2022 in review: Recruitment problems persist

The Government has historically been optimistic about the prospects of recruiting GPs in England, and somewhat creative in describing how successful its strategies to do just that have been.

Pulse delved into how successive health departments have promised much and delivered relatively little in July.

Go back to 2015, when NHS England’s plan for the GP workforce largely entailed boosting GP trainee numbers and persuading overseas GPs to come and work here.

Trainee targets have been surpassed every year since, and the government has used that success to overstate actual GP workforce figures, stating numbers of GPs increased by 4,000 between March 2016 and 2022[i].

Despite a 2019 pledge to have an extra 6,000 GPs on the books by 2024, the signs are far from promising, and FTE number are instead on the decline.

Then came the additional roles reimbursement scheme (ARRS), also in 2019. Here was the silver bullet for primary care, with zealous targets to bring onboard 26,000 more non-GP healthcare staff by 2024/25.

PCNs had money to throw at these new roles, which include pharmacists, physios, paramedics and others to work in patient care and clinical roles. In the three years following the scheme’s launch, almost 17,000 ARRS staff had joined primary care.

While that’s ostensibly a great start, it’s not the solution general practice needed.

For starters, the 2022/23 Network DES permits just two mental health practitioners per PCN despite GPs crying out for more of them, such is their value given the demand for mental health support.

Some conditions apply to ARRS recruitment, too, including how much can be spent on each role.

And GPs – of whom there are too few – are often required to provide clinical supervision for the new staff, whose purpose in the first place is to ease pressure on GPs!

Currently, everyone awaits the Government’s latest workforce strategy that’s due imminently. It will need a bit of magic if it’s got any chance of getting more trained doctors into general practice to fill the growing shortfall.

Pulse readers told us in July that around one in six GP positions remained vacant. Many had thrown in the towel and stopped trying to fill empty posts.

Fingers point squarely at the Government’s failure to retain existing GPs and reattracting those who had left the profession for these data.

But if RCGP data are accurate, even more are set to leave in the foreseeable future in what the College predicts will be a ‘mass exodus’. Some 19,000 GPs and trainees, it says, will quit in the next five years if workload pressures are not eased.

It’s unlikely that the government’s ‘major international recruitment drive’ will bring in the numbers it hoped for – arguably due in large part to Brexit – just 124 of the planned 2,000 positions were filled as of June.

As one GP told Pulse, what’s needed now is ‘a concrete, positive plan for how to get more doctors at the frontline because that is what we are sorely lacking’.

Such a plan will entail providing more of everything: more routes into general practice other than the traditional partnership model, working across organisations; more work on boosting numbers of non-GP staff; more flexibility and clarity on making the ARRS more workable.

Importantly, a change to pensions taxation rules will be a step in the right direction towards improving retention.

What’s clear is that with plans A, B and C having fallen short of the mark, there is no room for plan D to fail.