A recruitment bounce at last?

One of the constant refrains in relation to general practice at the moment is that GPs are retiring, young doctors are not attracted to the life of a GP and that practices across the country are groaning under an unmanageable workload which is linked to a recruitment and retention crisis of doctors and other staff. NHS England has vowed to turn this situation around – how’s that going? Improving, it seems. Read on…

This item is based on a news item posted on the NHS England website.

The General Practice Forward View committed to real terms increased investment in general practice of 14% between 2015-16 and 2020-21 to over £12 billion a year. This will be further strengthened by and an extra £4.5 billion overall a year in real terms in primary and community healthcare by 2023-24.

NHS England has recruited 300 more family doctors and thousands more nurses, pharmacists and other staff to work alongside GPs delivering better care in the community.

There are now 7,302 more full time equivalent (FTE) health professionals working in primary care than three years ago according to figures released by NHS Digital. This exceeds NHS England’s target of an additional 5,000 by 2020 as set out in the General Practice Forward View.

In the last year alone, there were 2,635 FTE (2%) more staff working in primary care overall than in March 2018 – an increase of 703 FTE (0.5%) over the previous quarter. The data also shows an increase of 226 FTE doctors over the last quarter – and an increase of 312, year-on-year, when compared with March 2018 – as GP retention and return to practice schemes take effect and new GP trainees enter the workforce. The much lamented loss of workforce appears to be stabilising, with 750 more FTE trainee GPs and 394 more FTE salaried GPs now working in general practice compared with March 2018.

The figures also show there were 1,029 FTE clinical pharmacists working in general practice at the end March 2019 – which represents an increase of 58 FTE over the last quarter, and an increase of 287 FTE since March 2018. In total, the FTE count of clinical pharmacists in general practice has increased by 38.6% over the year.

Numbers of other healthcare professionals are also on the rise. There were 16,483 FTE nurses working in general practice, an increase of 313 on last year and 167 FTE physician associates working in general practice (194 headcount) in England as at March 2019. This represents an increase of 37 FTE over the last quarter and an increase of 97 FTE since March 2018. In total, the FTE count of physician associates in general practice increased by 138.6% over the year.

“While the GP numbers show some encouraging signs, recruiting, retaining and supporting more doctors into practice remains an absolute priority for us,” Dr Nikki Kanani, interim medical director for primary care and a London GP said. “Today’s figures highlight the good work being done locally to support GPs through retention schemes and flexible working, as well as taking on more trainees.

“A significant increase in the number of other health professionals – such as nurses, pharmacists and physicians who work alongside GPs – means patients can get more timely and appropriate access to a wider range of highly trained staff. This supports family doctors to focus on patients with the most complex conditions and eases the workload pressures our GPs face.”

From 1 July patients will have seen general practices working together in primary care networks, supporting each other to provide a wider range of specialist services, as well as offering the weekend and evening appointments which were rolled out across the country at the end of last year. This is part of the new GP contract.

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The NHS has a growing number of other highly trained health professionals working with GPs in multidisciplinary teams (MDTs). Increased investment of £4.5 billion going into primary medical and community services each year by 2023-24 (the GP contract will invest around £1.799 billion) as part of the NHS Long Term Plan, will support the recruitment of 20,000 more health professionals, including physios, pharmacists, paramedics, physician associates and social prescribing link workers over the next five years to support GPs. This means patients can get more timely access to a range of health professionals, depending on their needs, allowing GPs to focus on patients with the most complex conditions. In addition, as these multi-disciplinary teams ease the GP workload, it is hoped doctors will be able to offer longer appointments to patients who need them.

Health professionals who work alongside family doctors play a vital role in delivering high quality, safe and effective care for patients. GP practice-based clinical pharmacists work as part of the general practice team to improve value and help patients get the best outcomes from their medicines.

In brief

What the NHS Digital GP Workforce March 2019 data shows:

  • GPs
    • Increase of 226 (FTE) over the last quarter.
    • Increase of 312 FTE year on year compared with March 2018
    • 8,299 Salaried GPs in March 2019 – up 394 year on year.
    • 6.039 GP registrars – up 752 on March 2018.
  • Staff overall
    • 2,635 FTE (2%) more staff overall than in March 2018
    • Increase of 703 FTE (0.5%) over the quarter.
  • Non GP staff
    • 2,324 FTE more than March 2018.
    • 477 FTE more over the quarter.
  • Pharmacists
    • 1,029 FTE clinical pharmacists working in general practice as at March 2018
    • Increase of 58 FTE over the last quarter and an increase of 287 FTE since March 2018.
    • Total FTE count practice increased by 38.6% over the year.
  • Physician Associates:
    • 167 FTE in general practice (194 headcount) in England as at March 2019.
    • Increase of 37 FTE over the last quarter
    • Increase of 97 FTE since March 2018.
    • Total FTE count increased by 138.6% over the year.
  • Nurses
    • 16,483 FTE nurses working in general practice.
    • Increase of 313 on March 2018.

NHS England reports that there are more GPs in training than there ever have been. The GP Retention Scheme is a package of financial and educational support to help doctors – who might otherwise leave the profession – remain in clinical general practice. The £10 million Local Retention Fund aims to help local systems set up arrangements to support GPs and encourage them to remain in practice. £18 million was additionally invested in GP retention last year with further funding to be available during 2019-20. 

How does this data chime with what you are seeing on the ground? Are things improving? Are new staff beating a path to your practice door? Let us know how your day-to-day experience reflects – or refutes – current NHS England optimism.

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