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Boost to GP training places to offset 15,000 shortfall by 2036

by Rima Evans, Eliza Parr, Jess Hacker
3 July 2023

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The first ever long-term workforce plan for the NHS has committed to an increase of GP training places by 50% to 6,000 by 2031/32.

The number of GP specialty training places will rise to 5,000 a year by 2027/2, the plan published by NHS England last week has pledged.

And the first 500 extra places will become available from September 2025.

Meanwhile, the number of medical school training places will be doubled by 2031/32, with the total number of places reaching 15,000 a year. There will be more medical school places in ‘areas with the greatest shortages to level up training and help address geographical inequity’, said the workforce plan.

The 15-year plan will be backed by a £2.4bn investment from the Government ‘to fund additional education and training places over five years on top of existing funding commitments’, NHS England said.

It has also committed to reforming training by, for example, ensuring that by 2030/31, all foundation doctors can have at least one four-month placement in general practice to provide them with an understanding of work in primary care. At present these opportunities are ‘variable’, the plan admitted.

Meanwhile, GPs in training will be able to spend their full three years in primary care settings.

The long-awaited plan also stated an intention to reduce the number of years required for a medical degree from five or six years to four years in order to ‘bring people into the workforce more efficiently’.

NHS England warned that without taking any additional measures the GP shortfall will grow to 15,000 full-time equivalents by 2036.

‘The model assumes a boost in doctors in GP specialty training and newly qualified GPs from interventions in recent years, but more will be needed to keep up with expected demand,’ it said.

NHS England has calculated demand using the 2015 ratio of patients to qualified GPs, while also taking into consideration the new measures in the recent primary care recovery plan.

In addition, the plan highlighted the need to expand physical estates to enable supervision to take place, and put a focus on primary care ‘where insufficient physical space across an ageing estate limits GPs’ ability to increase training placements’.

However, measures required to tackle this are ‘outside the scope’ of this plan, NHS England said, and will need ‘continued, sustained investment in the primary care estate’.

Other measures announced in the plan include:

  • Introducing more than 20,000 additional clinical staff to general practice by 2036/37 (see box below)
  • Providing 22% of all training for clinical staff through apprenticeship routes by 2031/32, up from 7% today
  • Reducing reliance on international recruitment, with 9-10.5% of the NHS workforce recruited from overseas in 15 years’ time, compared to nearly a quarter now.

The BMA’s representative body chair and workforce lead Dr Latifa Patel raised concerns that NHS England’s projections have ‘not been independently verified in their entirety’ as promised by the Chancellor last year, meaning it will be ‘difficult to have confidence’ that the plan will ‘achieve its goals’.

Dr Patel also said: ‘While the plan acknowledges the need for expansion in foundation and specialty training placements and infrastructure commensurate with the growth in undergraduate medical training, we don’t yet have a credible path to get there.

‘Approaches such as medical apprenticeships and accelerated degrees are also untested, so we have concerns about their role in addressing the crisis.’ She also said that while an increase in GP numbers and junior doctors spending more time in general practice are ‘much-needed’, the plan does not make it clear ‘how they will be supervised given how stretched our colleagues working in practices are’.

Prime Minister Rishi Sunak said: ‘On the 75th anniversary of our health service, this government is making the largest single expansion in NHS education and training in its history. This is a plan for investment and a plan for reform.

‘In the coming years we will train twice the number of doctors and an extra 24,000 more nurses a year, helping to cut waiting lists and improve patient care. And we will do more to retain our brilliant NHS staff and reform the way the health system works to ensure it is fit for the future.’

Extension of ARRS announced, with 20,000 new staff

Under the long-term workforce plan, NHS England said it would look to increase capacity and free up available appointments in general practice by bringing in 15,000 non-GP direct patient care (DPC) staff and more than 5,000 primary care nurses.

It said it sought ‘to extend the success’ of the ARRS, but NHS England did not specify if this meant it would introduce new roles to the scheme or add to the total available funding pot.

NHS England said: ‘This expansion would be carefully managed taking into account additional training of pharmacists, to ensure the growth in workforce is sustainable, and considers the additional capacity required to staff roles across primary care.’

The plan also said there was a need to expand roles that support self-care and facilitate patient access to other local services, such as health and wellbeing coaches or social prescribing link workers. It’s estimated that one-in-five people who go to their GP do so with concerns that cannot be addressed with medical treatment, NHS England said.

It has set out ‘estimated expansion’ numbers of these roles by 2036/37, with care co-ordinators increasing from 4,000 to 12,000; social prescribers boosted from 3,000 to 9,000; and health and wellbeing coaches rising from 1,000 to 6,000.

It is unclear if these roles are counted toward NHS England’s newly pledged 15,000 non-GP direct patient care (DPC) staff.

Data published in May revealed PCNs and GPs had hired 29,103 more full-time equivalent (FTE) DPC staff, delivering on the Government’s manifesto commitment. 

Versions of these stories first appeared in our sister title Pulse