Pulse editor Jaimie Kaffash makes the case for prioritising GP training in any future workforce plans
Even when the NHS and Government tries their best to promote general practice, they don’t quite get it right.
Last year, the NHS’s major workforce plan laid out how it intends to increase the number of GPs in England.
One of their aims was to have GP trainees spending their whole three-year placements in general practice. The reasoning behind this was… well, there wasn’t much reasoning (although the more cynical of you might say it is an easy way of inflating the number of GPs in the workforce).
The passage from the plan reads: ‘We will… increase training and supervision capacity in primary care so GPs in training can spend the full three years of their training in primary care settings.’ (Their emphasis.) This was in the context of increasing foundation doctors’ exposure to general practice. In the same paragraph, they made a commitment for all to spend some time in general practice.
This is laudable. Too often in the past, we have heard sneering attitudes about trainees who want to go into general practice. Whether exposure to general practice in its current state will attract people to the profession is another matter altogether, but the thinking behind it is sound.
But there are two big problems with such an aim. First, as Pulse reported extensively at the time, we have seen absolutely no ideas about how they will increase training capacity in general practice. We calculated that achieving all the aims – including all FY trainees spending at least four months in general practice, GP registrars spending all three years in general practice, and the increase in GP training places and medical school numbers – will require a three-fold increase in capacity. And this is at a time when they are struggling to meet current demand.
The second big problem was highlighted last week at the LMCs Conference in Wales. The chair of the BMA’s GP registrars committee, Dr Malinga Ratwatte, stated that the committee policy was to oppose GP trainees spending 100% of their time in primary care. This was informed by a survey carried out by the committee, which found that trainees wanted exposure to secondary and community care. This was especially true for overseas graduates, who make up a huge proportion of GP trainees – they particularly appreciate the understanding of how other parts of the NHS works.
This pretty much sums up the Government’s whole approach to GP recruitment. A lot of lip service around how important it is to increase GP numbers, followed by some nice sounding policies. But scratch beneath the surface, and the policy seems ill-thought out, unachievable and counterproductive. And almost certain to be swept under the carpet once Labour gets in.
Since the plan was announced, the environment has changed a lot. The row around the role of PAs in general practice has intensified and – more importantly, but not unconnected – we have moved to an employment crisis, with GPs out of work.
I fear that this employment crisis might lead to GP recruitment being deprioritised. But this simply must not happen. We still need to train more GPs. There is a simple remedy to out-of-work GPs, and that is to increase funding. We still need more GPs – as jarring as that may sound for those GPs who find themselves out of work through no fault of their own. (A new Labour government would have an easy win by increasing funding and tweaking ARRS, which would have an immediate effect – I can’t see that happening though).
I am glad that the NHS and the Government at least made (half-hearted) efforts to increase GP training. But I hope that after the election there is a new workforce plan for GPs. One with policies developed following discussion with the profession; one with clear funding to support an increase in training capacity; and, more than anything, one with funding for practices to be able to employ these new trainees. Without such a plan, any promise to address the crisis in general practice is just hollow words.
Jaimie Kaffash is editor of Pulse. Follow him on X (formerly Twitter) @jkaffash or email him at editor@pulsetoday.co.uk
Jamie Oliver F.R.C.G.P.———— no training