Government drops time limit on pledge to recruit 5,000 more GPs

Matt Hancock's message about the GP workforce at last week's RCGP conference sounded unequivocal - plans to recruit 5,000 extra GPs were proving difficult, but 'we are going to make it happen'.

Health and social care secretary Matt Hancock
Health and social care secretary Matt Hancock

His exact words to the conference were: 'In 2015 the target was set to recruit 5,000 more GPs - and that target has proved difficult to say the least. But I am telling you today we are going to make it happen.'

What Mr Hancock wasn't telling the RCGP conference, however, was that although he is sticking to the planned workforce increase, he has quietly dropped the deadline.

Under the target set by Mr Hancock's predecessor Jeremy Hunt, the government pledged to increase the full-time equivalent (FTE) GP workforce by 5,000 by 2020/21, using the 34,592 FTE GPs in September 2015 as a baseline. The DHSC has now confirmed that an extra 5,000 GPs will instead be delivered 'as soon as possible'.

GP workforce

In some ways the real surprise is that it's taken this long for the government to admit - albeit without a direct acknowledgement from the health secretary in his RCGP message - that the target wasn't going to happen within the original timeframe.

The latest workforce figures published by NHS Digital showed that in June 2018 the FTE GP workforce was 33,163 - more than 1,400 below the figure when Mr Hunt's target was set. From the June 2018 starting point, the government would have to increase the FTE GP workforce by around 20% in just over two years to hit the original target.

Former health secretary Mr Hunt admitted in June that the government was 'struggling' to meet the 5,000-GP target, but insisted that despite being 'widely ridiculed' for the pledge he remained 'absolutely determined' to deliver it. Nonetheless, you'd probably be hard pressed to find a GP in the country who ever really thought it would happen by 2020/21.

So, is the 5,000-GP target destined to go down as a political trick - just a useful soundbite Mr Hunt dreamed up to keep the critics at bay as he remained in office long enough to become the longest-serving health secretary since the NHS began - or could it yet transform general practice?

GP leaders have called for a 'step change' in government and NHS efforts to tackle fundamental issues driving the workforce crisis, such as indemnity, workload, pay and factors highlighted in the ongoing review of the partnership model. Mr Hancock told the conference last week he wanted to make general practice more attractive 'by addressing the concerns of GPs'.

And although the 2020/21 deadline may not have been feasible, an array of plans is in motion that could ultimately deliver a rise in GP numbers.

Medical school places have been increased and a record number of GP trainees took up posts this year. State-backed indemnity could slash GP costs from April and measures to reduce the impact of pensions tax on GPs' cashflow have taken effect - both factors that have driven GPs out of the profession or forced them to limit working hours.

GP contract reform

Meanwhile, NHS England has said that 2019 could start the biggest reform of the GP contract since 2004 - with plans to drop a quarter of QOF indicators, proposals to come from the review to revive partnerships, and a review of premises.

GP partners were also awarded a larger pay rise in 2018/19 than other doctors - although it still fell well short of BMA demands.

Ahead of the RCGP conference, the college revealed its work to streamline the application process for doctors from Australia by as much as nine months; while NHS England said it had received applications from 1,200 GPs in Europe through an international recruitment programme, with another 700 doctors applying to join the improved induction and refresher scheme.

Perhaps these ongoing initiatives - as well as a sense that the original target was highly optimistic - have spared Mr Hancock any real anger from GP leaders at the softening of GP workforce plans.

Recruitment

RCGP chair Professor Helen Stokes-Lampard said: 'Our top priority remains recruiting more new GPs, retaining the expertise of existing GPs, and streamlining the processes that will enable qualified GPs to return to the profession. We will continue to work with the government and others to achieve this within the shortest possible time, notwithstanding the challenges we face.'

GPC chair Dr Richard Vautrey told GPonline: ‘I think it is welcome that the secretary of state is committed to increasing the number of GPs. But we wouldn’t want the government to give up on an important way of improving access to general practice and appointments for patients.’

He cited expansion of medical schools and GP training places and other workforce measures as evidence that there was a will on the part of government to address the GP workforce crisis.

But he warned that more work was needed to increase retention of GPs, warning that GPs leaving the profession or reducing their hours was understandable in the face of soaring workload pressures.

He added: ‘I don’t think they’ve given up, they have recognised how difficult that goal is. We have to see a step change in the ways they go about trying to address these fundamental issues of workload pressure, indemnity, issues raised in the partnership review. The problems are well known - we need to see investment and commitment to tackle them.’

Watch Matt Hancock's video message

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