Rise in GP trainee numbers 'does not go far enough to address workforce crisis'

The increase in the number of GP trainees in the UK over the past few years is 'too little, too late' and does not go far enough to address the current workforce crisis, a leading health management expert has warned.

Mark Britnell
Mark Britnell

Mark Britnell, global chairman and senior partner for healthcare, government and infrastructure at management consultancy KPMG and a former NHS trust chief executive and director general at the Department of Health, said that the UK 'had been too slow' over the past decade to deal with the NHS's growing workforce crisis.

Speaking at the RCGP's online conference 'A Fresh Approach to General Practice' on Thursday, Mr Britnell, who has worked with health systems in over 80 countries, said the UK government needed 'to think completely differently' to address the issue - and that a number of radical approaches would be needed.

'Governments need to be more entrepreneurial,' he said. 'We need more health workers now and certainly over the next 10 years.

'I don't believe that we're ever going to face a danger of having too much supply and not enough demand. That means [governments] have to think about the number of training commissions and, of course it's welcome that the number of trainee GPs has been increased, but it's too little too late – we need more.'

GP workforce

A record 3,793 trainees accepted posts in 2020 – 17% above the mandated figure of 3,250 for 2020 and 40% up from the 2,700 trainees recruited in 2014. Last year the government announced that the number of GP training posts will rise to 4,000 in 2021.

However, the most recent GP workforce figures for England showed that while the overall workforce increased by 1% in the three months to September 2020, overall the number of full-time equivalent (FTE) GPs remained 334 below the figure for September 2021 - and 1,421 (4.8%) below the total recorded in September 2015, when former health secretary Jeremy Hunt promised 5,000 more GPs within five years.

Mr Britnell argued that cutting bureaucracy and improving support for healthcare professionals would 'go a long way' to solving the workforce crisis in all areas of the NHS.

He said that in 'successive global surveys... 76% of doctors, and 79% of nurses tell us that they are overqualified for some of the tasks that they have to perform'. Freeing up time by cutting unnecessary regulation and paperwork could enable health professionals to 'perform at the top of their game', focus more on patient care and boost productivity, he argued.

Digital solutions

IT would also have a key role to play. 'It's anyone's guess really how many tasks can be automated or supported by digital technologies. But some global work suggests that about 36% of tasks can be supported digitally,' Mr Britnell said.

But he added that one of the 'mistakes that we've made in implementing big IT systems in the UK is not to let clinicians drive that process.' The only way to make technology work for organisations was to move to a more agile system that looked at the tasks people were undertaking rather than 'old fashioned job descriptions', Mr Britnell said.

The NHS also needed to get better at supporting its staff and providing opportunities or ways of working that suited healthcare professionals at different stages of their career in order to boost retention, he argued.

Mr Britnell said organisations that failed to offer flexibility or think about how their staff could have a better work-life balance were 'simply turning off the tap to future employees'. He highlighted that the NHS would also have to take steps to address the 'mental health burden' that had been placed on health professionals as a result of the pandemic if it wanted to retain people.

Global recruitment

The World Health Organisation (WHO) has predicted that there will be a global shortage of 18m healthcare workers worldwide by 2030 – a shortfall of around 20%. Mr Britnell warned that the UK would have to adopt 'progressive immigration policies' if it wanted to recruit sufficient workers to staff the NHS.

He said: 'The workforce in healthcare is the second most mobile globally after financial services. And so there will be once again a war for talent over the next decade, and we need to make sure that Britain is open and has progressive immigration policies, which respect the fact that our healthcare workforce needs to reflect our population demographics.'

Other steps that Mr Britnell suggested could help address the workforce crisis included giving patients more support to manage their own condition, which would cut staff workload and improve outcomes, Meanwhile, both health and social care should also look at how local communities could be empowered or funded to help support more vulnerable residents.

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