How the New to Practice Fellowship was quietly shelved

The scheme to help new GPs enter general practice helped a number of people. But the unemployment crisis and cuts to funding seems to have halted the programme. Emma Weinbren reports

Qualifying as a GP can be a lonely experience. So recalls Dr Katie Collins, clinical lead for GP New to Practice Fellowships at Hampshire & Isle of Wight ICB.

‘You’re having teaching sessions every week in your final year of training and then, when you qualify, you hardly see your peers at all,’ she says. ‘It can feel like a bit of a “falling off a cliff” moment.’

That experience means Dr Collins is particularly passionate about her role in providing local New to Practice Fellowships – a two-year programme that helps GPs make the transition between qualifying and taking on a practice-based role. For her, it’s the support she wishes she’d had as a newly qualified GP.

Evidence collected by her ICB suggests new cohorts are equally appreciative. ‘People say they would have left general practice if it wasn’t for that programme,’ Collins reports.

Yet this support is under threat. New to Practice Fellowships are no longer nationally funded, and under-pressure local authorities are either cutting or scaling back programmes to balance the books. Insiders fear the lack of support could trigger another wave of GP shortages.

Support offered

NHS England launched the national New to Practice Fellowship programme in December 2019. The scheme offered support to all newly qualified GPs and nurses working in a GMS practice in a bid to boost retention and job satisfaction.

The national scheme offered funding for one session per week plus costs to the employer, calculated at the individual’s salary. Funding for programme delivery – including CPD provision, administration and oversight – worked out around £3,000 per participant, based on one session per week.

Learning typically included a mix of training days and self-directed online sessions, as well mentorship sessions and peer support conversations. ‘Activities will vary week by week and will evolve across the two-year period as new aspects from the model are added,’ said the NHS England guidance.

‘For example, in the first six months an individual might expect to spend their weekly fellowship session undertaking a range of induction and peer support activities, whereas in their final six months on the programme they may utilise this weekly session for career coaching and plugging into system-wide leadership development and learning opportunities.’

Dr Mandy Yip, a salaried GP in Farnham who completed the national programme in 2021, found that mix invaluable. ‘The range of courses and training days was really, really good,’ she reports. ‘You can even go on courses where you learn how to coach.’

On a professional level, Dr Yip became more involved in the local PCN and gained an interest in coaching. On a personal level, she gained access to a network of newly qualified GPs – who are still in touch via a WhatsApp group – going through similar experiences to her.

For her, the monthly mentoring sessions were another highlight. ‘You can talk to them [your mentor] about anything,’ says Yip. ‘That was helpful because I think being a newly qualified GP can be daunting in terms of workload and work-life balance.’

GP unemployment

Still, she qualified in a very different environment. At the time, NHS England was facing GP shortages and was happy to plough funding into retention. In 2022, the RCGP warned the number of fully qualified GPs had fallen by 5% between September 2015 and 2021, despite the Government warning of a shortfall of 6,000 GPs.

Today, the BMA has warned of widespread GP unemployment and underemployment, as financially constrained practices cut down on the number of available roles. At the same time, NHS England highlights the number of full-time equivalent GPs has risen from 27,483 in November 2024 to 28,698 in November 2025. So, although recruitment still remains a major issue for many practices, there is less imperative for the national body to plough funding into the scheme.

The national programme came to an end on 31 March 2024, transferring instead to a local system. NHS England says it is ‘continuing to support GPs into employment, including recruiting over 1,000 extra full-time GPs in the past year and expanding the Additional Roles Reimbursement Scheme’.

However, now that ICBs are funding the scheme from their own budgets, there are fears over its future – and the potential knock-on effect. ‘The Royal College of General Practitioners (RCGP) is aware of concerns about limited availability of places in some areas,’ says RCGP chair Professor Victoria Tzortziou Brown.

‘This is worrying given the ongoing need to build and retain the GP workforce, but it also sits alongside wider frustrations from GPs struggling to find appropriate roles within the NHS,’ she says. ‘These challenges underline long-standing issues with workforce planning and the need for sustained investment in general practice.’

Regional variation

NHS England did not comment on how many ICBs are running New to Practice schemes – and it is widely thought a central figure is not available – but the picture is one of regional variation.

Some ICBs are determined to continue the programme. Dr Collins says Hampshire and Isle of Wight ICB has had to be ‘careful in how we budget’ but is committed to offering a two-year programme.

Other ICBs are making savings by offering a one-year version. And a few are phasing out the scheme entirely. Dr Yip says the scheme is likely to end in 2027 in Greater Manchester and Leeds.

She fears that the lack of support – alongside a rise in temporary practice-based GP roles through the ARRS, as opposed to permanent contracts – could have a far-reaching impact. ‘I think without a fellowship, we’re going to lose a lot of GPs,’ she says.

Those concerns are backed up by fellow GP Dr Charlotte Callaway, who practises in Warwickshire. She credits the support and networking opportunities offered by the new to practice fellowship scheme with finding a rewarding role in a local practice.

‘It’s hard to picture where I might be without the fellowship,’ she says. ‘It’s feasible that I could have remained in a job that was making me miserable. I might have left the area and returned to my training locality, which would have been difficult personally, or I might have left general practice altogether,’ she says.

These anecdotal experiences are far from isolated. Evaluations of the programme across ICBs point to its impact. In London, 88% of GPs who completed the local new to practice fellowship said it had increased their intention to continue working at a practice in the area, found an analysis of 2019-2021 cohorts.

Sussex Training Hub posts several positive testimonials on its site, including one particularly telling account: ‘If it were not for this programme, I am certain I would not have remained a salaried GP for as long as I have!’

If the New to Practice Fellowship falls by the wayside, Dr Collins points out there is very little in terms of comparable support. The RCGP offers a First5 programme, which includes mentoring, professional networking opportunities and resources for newly qualified GPs, but that is funded through membership fees.

Dr Collins says national funding for that early support can pay off in terms of a settled, happier GP workforce. ‘These programmes very much are key to retention,’ she sums up. ‘If you can get people settled in that first couple of years, and work as a salaried GP, they’re far more likely to stay.’

So if new to practice support dies down, the true fallout may only be visible in years to come.