GP numbers will fall ‘substantially short of demand’, even though there is a major focus on increasing GP trainee numbers by 2024, posing a ‘fundermental threat’ to primary care, according to a major new report.
The report – published today by three major health think tanks – analysed NHS workforce gaps and found the health service will have 7,000 fewer FTE GPs than needed within five years, not taking into account the ‘growing expectations’ placed on GPs by the long-term plan.
This major workforce shortage is a ‘fundamental threat’ to the sustainability of primary care, and a ‘new model of general practice’ is the ‘only way forward’, the report said.
The document, released by The Health Foundation, The King’s Fund, and Nuffield Trust, outlines a series of policy recommendations for the upcoming NHS workforce implementation plan, focusing on nursing and general practice, where the problems are ‘particularly severe’.
The recommendations include adding an extra £900m per year by 2023/24 into the budget of Health Education England, to enable the workforce to grow.
The report said: ‘The NHS in England has 2,500 fewer FTE GPs than it needs this year, and a projected gap of 7,000 FTE GPs within five years if current trends hold.
‘These figures do not take account of the growing expectations of general practice as underlined in the NHS long-term plan. Unless action is taken, shortages of this scale represent a fundamental threat to the sustainability of primary care in England.’
It continued: ‘The only way forward is to make substantial progress towards a new model of general practice with an expanded multidisciplinary team drawing on the skills of other health care professionals.
‘The new GP contract and the NHS long-term plan support this shift, but the key issue is the speed, consistency and quality of implementation across the NHS.
‘The workforce implementation plan needs to clearly outline how this model will be rolled out safely across the country, and at pace.’
The new five-year GP contract, released this year, includes funding for 22,000 additional practice staff –pharmacists, physiotherapists, paramedics, physician associates and social prescribing workers – by 2023/24.
Nuffield Trust director of workforce strategy Candace Imison said: ‘The imminent workforce plan needs to mark the moment we stop treating the staffing of health and social care as a second order issue.
‘Our recommendations might seem radical, but the time for tinkering at the margins has passed.
‘I’m especially worried that while medical and technological advances mean staff need to adapt and learn more quickly than ever, we have slashed the funds that support this. If any of our lofty aspirations about better outcomes and digital technology are to become a reality, we need to get the budget for developing skills at least back to where it was – and that means a fourfold increase by 2023/24.’
King’s Fund chief executive Richard Murray said: ‘Without radical action to expand the NHS workforce, there is a very real risk that some of the extra funding pledged by the Government will go unspent, waiting lists will continue to grow and important improvements to services like mental health and general practice will fail.’
RCGP chair Professor Helen Stokes-Lampard said: ‘We agree with the writers of this report that the GP workforce faces significant challenges but we disagree that these are insurmountable.
‘We must not, under any circumstances, give up on our aims and endeavours to build the GP workforce – achieving these is vital for the future of the NHS, and patient care.
She continued: ‘We are extremely grateful to the hard work, skill and dedication of members of the wider practice team – they are pivotal in supporting us to deliver care to over a million patients every day – but they are not GPs and must never be seen as direct substitutes or used to “fill the gaps” long-term where numbers of GPs are insufficient.
Professor Stokes-Lampard added that it is ‘imperative’ that the upcoming NHS workforce strategy not only include plans to expand the multi-disciplinary team practices, but also ‘comprehensive plans to further boost GP recruitment, make it easier for trained GPs to return to NHS practice, and to keep existing GPs in the profession longer’.
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