Review backs integrated training across primary and secondary care

A major review of UK medical training has backed extended GP training and called for more integrated training across primary and secondary care to support the shift of services into the community.

Professor Sir Peter Rubin: training review backs major reform
Professor Sir Peter Rubin: training review backs major reform

The Shape of Training review, chaired by Nottingham University vice chancellor Professor David Greenaway, found that GPs will ‘probably need at least four years of training to meet their outcomes and enter professional practice’.

Medical Education England backed the RCGP’s call to extend GP training to four years last April but funding for this has yet to materialise.

The review, published on 29 October, called for training to meet ‘patient and service needs’ with a ‘systematic way of managing medical workforce numbers’.

It said more doctors will need general practice skills because they will increasingly be working in the community.

'GPs will develop GP and healthcare networks where patients can access more targeted and specialised care in the community when needed,' it reads. 'To deliver safe care in any setting, all doctors will need generic knowledge and skills coupled with the ability to diagnose, initiate treatment and manage the interface between different services and specialists.

'Locally delivered care will require more doctors trained in broad specialties, including general practice.

‘They will have to be able to manage acute situations in the community with the goal of keeping people out of hospitals as much as possible.

‘Evidence suggests that involving specialists in community care and involving GPs and doctors trained in general areas of a specialty in coordinating hospital and community care lead to improved patient outcomes; higher levels of patient and staff satisfaction; shorter hospital stays; fewer emergency readmissions of acutely ill patients.’

Professor Greenaway said: ‘Patients’ needs are changing fast and we need to ensure that medical training keeps pace.

‘Today’s report sets out a framework for delivering this. It will ensure that the training doctors receive continues to be of the highest standard and meets the increasingly complex demands of future medical care.

‘I trust the government, and all those that work in and with the health service will adopt and use the report to steer the changes in postgraduate medical education and training to meet patient needs and ensure that doctors in the UK continue to receive the highest quality training.’

The review called for GMC registration to move to ‘the point of point of graduation from medical school, provided there are measures in place to demonstrate graduates are fit to practise at the end of medical school’.

GMC chairman Professor Sir Peter Rubin said: ‘We warmly welcome the final report from Professor David Greenaway’s Shape of Training review.

‘We are pleased Professor Greenaway’s focus is on the changing demographics in the UK, and especially on the ageing population and growing number of people with complex medical conditions.

‘Some of the recommendations will require further discussion, including the suggestion that full registration should be awarded at the point of graduation from medical school. But overall we are confident that these recommendations will help to improve the way doctors are trained and provide clear benefits for patients and the public within the health service now and in the future.

'The key is to ensure that we are able to make steady progress towards these reforms while maintaining some stability in a system that has already been subject to a great deal of change and pressure in recent years.’

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