Two royal colleges have written to the health secretary urging a review of GP and physician associate (PA) workforce projections.
Both the RCGP and the Royal College of Physicians (RCP) have asked Wes Streeting to reconsider elements of NHS England’s long-term workforce plan, which was published last year.
The plan aims to establish a PA workforce of 10,000 by 2036 and to increase GP training places by 50% to 6,000 by 2031.
In its election manifesto, the Labour Party committed to delivering the NHS workforce plan, and Mr Streeting has regularly claimed that it was based on Labour’s own policies.
The RCGP argued this week that, despite the boost to GP training, the plan will increase the number of fully qualified GPs by only 4% by 2036, compared to a 49% growth in hospital consultants.
This disparity was highlighted by the public spending watchdog earlier this year in a review of NHSE’s workforce modelling which found that its ambitions were based on ‘significant’ substitution of fully-qualified GPs with trainees and SAS doctors.
Just over 6,500 GPs, GP trainees and retired trainees have signed the RCGP’s letter to Mr Streeting, which said ‘successive governments’ underfunding of general practice’ has left practices unable to ‘recruit the GPs they need’.
RCGP chair Professor Kamila Hawthorne said the 4% increase in fully qualified GPs ‘would leave an already chronically understaffed general practice woefully unprepared to meet the growing needs of patients’.
She continued: ‘This would fly in the face of your manifesto commitment to shift resources to primary care and community services to focus on prevention and enable patients to receive the care they need, closer to home.
‘We therefore ask you to urgently review the NHS’s Long Term Workforce Plan to better reflect your manifesto commitments.’
Surrey GP partner Dr Dave Triska told Pulse he ‘100% supports’ the RCGP’s stance, highlighting that it is ‘not just about training GPs, it’s about experience’.
‘So it takes many years after CCT to become a really good GP and we are haemorrhaging those at the moment – we’re haemorrhaging people in their 40s, 50s and beyond because they can’t see a future in partnership.’
He continued: ‘So the real changes that need to happen are firstly to make partnership sustainable because that will stop a lot of the exfil from general practice.
‘The second bit is role substitution, because it’s all very well and good saying we’re going to train all these people, but while financially it remains punitive to employ GPs, then that is going remain a problem for practices that are struggling with funding.’
Dr Triska argued that the Additional Roles Reimbursement Scheme (ARRS) ‘needs to be completely re-thought’, and also that the long-term workforce plan’s goals to boost other roles such as PAs is ‘absolutely contrary to all the evidence’ that suggests continuity with a qualified GP is better for patients.
He also told Pulse that ‘improving retention’ is the ‘fastest way to increase GP numbers’, which should be the ‘absolute priority’.
Meanwhile, RCP vice president for education and training Dr Mumtaz Patel told Mr Streeting that ‘too many doctors feel ignored, disillusioned and frustrated’ and that ‘it is time to act’.
On workforce policy, she said: ‘Reviewing some of the commitments in the NHS Long Term Workforce Plan, for example on physician associate projections, and making sure that doctors are engaged meaningfully in its implementation would be a good start.’
While in his shadow health secretary role, Mr Streeting said that doctors’ concerns about physician associates should be ‘seriously addressed’ and that leaders have ‘not listened’ to doctors.
Pulse approached the Department of Health and Social Care for comment.
Earlier this week, the new health secretary committed to reversing the underfunding of general practice, in his first policy announcement.
