Junior doctors and medical students are being put off training as GPs because of ‘fundamental flaws’ in how the profession is perceived, the chief executive of Health Education England has told HSJ.

  • HEE says average number of GP trainees is static
  • GPs face pressures from population growth and long term conditions
  • Future of general practice lies in new workforce models

Ian Cumming warned that negative comments and views of general practice could dissuade junior doctors from choosing the specialty. He denied applications for GP training had fallen but did accept more needed to be done to meet the government’s target to recruit 5,000 new GPs by 2020.

He said: “There is a perception in some medical schools that general practice is what you do if you don’t get into specialist training for a hospital based specialty. That is a fundamental flaw and we have to stamp that out.

Ian Cumming

HEE hopes to increase medical students’ exposure to general practice, Ian Cumming said

“There are a lot of people understandably talking about the pressures, challenges and problems the specialty faces without necessarily realising the impact that is going to have on people considering their career choices. If you are a junior doctor considering the options for your future and all you ever read and hear about is how bad things are, is that going to impact the decisions you make? I think it is.”

He said it was important planned improvements and investment in general practice were recognised, adding that HEE has launched a major campaign to attract doctors to train in general practice. For the second year running HEE has carried out a third round of GP training recruitment to try and fill 3,250 places nationally.

Last year more than one in 10 GP training posts in England were unfilled. Mr Cummings said HEE hoped to increase the exposure to general practice that medical students receive, as well as potentially keeping open GP recruitment all year round in an effort to boost trainee numbers.

Mr Cumming said: “There is undoubtedly a gap between supply and demand for GPs at the moment but the absolute number of people entering GP training hasn’t changed over the last five or six years, it’s remained constant at an average of 2,600. What we have done is create more and more training posts therefore the fill rate, or the percentage of the posts filled, has gone down but the absolute number hasn’t.

“Roughly speaking, we are producing 2,600 GPs a year and around 2,100 GPs leaving the profession. So every year we have a net growth of around 500.”

He also said there were regional differences, with London’s training places completely filled. He added: “We’ve sucked more people into training in London which has created more gaps, generally speaking the further up the M1 that you go.

“So why does it feel like a shortage? More people are working part time than they used to and the population of this country has grown, so we are training more GPs to effectively maintain the same GP to patient ratio. I also don’t think we should be afraid of saying the NHS has got much better at keeping people alive and treating long term conditions. The huge burden of that falls on GPs, so what a GP does now is incomparable with what they did 10 or 15 years ago.”

He said HEE was signed up to plans to transform general practice, including expanding the workforce with new multidisciplinary teams. He said this would help end “the absolutely enormous” variation between some practices.

“The concept of delivering general practice is a team sport. I believe the contribution of GPs is critically important but so too are nurses, paramedics, physician associates and pharmacists and the wide range of allied health professions. If you put the whole lot together, and of course GPs are at the heart of it, you need that whole team around them and it’s important we don’t just focus on doctors,” he added.