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Train non-medical staff to solve GP workforce crisis, employers told

Training non-medical staff to do the work of doctors could be a ‘rapid solution’ for the workforce crisis, a report commissioned by NHS Employers has suggested.

The Nuffield Trust report, published today, calls for the Health Education England budget to be protected, and for increased training for existing NHS staff in non-medical roles, citing this as ’a cost-effective and rapid solution to mitigating some of the pressures on more senior staff.’

Quoting a study estimating that up to 70% of a GPs’ workload could be taken on by other healthcare professionals, such as pharmacists, the think-tank predicts that in future ’care will be supplied predominantly by non-medical staff’ with patients ‘playing a much more active role in their own care’.

The report also supports NHS England’s plan to introduce more physician associates to take on GP workload, saying that ’the training provides a relatively rapid route into the NHS for graduates keen to undertake a clinical role and opens up a new workforce pool to the NHS’.

But, citing Pulse’s article from last month which reported that only six physician associates have been recruited to general practice, it admits that numbers will be small in the immediate future.

The Nuffield Trust also points out that ’the [PA] role requires an extended period of supervision before its full benefits are realised’ and that their impact on GP workload will be ’limited by the lack of a regulatory framework, which prevents physician associates from prescribing and ordering tests’.

The report further highlights the issues with medical indemnity for existing and new roles working in general practice.

It said: ’The Department of Health should expedite a review into the current legal indemnity arrangements for staff in primary care with new and extended roles.’

Quoting Health Education England’s GP director for Yorkshire and Humber Mark Purvis, the report highlights the scale of recruitment problems in general practice.

He says: ’I’ve got parts of Yorkshire and Humber where I can’t get many GPs and, unless I’m going to deliver care from an empty chair, I’ve got to deliver care from a chair with somebody different in it.’

NHS Employers chief executive Danny Mortimer said it would ‘take forward the learning and recommendations in the report’, but BMA chair Dr Mark Porter warned that training non-medical staff must not come ‘at the expense of good quality training for doctors or indeed doctors themselves’.

Dr Porter said: ’It takes doctors many years to learn how to provide the best care for their patients, and there is no substitute for this kind of expertise and experience.’

Patient Association chief executive Katherine Murphy also warned against trying to find ‘quick fixes’ to the workforce problem.

She said: ’The proposed new roles and extra responsibilities for existing staff should not be adopted as a “quick fix” solution to the complex staffing problems within the NHS, nor be seen as a cheaper alternative to highly qualified staff.

’These proposals will not solve the shortage of skilled doctors and nurses across the health service and should not aim to do so. Instead, the government needs to do more to invest in the training and retaining of these qualified practitioners.’

The General Practice Forward View, published last month by NHS England, ring-fenced spending for training of receptionists and practice managers to reduce GP workload, and also expanded on the existing scheme to make clinical pharmacists available to practices.



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