GP trainees not prepared for urgent care, says GPC negotiator

The BMA's GP out-of-hours lead has criticised the RCGP for failing to prepare trainees properly for urgent care work.

Dr Peter Holden: critical of GP training
Dr Peter Holden: critical of GP training

GPC negotiator Dr Peter Holden, speaking at the recent Urgent Health UK (UHUK) conference of social enterprise providers, said he was ‘deeply concerned’ that new GPs were not ‘fully equipped to be allowed to go out on shift straight away’.

Dr Holden, who works shifts for the EMICS urgent care service in the East Midlands and with Lincolnshire and Nottinghamshire Air Ambulance, as well as teaching pre-hospital emergency medicine, accused the RCGP of not listening to concerns.

‘They're into too much touchy feely stuff,' he said. ‘I think [trainees] don’t get enough on what I call sharp-end primary care.'

‘I think we’ve got a real problem here, that we’ve developed a whole generation of desk doctors. I think the real problem we’ve got is we’ve produced 10 years of doctors … who seem to think general practice is a 9-5 occupation. It isn’t and it never was.'

Dr Holden, who said he was expressing personal concerns rather than those of the GPC, added: ‘I’m not for one moment advocating we go back to 2004, or even 1996, but the concept that you can become a doctor and never work out-of-office hours, you are bonkers, you’re in the wrong job. And I think it’s time we got that across to the young ones: if you want to read medicine, you’ve got to accept that there will be some out of hours work.’

RCGP chairwoman Professor Clare Gerada said Dr Holden’s comments backed up the college’s proposals for extended GP training, but admitted the training itself, run by local providers, varied in quality.

She said: ‘Improving out-of-hours and urgent care is one of the key training priorities highlighted in the college's proposals for four-year GP training and Dr Holden's remarks add weight to this. It also reinforces our plan to provide GP trainees with opportunities to work in unscheduled care services and in deprived communities in their fourth and final year of training, to increase benefits to patients and provide those doctors with essential skills that they can build on throughout their careers.'

She said GP training mandated all doctors to work in out-of-hours care and the college had produced a curriculum statement detailing the competencies required for urgent care, while the curriculum ensured training included common medical emergencies.

‘However, the out-of-hours training itself is delivered by local providers and variations in the quality of the delivery of this training have been noted,' Professor Gerada said. 'It is essential that service commissioners assure the quality of out-of-hours training, ensuring that it delivers good clinical supervision for all sessions and supports the professional development of clinical supervisors.’

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