Neighbourhood model depends on general practice becoming ‘more attractive’, warn MPs

The Government has been warned that the success of the neighbourhood health model and the upcoming NHS 10-year workforce plan depends on making general practice a ‘more attractive place to work’. 

In a letter sent today to secondary care minister Karin Smyth, the parliamentary health and social care committee warned that the model will not succeed if the community sector continues to offer ‘worse pay’ and ‘fewer opportunities’ than the acute sector.  

It said the refreshed NHS workforce plan, now expected in the Spring, would need ‘clear proposals’ to make general practice and community services ‘more attractive’.

The committee was relaying its findings from a November session which heard from healthcare leaders including then-RCGP chair Professor Kamila Hawthorne. 

The ‘lower status attached to working in a community setting’ which currently persists would need to be addressed, the letter said. It referenced Professor Hawthorne’s testimony that the ‘“dissing of general practice” as a less difficult speciality was common’. 

A ‘lack of training, supervision and peer support in the community’ is contributing to this issue, the letter said, referencing Professor Hawthorne’s view that a ‘lack of infrastructure for GP training’ and ‘shortage in training places’ meant there are ‘not enough training practices or premises to train more GPs’. 

Professor Hawthorne also argued at the November session that the additional roles reimbursement scheme (ARRS) ‘needs to be disbanded’ and the money redirected to core GP contract funding. 

The letter said: ‘The Government’s desired shift towards neighbourhood health will not be delivered if the community sector offers staff worse pay, fewer opportunities to advance their careers and make use of their skills, and poorer training and supervision than the acute sector.

‘The upcoming 10 year workforce plan must contain clear and concrete proposals to address these challenges and make the community a more attractive place for staff to work and build a career.’

It requested a response from the minister by 30 January. 

The workforce plan was originally scheduled to be published in 2025, but the Government has pushed it back until Spring 2026 to give stakeholders more time to respond to the consultation, the Department of Health and Social Care told Pulse. 

The ‘refreshed’ plan is set to replace the 2023 Long Term Workforce Plan, whose aim to increase NHS headcount 60% by 2037 was rejected as unworkable. The 2023 plan was also criticised for its projected 4% increase of fully-qualified GPs by 2036/37, compared to a 49% increase in hospital consultants. 

The Government has already suggested the workforce plan will include ‘fewer staff than projected’ by 2035, but said those staff will be ‘more motivated’ and receive ‘better training’. 

In July, health secretary Wes Streeting promised that NHS reforms over the next 10 years will generate ‘enthusiasm’ about working in general practice from future generations of doctors.

A Department of Health and Social Care spokesperson told Pulse: ‘Neighbourhood health centres fundamentally reimagine how the NHS works – bringing care closer to home and making sure the NHS is organised around patients’ needs, not the other way round.

‘Starting in the most deprived areas, the NHS Neighbourhood Rebuild programme will deliver 250 facilities and be subject to market testing, learning lessons from past and current models. Our approach means providers only get paid when they deliver, contracts are more flexible, and everything is on the government’s balance sheet from day one – with no hidden debts down the line.’