Golden handshakes won't fix GP shortages, NHS England official admits

One of the key planks of NHS England's 10-point plan to tackle the GP workforce crisis 'doesn't work', the organisation's primary care commissioning lead has admitted.

Dr David Geddes: golden handshakes don't work (Photo: Nathan Clarke)
Dr David Geddes: golden handshakes don't work (Photo: Nathan Clarke)

Speaking at a Westminster policy forum event on Thursday, Dr David Geddes said solutions ‘more subtle than golden handshakes’ should be devised to tackle workforce issues.

A workforce action plan released in January - agreed by NHS England with the RCGP, GPC and Health Education England said that ‘time-limited incentive schemes’, or golden handshakes, should be offered to GP trainees who commit to working in under-doctored areas for at least three years.

But Dr Geddes admitted the policy would not fix the problems facing understaffed practices in rural and deprived areas.

‘We know that golden handshakes don't really work,’ he said. ‘We end up with bidding wars between different areas which means we’re robbing Peter to pay Paul.’

Build up support and education

Instead, the focus should be on building better infrastructure of support and training hubs to draw GPs and keep them in the areas with long-term shortages.

‘We need to look at targeted ways of investment. Very often you will find there are areas in the country which are under-doctored. And when they're under-doctored they're often under-nursed as well, and it often persists for years or decades. There's a clear correlation between being under-doctored and having worse outcomes for patients.'

NHS England needs to look internationally and nationally at projects that have worked, he added.

He cited a doctors' returner scheme in Greater Manchester that supported doctors unfamiliar with the NHS to get into general practice, such as doctors from overseas or those who have been long out of practice.

Need to be creative

Setting up similar projects in other understaffed areas could attract doctors and convince them to stay, he argued.

Dr Geddes said: ‘There's been some really good work in, for example, Manchester. They have been able to build up their workforce because people come back and tend to stay afterwards.'

He also mentioned an ‘innovative’ scheme in Hull that sees new GPs given opportunities to work in CCGs, Public Health England (PHE) and acute trusts.

‘We need to be creative to draw people into these areas,’ he said.

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