GP leaders call out lack of workforce retention plans

GP leaders have called the Government and NHS England out on their lack of plans to retain existing GPs in today’s landmark long-term workforce plan.

The document sets out a plan to ‘ensure up to 130,000 fewer staff leave the NHS over the next 15 years’, however that segment of the 135-page report does not specifically mention GPs.

It says the NHS will ‘implement plans to improve flexible opportunities for prospective retirees’ and ‘deliver the actions needed to modernise the NHS Pension Scheme’ in line with Spring Budget tax amendments.

It also mentions specific retention plans for consultants, who will be able to offer their services flexibly to trusts across England after retirement staring this autumn; incentives for dentists to spend a minimum amount of time on NHS work; and career development for nurses, midwives and allied health professionals.

It also pledges to ‘support NHS staff to make use’ childcare support to working parents that was announced in the Spring Budget ‘to help staff to stay in work’.

GP training places in England will increase by 50% to 6,000 by 2031 under the £2.4bn plan however Londonwide LMCs chief executive Dr Michelle Drage warned that ‘we cannot just recruit our way out of the current workforce crisis, we have to also focus on retention’.

‘Our most experienced staff are our most valuable staff and they are struggling to maintain safe care against a headwind of increased patient need and long-standing underfunding, 12-plus hour working days, increasing supervisory demands and scapegoating from the Government for waiting lists elsewhere in the system.’

‘Training more GPs and other supporting roles does not recognise that retention is the biggest issued right now,’ she stressed, adding that reducing GP training time ‘is a false economy, as newly qualified GPs will need more support from experience colleagues, drawing them away from patient care’.

Meanwhile, the ‘expectation that GPs have the time to supervise growing numbers of pharmacists, physiotherapists and other roles which have been worked into the general practice team over recent years is unrealistic’, she argued.

She added: ‘How it looks to GPs in London is neither the plan, nor the policymakers, understand the role that GPs play at their core in terms of continuity and management of multiple conditions and complexity. Because they do not see the value of this to the NHS and patients they continue to configure the service as if it’s a roll-on roll-off conveyor belt of single, unconnected conditions to batch and dispatch as cheaply as possible.

‘This fundamental misunderstanding worsens all the current problems relating to access and attrition, with the Workforce Plan’s lack of funding for core general practice doing nothing to reverse the decline.’

Dr Latifa Patel, BMA representative body chair and workforce lead, said that keeping existing staff in the NHS ‘must be the absolute priority’ but that the workforce plan was particularly ‘light’ on this topic.

She said: ‘Doubled medical school places means more doctors entering the system, which is no doubt a good thing, but we need guarantees that the initial expansion will be followed with the infrastructure needed to support doctors throughout their training and into their future careers.

‘There’s no point having more students if there are no academics to teach them, no spaces to learn in and no consultants and GPs to supervise them once they graduate.’

‘This is why retention is key, and where today’s announcement feels particularly light. It’s all well and good training new doctors, but pointless if they don’t stay in the workforce.

And she added: ‘Training new doctors will be to no avail if they don’t stay in the workforce, so the focus on retention is important – but doctors need to be valued fairly for their work and expertise or they will leave for better-paid jobs elsewhere. This plan is set up to fail if doctors’ pay continues to be eroded, the pay review process continues to be interfered with and pay disparities across the public health system persist.’

Dr Matthew Lee, MDU chief executive, said: ‘There is much to welcome in this plan, but workforce retention in the NHS is not helped if the regulatory system that healthcare professionals are subjected to is as outdated as the ones currently operated by the GMC, GDC and other regulators. Long awaited reform of these regulators must now urgently follow today’s announcement.’

Calling for more mental health support for NHS staff, MPS medical director Dr Rob Hendry said ‘the key challenge will be delivering on the promise of a renewed focus on retaining the skilled, passionate healthcare professionals who have a long career ahead of them, but are on the verge of quitting’.

‘If even more doctors leave, this will negate the planned injection of new doctors. Retention of staff will also improve numbers immediately, while training new staff will take many years.’

Dr Naeem Nazem, head of medical at MDDUS, said that ‘while this plan is ambitious, there is a serious question over how effectively this it can address the problems of today not just those anticipated in the future’.

‘Surveys of our members, and those carried out by other organisations, highlight time and time again that the NHS is firmly in the grip of a retention crisis.

‘Creating a sustainable NHS needs to start today with measures to retain the current workforce. That effort must include retaining the international medical graduate (IMG) doctors who make up a substantial and skilled percentage of the current workforce.

‘Sending a message to them today that they’ll no longer be required in the future seems a misjudged tactic when safe patient care relies upon their work so heavily.

‘It’s also concerning to see very little importance given to improving staff welfare, which is so vital when we ask healthcare professionals to work around the clock, alongside no mention whatsoever of pay.’