokesperson denied there was a current crisis in the GP workforce, but said they would be asking LETBs to plan to increase the number of GP training posts steadily towards 2015.

He said: ‘We're carrying out detailed research and planning to understand what training programmes are needed to fill the required posts.' A spokesperson for Health Education England said GPs would be ‘well represented' on LETBs.