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Make general practice more appealing, concludes DH-funded study of GP workforce

Making general practice a more appealing option for medical students and boosting retention rates may both be necessary to achieve goals of a 41% increase in GP numbers by 2030, a Department of Health-commissioned study has concluded.

The study also suggested boosting the number of practice nurses and improving workforce retention.

The findings form part of preliminary results from an in-depth review of the GP workforce in England by the Centre for Workforce Intelligence (CfWI), which said that while there has been significant growth in the size of the NHS medical workforce, there has been a shift in the balance from general practice towards secondary care.

Between 1995 and 2011, consultant numbers doubled while GP numbers grew by just 29%, to around 35,400, excluding GP registrars and GP retainers. The number of other doctors grew by 50%.

The review’s remit is to provide the evidence base for planning the future GP workforce, looking ahead to 2030. The information will be used to inform a round of consultation prior to publication of a final report this summer.

The report finds there were 67.8 GPs per 100,000 population in England in 2011, compared with 58.1 in 2000. The study authors said this needed to improve to around 83 to 84 GPs per 100,000 population by 2030. On a full-time equivalent basis, this would translate to an an extra 12,800 GPs by 2030 - a rise of 41%.

The CfWI estimates that if the planned 3,250 GP trainee places target is achieved by 2015, and maintained, it would increase baseline supply projections by around 43%, with an additional 15,300 GPs by 2030.

But it said a range of other measures might help improve effective workforce supply, including making general practice a more appealing career choice for medical students; measures to encourage returners and improve retention; making it easier for consultants in other specialties to switch to general practice; increasing the supply of practice nurses and; greater collaboration with specialists.

The report concluded: ‘Taking into account likely supply and demand scenarios, it is our preliminary assessment that the boost in GP trainee numbers to 3,250 by 2015, if achieved and maintained, may be sufficient for workforce supply to meet expected future patient demand to 2030.’

‘However we note that several demand scenarios are well above our baseline supply projection, while most of our supply scenarios are below it. Accordingly, a range of other measures to improve supply or curb demand may be needed to accompany the boost in GP training numbers.’

The study authors said that the boost will be necessary to cover growing demand for GP services driven by a range of factors including population growth, higher birth rates and an ageing population, increased prevalence of chronic conditions and multi-morbidity, better-informed patients with higher expectations, increasing non-clinical duties (for example GP representation on clinical commissioning groups) and policy initiatives for better-quality care, delivered closer to home.