Cash incentives, flexible careers, cut 2,000 hospital trainees: a blueprint to save general practice

The NHS should offer a range of financial inducements to bolster the GP workforce and cut 2,000 hospital specialist training posts to fund a 15% rise in GP trainees, a DH taskforce has recommended.

Richmond House: DH taskforce set out plans to revive general practice (Photo: Emma Platt)
Richmond House: DH taskforce set out plans to revive general practice (Photo: Emma Platt)

Securing the Future GP Workforce, published on Tuesday, acknowledged that general practice now faces a workforce crisis that could put ‘unmanageable pressure’ on the wider NHS.

Financial incentives to attract and retain GPs and a decisive shift in training posts towards primary care are among its key proposals.

Here, GP summarises the main recommendations from a report that the GPC has said ‘puts forward many of the solutions that we too have been calling for’.

Training

  • Decommission 2,025 specialty training posts to fund increase in training posts for general practice.

  • Ensure 100% of foundation stage doctors experience general practice during training.

  • Raise profile of general practice as an academic discipline by promoting ‘integrated academic training programmes in general practice during foundation and specialty training’.

  • Interim target of 3,050 GP training ST1 entry points for 2014 (increase of 250) rising to 3,250 by 2015, and matching reduction in hospital training posts.

  • Shift towards allocation of trainee posts and funding for local education and training boards (LETBs) in line with weighted population.

  • Local LETB capital investment programmes (of around £10,000-20,000 per project) to recruit and develop new primary care training capacity.

Financial incentives/flexibility

  • Financially incentivise medical schools to drive up the proportion of their intake choosing general practice.

  • Assess feasibility of more flexible rules for doctors wishing to return to practice.

  • NHS England and Health Education England should provide and fund a GP returner programme.

  • Renewed financial support and promotion of the GP retainer scheme.

  • Set up networks for senior GPs (‘Twenty Plus’ groups similar to First Five schemes for newly qualified GPs) providing tailored educational and support activities, and facilitating opportunities for portfolio careers and balancing clinical with non-clinical commitments.

  • Consider reintroduction of the flexible careers scheme, which provided salary contribution and professional support for doctors working less than full time in general practice.

  • Encourage doctors from other specialties to switch to GP training with greater flexibility to recognise prior training and career progression.

  • Fully fund induction and refresher training for eligible doctors who have not previously worked in UK general practice.

Research

  • Reinstate the GP workload survey and implement more effective monitoring of GP vacancies.

  • Use data from GP clinical computer systems for workforce planning, collecting data on productivity.

  • Carry out research to identify why doctors leave general practice early and barriers to their returning to practice.

  • Review why 25% of applicants to GP training are considered unappointable.

Marketing

  • Professionally-led marketing strategy to target a wide range of audiences, including the general public, to promote an accurate and positive image of general practice

  • Research into factors that influence the observed differences in proportions of students from different medical schools choosing general practice as a career.

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