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No time to stint on GP training

The news that SHAs are slicing chunks from the training budget for general practice will be greeted by many GPs with a mixture of astonishment and despair.

GPs are to be the leaders and saviours of the NHS, responsible for up to £80 billion of budget, and the arbiters of what gets cash and what gets cut. You would think it would be a fairly high priority to ensure they were properly trained. The news that SHAs are slicing chunks from the training budget for general practice will be greeted by many GPs with a mixture of astonishment and despair.

Our investigation reveals deaneries across England are having their funding for GP training reduced by an average of 6% per registrar this year. But alarming although that figure is, it masks a far worse situation in some parts of the country. West Midlands Deanery, one of the largest in the UK and where RCGP chair Professor Steve Field cut his teeth in education, is being forced to slash 14% from its GP training budget this year, even as its number of registrars goes up by 5%. It’s a cut per registrar of almost a fifth.

Hatchet jobs like this were never going to look sustainable, but the picture might not seem quite so grim if GP training had until now been in rosy health. Sadly, that’s far from the case.

The RCGP has been arguing hard, although so far without success, for a more thorough, five-year GP training programme to ensure registrars are not only competent, but also confident enough to face the increasing complexity of the job. Professor Field just last week described the lack of paediatric placements on most GP training courses as a ‘disgrace’.

Yet the college itself has also attracted criticism for the way it is running registrar training, with Dr Arnold Zermansky, a GP trainer of 30 years’ standing until his recent retirement, writing in this weeks letters section that the programme has been reduced to a giant box-ticking exercise. There are concerns that the gaps in GP training, and perhaps the way it is being organised, could be contributing to the shocking fall in the pass rate for the RCGP’s clinical skills assessment, from 81% to 46% for the autumn cohort.

These are troubled times for GP training. It is hard to see the quality of training improving this year, given the cuts that are being imposed, and more difficult still to see even these levels of funding maintained next year, when the NHS funding squeeze really begins. Yet this is a time when general practice not only needs its training protected but aggressively expanded, with education provided not only to registrars but to all GPs, to equip them for their upcoming commissioning responsibilities.

GP training is unlikely to be prioritised in such a way unless the Government hands GPs themselves responsibility for the medical education budget. General practice has been given the opportunity to shape the NHS of the future. The profession must be offered the opportunity to expand its own skills set, to ensure it has all the tools it needs for the job.

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