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GPs to be offered incentives to delay retirement under £10m strategy to solve workforce crisis

Experienced GPs will be incentivised to stay practising – or return after a career break – under a major £10m workforce plan launched by NHS England today.

A major marketing campaign on the ‘positive aspects’ of general practice will be launched to persuade more medical graduates to become GPs and incentives to encourage returners and trainees to work in underdoctored areas will also be introduced.

GPs will be incentivised to either stay in practice or return from a career break by offering older GPs the option of a portfolio career or payments to mentor less experienced GPs.

The plans are designed to counter a growing workforce crisis. Pulse revealed last year that GP vacancy rates had quadrupled over two years and the RCGP has highlighted a need for 10,000 more GPs by 2020.

NHS England says the money, which will be reallocated from the Government’s £1bn general practice infrastructure fund, will also create a new national retainer scheme and set up ‘training hubs’ to allow practice staff to extend their skills.

The ‘10 point plan’ has been designed together with Health Education England (HEE), the GPC and RCGP.

But the GPC warned that it did not go far enough to tackle the rising workload that is leading to ‘tens of thousands’ of GPs planning to retire and a rise in emigration.

Although the plan does include piloting schemes to introduce new grades of general practice support staff to support GPs, including physician associates, medical assistants, clinical pharmacists and advanced practitioners (including nursing staff).

The plan includes several of the recommendations from the GP Taskforce report published in July 2014, such as for example the marketing campaign, funding of a new returner scheme, focusing incentives to GPs willing to work in under-doctored areas and offering flexible career paths for older GPs.

However it also omits several recommendations, including a proposal to make exposure to general practice mandatory for trainees in all medical specialties or decommissioning other specialty training posts to pay for more GP posts.

The RCGP said it will kick off the general practice marketing campaign with 16 roadshow events aimed at medical graduates and starting in Kent next week (28 January).

It comes as almost 40% of GP training places were unfilled in parts of England last year.

Dr Krishna Kasaraneni, chair of the GPC’s education and training subcommittee, welcomed the plan, but said it was not a ‘magic solution’ and the £10m funding should be recurrent.

He said: ‘It is a long-term plan, which is positive. And it does have potential to deliver gains in areas like recruitment, induction and returner schemes a lot sooner, but quite a lot of these proposals are essentially looking ahead to the future.

‘While NHS England and HEE have acknowledged the situation, we recognise that this plan alone isn’t going to yield immediate returns, cut down waiting times for GP appointments or provide better access.’

‘I think [the plan] is rightfully focused on the under-doctored areas but by that it doesn’t mean that the rest of the country doesn’t have workforce problems. You have to treat the worst problem first, in a way, which is what this paper is aimed at.’

NHS England chief executive Simon Stevens said: ‘We need greater investment in GP services, extending to community nursing, pharmacy and eye care services. This £10m will kick start a range of initiatives to drive that forward so every community has GP services that best meets its health needs.’

RCGP chair Dr Maureen Baker said: ‘There is now a real push to put more resources into general practice and build up the GP workforce, with the “new deal” for general practice announced by NHS England in its Five Year Forward View and new funding for general practice infrastructure. As a result, the future of general practice is looking bright and GP skills have never been more in demand.’

Health secretary Jeremy Hunt said: ‘As we move more care out of hospital into the community, and continue to focus on prevention rather than cure, we need to support this with greater access to primary care. I welcome this ambitious plan which helps set a clear direction for the future of general practice, and I hope it will encourage even more young, aspiring medical students to take up careers as GPs.’

What does the 10-point plan include?

  1. A marketing campaign including a letter to all newly qualified doctors setting out positive aspects and future careers in general practice
  2. Offering GP trainees an additional ‘flexible’ year of training where they can train in a special interest, get an MBA in leadership skills or another academic pursuit
  3. Setting up ‘training hubs’ for GP practice staff to extend their skills
  4. A time-limited incentive scheme for GP trainees committing to work in an under-doctored area for at least three years, including financial support
  5. Reviewing current retainer schemes and investing in a new national scheme
  6. Offer premises funding to training practices focused on the agenda of transferring care into community settings
  7. Reviewing how to incentivise experienced GPs to remain in practice, for examples via a funded mentorship scheme or offer portfolio careers
  8. Piloting new general practice support staff to take workload off GPs, such as physician associates, medical assistants, clinical pharmacists and advanced practitioners (including nursing staff)
  9. Making it easer to return to practice after working overseas or taking a career break, via a new clearer induction and returner scheme
  10. Offering financial incentives to returners opting to go work in under-doctored areas and reviewing the value of the performers list in its current form

Read the full plan here.