We have repeatedly warned the government of the deepening workforce crisis in general practice. This has been glaringly obvious to those of us faced with unmanageable workloads and recruitment and retention difficulties - from ongoing vacancies to GPs retiring early or emigrating, training places going unfilled and problems staffing out-of-hours services.
This harsh reality is now official in light of two independent Department of Health-commissioned reports published last month, both of which make for disturbing reading. The CfWI (Centre for Workforce Intelligence) In-depth Review of the General Practitioner Workforce is unequivocal:
'evidence points to a workforce under considerable strain ... current workforce levels are not sustainable ... Without a significant increase in size, the GP workforce will be insufficient to adequately meet expected patient demand'.
The second report, Securing the Future GP Workforce, from the GP Taskforce, which was set up by the DH and Medical Education England to recommend how to encourage more doctors to enter GP training, reinforces this point:
'there is a GP workforce crisis which must be addressed immediately even to sustain the present role of general practice in the NHS, let alone enable it to expand and meet the growing healthcare needs of our population, irrespective of future models of care'.
Despite the damning consensus these two reports reveal, there are few signs that any effective action has been taken to combat the workforce crisis. GP specialty training was the third least popular specialty last year, with a 15 per cent reduction in applicants and a significant number of vacancies remaining unfilled, according to the National Recruitment Office for GP Training. Meanwhile, over the past 20 years only 20-30 per cent of UK graduates have indicated general practice as their unreserved first choice of career, according to a longitudinal questionnaire. Compare this with the English government's own target of getting 50 per cent of doctors into general practice and it's clear we have a problem.
We are also experiencing a retention crisis, with growing numbers of GPs retiring prematurely or going to work abroad. It is tragic that 40 per cent of women leaving the profession do so before they reach the age of 40. This is a scandalous waste of taxpayers' money given that it costs around £500,000 to train a GP and considering that better return-to-work schemes could do much to address the problem.
A national survey of 2,000 GP trainees by Wessex local medical committees confirms that younger doctors have not been spared either. The survey reveals 12 per cent of trainees are intending to leave the country within the next 12 months, and 83 per cent of the comments they made on their impressions of general practice were negative.
We are actively calling on the government to cease being in denial about the crisis at the heart of general practice and take decisive action before it's too late. The government should heed the recommendations made in the CfWI report that it commissioned by:
These actions would:
Fundamentally, in order to safeguard retention and recruitment, the government has to make the job of being a GP both manageable and rewarding. Is it any surprise that medical students and doctors in training are put off as they observe stressed, exhausted GPs with seemingly limitless workloads being denigrated and scapegoated rather than appreciated, many forced to practice in buildings without adequate physical space to teach, let alone see patients?
Your GP cares latest
Improving recruitment and retention is one of the main goals of the Your GP cares campaign, which is calling for long-term, sustainable investment in general practice.
So far, 12,000 practices across the UK have received campaign packs. Many are choosing to download our short film to show on their websites, which is a simple way of informing patients about the campaign. They include Brownlow Health, which provides GP services on four sites in and around Liverpool city centre. Many other practices are requesting additional materials, such as Swanage Medical Practice in Dorset, which is displaying our posters on its notice boards and leaving leaflets on the seats in its waiting room to inform patients about the campaign.
You can do your bit by accessing materials and signing up to the campaign. I also encourage you to sign the Royal College of GPs' e-petition, which closes this week and is similarly pushing for better funding for general practice.
This week, NHS England announced funding support for a limited number of practices adversely affected by the withdrawal of the MPIG (minimum practice income guarantee). This development follows prolonged pressure from the GPs committee on NHS England to provide this vital assistance. Last week, we also supported the presentation to Downing Street of a petition from 20,000 patients protesting against East London practices facing severe MPIG cuts.
While the MPIG announcement provides temporary assistance, it does not provide a long-term solution to the problems facing these practices or the many other surgeries that will not be receiving even this limited financial support. Find out more in our press release.
We continue to push for a long-term, sustainable solution to provide fair resources to all GP practices.
With best wishes,
Chair, BMA GPs committee
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