Viewpoint: DH must act now to tackle GP workforce crisis, says Dr Krishna Kasaraneni

Writing exclusively for GPonline, Dr Krishna Kasaraneni says recent reports offer the government a roadmap to tackle the GP workforce crisis, and now it must take action to address the problem.

Dr Krishna Kasaraneni: DH must act on GP workforce crisis (Photo: JH Lancy)
Dr Krishna Kasaraneni: DH must act on GP workforce crisis (Photo: JH Lancy)

In the last week, the long awaited report by Health Education England (HEE) on recruitment and retention of GPs was published without much of a fanfare.

This was followed shortly by the publication of the Centre for Workforce Intelligence (CfWI) paper In-depth review of general practitioners workforce.

Both reports, which the BMA has been drawing attention to publicly, have a similarly worrying prognosis of the state of the GP workforce.

Time for government to act

The key question is: will the government finally take note of the crisis that is already hitting how we deliver GP services?

The HEE report in particular raises a lot of valid points and asks uncomfortable questions.

It asks for research to identify why doctors leave general practice early and what are the barriers to their returning to practice.

Crucially, it calls for financial support and promotion of the GP retainer scheme (or successor scheme), prioritising the funding for GP retainers to work in under-doctored areas.

It is no wonder its publication was delayed for so long.

The CfWI report complements the paper by HEE in many ways and provides potential scenarios of what general practice will look like in a few years. Provision of more flexible careers is one option that stands out.

Solutions spelled out

Also of note is the need for more accurate data. The report calls for the Health and Social Care Information Centre to work with its commissioners to produce an annual statistical publication on GP activity and consultation rates, drawing on the General Practice Extraction Service (GPES).

It would certainly be useful for this to be supplemented by the GP workload survey and collection of workforce data on GP locums, as well as better data on practice nurses, direct patient carers and the wider primary care workforce by the time of the next workforce review.

Between the two reports, there are enough recommendations for the government to address the workforce problems both in the short term and the long term. However, this will not solve some of the underlying problems facing our profession, namely the workload and funding crisis that the BMA’s Your GP Cares campaign has been drawing attention to.

These pressures are having a real and direct effect on the workforce. A recent BMA survey showed that six out of 10 GPs are considering early retirement, with a third actively planning for this decision. A lot of this is because the working lives of GPs are becoming increasingly intolerable.

GPs doing more with less

We are being asked to do more with less, often in decaying practice buildings that are being starved of investment. Patients are increasingly sharing our frustration, not least as we are struggling to provide enough appointments for the huge numbers of people who come into our practice day in, day out.

The DH needs to pay serious attention to the CfWI report’s points that growth in the GP workforce is too slow and GP trainees are proving difficult to recruit.

It adds that the 'GP workforce is getting younger and more female'. The NHS needs to embrace this change and put measures in place to make sure that we provide the right employment conditions to keep female GPs in the workforce.

For a jobbing GP, the solutions are obvious.  Curtailing the workload is a priority.  Increasing investment in staff – not just GPs, but the nurses, healthcare assistants, administration staff and others who do a sterling job day in day out as a matter of urgency, and investing in premises that are fit for the 21st century.

The process needs to start somewhere - these two reports have given the government a starting point and it needs to act before it is too late.

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