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Workforce strategy needed to prevent ‘disintegration’ of general practice, warns academic



General practice is in need of an urgent ‘coherent plan’ and ‘robust’ funding for workforce development to prevent ‘further disintegration’ of the profession, an academic has said.

Veronica Wilkie, professor of primary care at the Institute of Health and Society, University of Worcester, argued that preventing attrition in the GP workforce is just as important as recruiting new trainees, in an article published in the BMJ.

Trainees who witness ‘stressed and burnt-out GPs’ are unlikely to choose general practice – regardless of ‘how good the marketing at undergraduates is’, she said.

Work activity in general practice ‘as a whole’ needs to be analysed as well as workforce numbers, to reflect the impact a small change in secondary care can have ‘over and over again to the working day on a practice’, she added.

Her comments come after health secretary Jeremy Hunt recently announced the launch of an independent review to establish how many GPs need to be trained and deployed in each area in order to cope with future pressure on the service. Labour pledged to train 8,000 more GPs to boost the workforce

Professor Wilkie refers to a report published in 1950 by researcher JS Collings that described general practice as ‘appalling’ at the time, and subsequently led to new initiatives.

She claims that the current failings in primary care could represent ‘another Collings moment’, asking ‘how many reports need to be published before action is taken?’

Professor Wilkie highlights the recent publications of Health Education England’s Centre of Workforce Intelligence review and the GP Taskforce report – which both concluded that there are too few GPs and that GPs are under too much pressure to deliver healthcare safely.

She said: ‘What neither report recognises is that students and trainees who witness stressed, burnt-out GPs, who feel isolated and unsupported, are unlikely to choose general practice. This is regardless of how good the marketing at undergraduates is, or how access to flexible postgraduate training is improved. Preventing attrition in the existing workforce is as important as recruiting new trainees.

‘We need a coherent plan for workforce development in primary care, taking into account undergraduate and postgraduate training and beyond, with a robust funding plan that is flexible enough to reflect the local population’s needs but big enough to prevent further disintegration and a lack of investment.’

She added: ‘Work activity in general practice as a whole needs to be analysed — not just outpatient referrals or access — to reflect the change in complexity and the effect that a small change in all areas of secondary care can have, over and over again, to the working day on a practice.’