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Everyone knows there is a recruitment – and retention – crisis in general practice.
But what is less well-known is that the situation is about to get a lot worse if proposals by the Doctors and Dentists Review Body go ahead.
The DDRB recommends removing the GP trainee supplement, which currently ensures that GP trainees are not disadvantaged for their choice of specialty compared with hospital trainees — and is aimed at keeping recruitment to general practice at an appropriate level.
But even with the supplement in place, we know that not enough future doctors are choosing to apply to be GPs with training recruitment targets being consistently missed.
The removal of the supplement could have a devastating effect on trainee applications to general practice.
Meanwhile, there is also a tandem workload crisis with too much work for the current numbers working, and the BMA’s recent GP survey shows that a third of all GPs are hoping to retire in the next five years. It also comes at a time when everyone agrees that more GPs are needed to meet the needs of patients. If things continue as they are, general practice will no longer be sustainable.
The DDRB report does advocate the use of flexible recruitment and retention premia or flexible pay premia in shortage specialties, saying that GP trainees would be likely to receive such a premium, given current recruitment difficulties. However, such a premium would be less stable than the current supplement — it might only be offered in certain geographic areas and could be removed over time.
This uncertainty would prove difficult for any trainee but could be more so for those with mortgages or childcare costs. Indeed, I have heard from current GP trainees that if the supplement wasn’t in place when they applied they would not have chosen general practice.
The future of general practice is already concerning, but the implementation of these recommendations could make things a lot worse.
Donna Tooth (pictured) is a GP trainee in London and chair of the BMA GP trainees subcommittee
Visit the BMA website for more information and updates on junior and consultant contracts
Hard to fathom that such changes could possibly be suggested or justified given the current recruitment problems in GP training. The government is unlikely to deliver on their promise of increased GPs, and they're already back-pedalling. The RCGP has admitted that patient care could be compromised if the GP workload continues to spiral upwards, and this is the real concern in all this. If general practice and general practice training doesn't get more (not less) support, vulnerable patients in the community will suffer.