Greater increases in newly trained GPs are needed to fix an effectively ‘stagnant’ workforce because of an increase in part-time working, the independent pay review body has warned.
While trainee numbers are rising it has not kept pace with the falling numbers of contractor GPs and a drop in average working hours among salaried GPs, the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) found.
Retention in general practice was a clear issue laid out by the DDRB which also noted that the increasing proportion of international medical graduates entering GP training will present a challenge for workforce retention in coming years.
The DDRB also raised concerns about increasing rates of early retirement among senior doctors. It specifically urged UK governments to explain how they will ensure retention is not further hampered by the recently-announced freezing of the Lifetime Allowance in the NHS Pension Scheme.
The DDRB said: ‘We welcome the continued increase in the number of doctors who are entering general practice training.
‘This shows that it remains an attractive option for newly-qualified doctors when making their career choices.
But while the ‘headcount is growing’, its effective size in England is stagnant as the number working part-time increases, it said.
‘We would expect this dynamic to apply also in Scotland, Wales and Northern Ireland.
‘It is therefore crucial that in the coming years, the increases in the number of general practice trainees translates into an effectively larger workforce which can, alongside developments in the introduction of multidisciplinary teams, maintain and improve access to [GP] services.’
The review, which fed into the Government’s announcement for a 3% pay rise for salaried GPs for 2021/22, also urged ministers to recognise the contribution of NHS staff outside the DDRB remit, including GP partners.
It said GPs had played ‘an important part in the pandemic response, including through assisting those who were shielding and the national vaccination programme’.
‘This has underlined the critical importance of general practice and primary care more generally.’
The report said: ‘For those that we have not been asked to make recommendations for, we would stress that recognising their contribution during this period, as well as responding to the impact of the pandemic on them personally and on recruitment, retention and motivation, is as important as it is for other groups.’
The BMA said this represented ‘clear’ advice that doctors on multi-year deals, including GP partners, should also receive equivalent financial recognition for their efforts.
BMA council chair Dr Chaand Nagpaul said: ‘Yesterday the Government said it had accepted the [DDRB] recommendations in full this year and that this was in recognition of the extraordinary efforts of NHS workers. What they didn’t say was that it was in recognition of just some of them.
‘The Government has chosen to ignore the Review Body’s strongly worded advice that all doctors should be recognised and rewarded.’
He added that the BMA would now be pushing the Government to ‘do the right thing’ by honouring the review body’s recommendations in full.
The BMA had already pointed out that the 3% pay rise for salaried GPs in England comes with no extra funding for practices to pay for it.
Fair pay for salaried GPs is also a critical part of addressing the gender pay gap in medicine, the DDRB said, and as part of this, it is important that pay uplifts reach salaried GPs.
Dr John Hughes, chair of GP Survival, said the profession had been warning about workforce shortages for more than a decade.
He added that anecdotally it feels like the problem of retention has got worse over the pandemic.
‘There are quite a number of GPs that with the rise in workload and constant denigration from Government and NHS England have decided to pack it in and retire early,’ he said.
‘First of all we need recognition that GPs are open and working and a clear apology from NHS England for what they were implying otherwise.
‘As far as other steps go, we need a proper and adequate change in funding.’
The number of doctors accepting GP trainee places in England has risen again this year – by 7% – following initial recruitment rounds.
This is the fourth year in a row that the number of trainees has risen and already exceeds the Government-mandated target for 3,250 GP trainees to be in place every year.