Integrated care systems (ICS) and sustainability and transformation partnerships (STPs) will receive £12m in 2019/20 and a further £12m in 2020/21 to support GP retention. NHS England has also developed a new toolkit to help improve retention of GPs called Making general practice a great place to work.
Earlier this month health secretary Matt Hancock admitted that the 2020 deadline for adding 5,000 GPs to the workforce had slipped because there had not been sufficient efforts to retain GPs.
Mr Hancock said that the 'number one focus' in recent years had been on hiring new GPs - pointing out that with record numbers of GPs in training, this had 'been successful'. But he admitted: 'I think there wasn't enough focus on retention, both in terms of people doing full-time work and in terms of keeping people in NHS general practice.'
The new toolkit is based on findings from seven 'GP retention intensive support sites', which were established across England last year 'to "hothouse" local support at different levels'. ICS/STPs have been mandated to include recommendations from the toolkit as part of their local planning to improve GP retention.
The toolkit sets out steps that the NHS can take at ICS/STP level, practice/primary care network (PCN) level and individual level. It argues that GPs may need support at all stages of their career, including when they are newly-qualified, if they are to remain working in the NHS.
However, the intensive support sites found that 'person-level' career support 'can have the greatest impact for GPs in the early stage of their career'. The retention toolkit said that ICS/STPs will receive further funding this year to develop the two-year fellowship idea that was suggested in the GP partnership review and which NHS England backed in its long-term plan.
The fellowship is aimed at supporting newly-qualified GPs as they make the transition to independent practice and to encourage them to take on substantive roles in primary care rather than opting for locum work. The toolkit said that guidance would be provided shortly on how to set up the scheme, which would be based on 'existing best practice which is starting to emerge across the country'.
Other initiatives aimed at providing support to GPs at various stages of their career recommended by the toolkit include one-to-one coaching, peer support programmes, leadership development schemes, mentoring, a more supportive approach to appraisal and initiatives that help GPs to develop portfolio careers.
Primary care networks
The toolkit said that primary care networks (PCNs) would 'play a key role in creating a sustainable workforce'. It added that ICS/STPs will receive 'significant development support funding' to work with PCNs to develop career deveiopment and support programmes for GPs and other staff.
Meanwhile, the toolkit suggested that at practice/PCN level leaders should be working to address workload concerns by 'developing the multidisciplinary team', communicating local support available to GPs and 'promoting and developing the practice/network as a great place to work'.
ICS/STPs should 'work across primary and secondary care with a focus on reducing GP workload' and ensure there is strong engagement between practices/PCNs and the new primary care training hubs that are being developed, the toolkit said.
An example of how the GP fellowship could work is the GP Salaried Portfolio Innovation Scheme developed by Barking, Havering and Redbridge CCGs in east London in partnership with Health Education England.
GPs on the scheme are offered a permanent salaried role of 4-7 sessions in general practice, with two other sessions in an alternative setting including mental health, community trust specialisms and CCG leadership roles. GPs also have access to peer support facilitated by an experienced GP trainer.
The scheme is currently in its second year and is being rolled out to other CCGs in the capital.