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GP Workforce:
Crisis and Action
HealthWatch Bolton Forum
18th March 2015
Dr Tom Howling
Associate Dean for GP Education
Summary
• How to grow a GP
• Future workforce need of a transformed
service
• Assessment of GP workforce crisis
• Action: Recruit, Retain, Return
• ‘Building the Workforce – the New Deal for
General Practice’ 10 point plan.
• Local implementation of the plan
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How to Grow a GP
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Is GP training sufficient?
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What do GPs do?
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Deal with patients’ acute problems
Systematic care for chronic diseases
Health promotion
Interpret medical complexity
Run practices
• Employ staff
• Bid for services
• Monitor performance
• Hit targets (lots)
• CQC compliance
Other things….
• Commissioning local healthcare
• Training workforce
• GPwSI, Others
Future Need for GPs in a
Transformed Service?
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Greater number of GPs (Trained Generalist Doctors working in the
Community) or fewer?
Centre for Workforce Intelligence report to NHS England…..
Future need requires 50% of medical graduates to train as GPs by
2016
How are we doing?
• <25% Foundation trainees opting to train as GP
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This year applications for GP Specialist Training fell by 6.2%
Year before fell by 9.7%
Next year: Survey indicates 23% of Foundation trainees planning to
apply to GP Specialist Training
www.nw.hee.nhs.uk
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The GP Workforce Crisis…
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Insufficient capacity to meet current patient needs
Falling numbers of FTE GPs per 100,000 patients
Rising numbers of long term vacancies
Substantial rise in the number of GPs intending to
quit direct patient care in the next 5 years
• Hospital consultant numbers increasing at twice
the rate of GPs
• Those communities with the greatest need have
the worst problem
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I wouldn’t start from here…
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Building the Workforce 10 Point Plan
Three key themes:
• Improving recruitment into GP Training
• Retaining doctors within GP
• Supporting those who wish to return to GP
Recruit, Retain, Return
www.nw.hee.nhs.uk
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Recruit
1. Promoting general practice
• Marketing campaigns
HENW recruitment video planned
HENW Careers/recruitment event
Increase FY2 attachments in GP
Medical school careers fairs
2. Improving the breadth of training
• Additional year of post CCT
training in hard to recruit areas
ST4 pilots in N Lancs, S Cumbria
3. Training Hubs
• Invest in development of multiprofessional training in primary
care
Development of multi-professional learning
environments – strategy in place
Most training practices already host
undergrad, nursing, FY2, GPST1-3
Some Trainers Groups act as training
hubs
4. Targeted Support
• Incentive scheme to work in
under-doctored areas for 3 years
Area for development
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Retain
5. Invest in retainer schemes
• NHS England to review and
invest in a national retainer
scheme
Funding was previously withdrawn so
these need re-establishing
HENW can provide educational support
6. Improve training capacity in
general practice
• £1 billion investment in new
infrastructure – improve
experience of medical students
and foundation doctors in GP
Capital bids submitted
Also supports multiprofessional training
7. Incentives to remain in practice
• Identify most effective ways to
encourage experienced GPs to
stay
SPED course run by HENW(GP)
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Retain
8. New ways of working
• Identify key workforce initiatives
that are known to support
general practice
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Primary Care Transformation
• Practice nurse training
• Advanced nurse practitioners
• Assistant practitioners
• Physician assistant role
• Pharmacy
• Optometry
Return
9. Easy Return to Practice
• HEE and NHSE funded I&R
scheme to be launched spring
2015
Current I&R strategy – NW leading the
way already
Support for career breaks and returners
Careers advisor role
Funded programme already in place
10. Targeted investment in returners
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National process to be announced
Summary
• How to grow a GP
• Future workforce need of a transformed
service
• Assessment of GP workforce crisis
• Action: Recruit, Retain, Return
• ‘Building the Workforce – the New Deal for
General Practice’ 10 point plan.
• Local implementation of the plan
www.nw.hee.nhs.uk
twitter.com/HENorthWest