Dr Margaret Ikpoh ponders the contradiction of our workforce crisis, and what future there is for GP trainees
We are approaching panel season, where the review and assessment of the skills and competence of our exciting bright-eyed and bushy-tailed GP registrars will take place. As a GP trainer myself, one of the joys from the end of year reviews is the sense of self-satisfaction in helping to develop the next generation of GPs. They have spent the last three years honing their communication and consultation skills into a fine art. They are ready to enjoy the fruits of their craft as UK independent practitioners.
But this week of reviews were notably less joyful in comparison to those I have experienced over the past 15 years as a trainer. My supervisees appeared despondent, demoralised and dejected. In the midst of a deepening GP shortage across the UK, a paradoxical scenario is unfolding whereby qualified GPs (including locums) find themselves struggling to secure employment. This conundrum, where the numbers simply do not add up, has left many in the profession and the public alike scratching their heads- or as my teenagers would say, ‘the maths is simply not mathing’.
The NHS long-term workforce plan projects the GP shortfall in just over 10 years to be 15,000. Record numbers are applying for GP specialty training places, and the plan stipulates that GP training places should increase to 5000 from September 2025.
Five years ago, my practice found ourselves on a workforce cliff edge, but a merger and reliance on funding for ARRS roles brought with it an increased and stable(ish) workforce. However, more bodies meant decreased space for us to practise and our buildings are still not fit for purpose. I no longer have ownership of a room adorned with memorabilia that would ignite ice-breaking conversations with even the shyest of patients. Now, desk sharing is my new norm.
GP registrars, mostly from the international community who have already committed to move to areas of socio-economic deprivation to help fill workforce gaps, now lack job opportunities. This lack of prospects and the dwindling forward investment in their careers post-qualification, will simply catalyse their movement elsewhere. As I was told earlier this week, ‘I’ve moved before, I can move again.’
The chronic underinvestment in primary care, the slow expansion of medical student placements, the lack of inclusion of GPs in ARRS are all perfect ingredients for a potential exodus from our GP waters. Without any true measure of workforce shortages at a national level, some practices will continue to be swamped with multiple applications for GP roles. And I know many GP registrars and sessional GPs are re-evaluating their UK job prospects and running to the Canadian (or other) hills .
Meanwhile we are still here, working harder than ever before, and 10% of my patients are still waiting more than three weeks to see a GP
Someone please make this make sense.
Dr Margaret Ikpoh is a GP in Holderness, East Yorkshire. You can find her on X (formerly know as Twitter) @docmagsy
It’s pure incompetence. Policy implementation in the NHS is imbecilic. The Fuller report was supposed to save general practice and it’s been implemented in a way that is destroying it. Additional roles to ‘support’ GPs hand in hand with funding policies that abolish them. It’s complete stupidity – centralised brainless and moronic.
MI, a sad, sorry tale of the current GP situation, and I also agree with MM. But something more pernicious has been going on – a policy decision to intentionally manufacture this crisis (a la right-wing thinktank playbook) in order to open up GP/NHS to future corporatisation, and transfer public capital to big business pockets. Hopefully the next Govt will change course and save GP and the NHS.
If you want to be looked after by an experienced and knowledgeable and accessible GP, who knows you, in the future, think carefully how to vote, and make sure you use your vote wisely on 4th July !
All this on a background of the Tories stating they have provided millions more GP appointments. However, no one in the press challenges this blatant lie that they are not appointments with a GP but with a noctor! I think we are past the point of no return and the only way GPs will find employment is by setting up private services. The NHS will provide noctor-led primary care and the public will soon learn if you want holistic care you will need to pay.
Vote Nigel, he’ll fix the NHS by deporting all foreigners 😂
It’s very simple. The large cohort of ARRS staff/non doctors have replaced GPs. They were never ‘additional’. Doctors with a decade or more of training and experience are now effectively unemployed, inexplicably and ludicrously forced into driving taxis and working for Tesco as revealed by GP Online today.
No jobs for GPs when there is a GP ‘shortage’ is an interesting paradox, but one that could have been predicted. The RCGP and other GP organisations need to be shouting from the rooftops about this. They are there to represent GPs ( many subscription paying members who are now struggling to find work) and no-one else.
While the deluge of money continues to pour into PCN Clinical Director bank accounts, the replacement of GPs by ARRs will continue
I hope the failed PCN experiment will soon be coming to it’s expected end. But the funding is not guaranteed to stay in primary care. There’s multitude of ways how whatever governments can screw us over and over again and again.
If I didn’t have material, physical, legal commitments here, I’d be searching jobs abroad right now