College calls on Health Secretary to end ‘vicious cycle’ of unfair funding for GP training

The GP workforce crisis is being worsened by inequity in the way GP undergraduate training placements are funded in comparison to hospital placements, the Royal College of GPs warns today.

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, has written to Health Secretary Jeremy Hunt calling for GP practices to receive the same funding as hospitals for hosting medical students as part of their training.

GP practices currently receive on average £620 a week to host training placements, yet the true cost is estimated to be £1000 – a 40% deficit, and also around 40% less than the average amount hospitals receive to host training placements, despite the costs being the same.

The RCGP is calling for at least £31m a year – taking into account the increase in medical school placements from next year – to rectify this discrepancy.

Earlier this week, the College revealed that the profession in England was over 6,000 GPs short – almost one for every surgery – despite Government pledges made over two years ago to boost the family doctor workforce by 5,000 by 2020.

Workload in general practice has risen 16% over the last seven years, but the proportion of NHS spending on general practice is lower than a decade ago and the number of GPs has not risen at pace with demand. Recent workforce figures from NHS Digital have shown full-time equivalent GP numbers have dropped over the last six months.

In her letter, Professor Stokes-Lampard writes: “You recently expressed concerns, which I share, that we will not reach the target set out in the General Practice Forward View for an additional 5,000 GPs by 2020; and given the challenges of retaining GPs in the workforce, I am sure that you will agree it it is even more vital that we attract more trainees into the profession. Ensuring that all students have access to properly funded placements in general practice is an essential part of this.

“Many practices are struggling with unsustainably high workloads and gaps in their workforce, which has implications on the provision of safe, high-quality patient care. Expecting these practices to train and inspire the next generation of GPs without sufficient funding to do so, is simply unviable, and will put our ability to expand the GP workforce at risk.

“The underfunding of training in primary care is not limited to the future GP workforce. For example, the low tariff available for undergraduate student nurse placements is also hampering efforts to increase the pipeline of nurses to enter the general practice workforce.

“The Government’s welcome announcement of additional funds for the NHS and its intention to develop an NHS plan provides an opportune moment to remedy this longstanding and urgent funding deficit.”

Last year, the College undertook the most comprehensive survey of medical students’ perceptions of general practice to date – the resulting report, ‘Destination GP’, found that exposure to GP placements during medical school were a key influencer on whether they were likely to choose general practice as their speciality.

The  report found that by their fifth year, 91% of those surveyed perceived their fellow students to have negative associations with general practice, and 54% perceived doctors they have encountered on placements in non-GP specialties to be negative about general practice.

It also found that medical students’ choice of specialty is most influenced by their interaction with individual GPs during their placement (81%), and that 84% of those surveyed perceived positivity towards general practice from GPs they encountered on placements.

Professor Stokes-Lampard said: “Providing high quality training placements in general practice costs around the same as it does to place medical students in hospitals, so it should be funded at the same level, and actually it’s a modest amount of money we’re calling for when you consider that the GP workforce is in dire straits and there is widespread consensus that we need to be encouraging more medical trainees into general practice.

“The NHS is 70 this week, and the Prime Minister recently announced an extra £394m a week for the NHS by 2023. It’s critical that additional investment is used to ensure a robust general practice service for the future, so that we don’t even need to consider charging patients for their care, and our service can continue to be the sustainable foundation on which the NHS is built. Building our workforce is central to this ambition.

“Being a GP can be the best job in the world when we are given the time and resources to do it properly – it is challenging, intellectually stimulating and full of variety. These are the messages we need to convey – and offering high quality educational placements in general practice are the best opportunity for us to do this, but this takes resources and general practice is losing out, creating a vicious cycle.

“Investing in general practice is investing in the whole of our National Health Service.”