The RCGP has called for ringfenced funding in locally devolved GP retention initiatives or risk losing more doctors.
The college has written a letter to the CEO of NHS England, Amanda Pritchard, and primary care minister, Andrea Leadsom, to set out concerns that funding for retention schemes will be lost to cover other financial pressures.
Last month, NHS England confirmed a primary care bulletin that two national GP retention schemes – the GP fellowship and supporting mentors schemes – would end on 31 March 2024.
However, NHS England said that although national funding for the schemes would cease, there would be continued investment in GP retention. It is understood that funding and responsibility for the retention schemes will be transferred to integrated care systems (ICSs).
But the RCGP fears that without ringfenced funding for GP retention, ICSs will redirect the money elsewhere ‘at a time when local budgets are tighter than ever’.
The RCGP letter warned: ‘Plans to devolve budgets and responsibilities to ICSs for GP retention initiatives will only work if there are sufficient and ringfenced finances.
‘However, retention scheme budgets are often the first to be squeezed when ICS budgets are tight – and last November, ICSs were told to “reprioritise” budgets away from some retention schemes to deal with wider financial challenges.’
The college said it was concerned that this could lead to the loss of even more GPs, while workloads continue to rise.
As well as ringfenced funding, the RCGP letter asked government for continued monitoring of retention initiatives that were devolved to ICSs.
It said: ‘Without these actions, we risk losing more GPs from the workforce, and patients will increasingly struggle to get the care they really need.’
The letter, co-signed by RCGP chair Professor Kamila Hawthorne, RCGP First 5 network chair Dr Toyosi Adeniji and Associates in Training (AiT) chair Dr Akram Hussain, said that general practice could not continue to deliver high levels of care when the workforce was dwindling.
It pointed to the delivery of a record 356m appointments in 2023 – 14% more than in 2019 – but with 642 fewer fully-qualified, full-time equivalent GPs in the workforce. It added that a significant proportion of GPs under 30 left general practice last year.
‘This is not sustainable,’ said the letter.
It said that the fellowship and mentoring schemes ‘have been shown to play a vital role in supporting early-career GPs to remain in the profession, with over 80% of those surveyed by NHS England saying the fellowship scheme supported them to remain as a GP’.
The college added that the NHS needed ‘to be doing absolutely everything we can to keep GPs, at all stages of their careers, in the workforce, so they can continue to deliver care for patients’.
It highlighted that training a doctor from medical school to the end of GP specialty training ‘has been estimated to cost nearly £500,000’.
‘Losing any GP from the NHS workforce earlier than planned is a major loss of investment and to patient care,’ said the letter.
