Retaining the current medical workforce
Research shows that a complex combination of factors are leading to poor job satisfaction within general practice including workload, remuneration, perceived lack of recognition, increasing bureaucracy, indemnity costs and lack of peer support. This is leading to an increase in the rate at which general practitioners are choosing to leave the workforce, or work on a more part-time basis.
NHS England continues to invest in ways to support GPs who might otherwise leave the profession, and is encouraging local systems to take action to work with practices, and identify ways to encourage and support GPs to remain in practice. Building on earlier piloting work – and emerging examples of good practice across the country — we’re investing an additional £10 million in 2018/19 to provide more help to those areas that are struggling most. This will:
- support the establishment of local schemes and initiatives that enable local GPs to stay in the workforce, through promoting new ways of working and offering additional support – through the new Local GP Retention Fund.
- establish seven intensive support sites across the country in areas that have struggled most to retain their GPs, linked to implementation of the Releasing Time for Care programme and wider work being taken forward under the General Practice Forward View. Sites will be announced by the end of June 2018
The Local GP Retention Fund
At least £7 million of additional funding is being made available during 2018/19 through the Local GP Retention Fund. This fund will facilitate the establishment of local schemes and initiatives that enable local GPs to stay in the workforce, through promoting new ways of working and offering additional support.
Specifically, the fund will support local systems to develop innovative local retention initiatives for:
- GPs who are newly qualified or within their first five years of practice
- GPs who are seriously considering leaving general practice or are considering changing their role or working hours.
- GPs who are no longer clinically practicing in the NHS in England but remain on the National Performers List (Medical).
This builds on emerging best practice across the country such as the Somerset Primary Healthcare Ltd GP Career Plus scheme, which provides facilitated peer support to GPs who have left general practice or who are seriously looking to leave, or the Great Yarmouth and Waveney CCGs GP Career Plus pilot which has created a scheme which seeks to retain experienced late career GPs through pooled working.
Workforce needs vary across the country and regional teams will work closely with CCGs and other key partners including Local Medical Committees (LMCs), the Royal College of GPs (RCGP) Ambassador Network and other local GPs to consider how to maximise impact.
Intensive support sites
Seven areas across the country were selected in 2018 to be GP Retention Intensive Support Sites. The aim is to bring interventions together at different levels – personal support for GPs, practice support and system support/improvements to achieve the greatest possible impact on the engagement and retention of local GPs.
The seven intensive support sites have been identified as:
- The Black Country Sustainability and Transformation Partnership
- Mid and South Essex Sustainability and Transformation Partnership
- North Kirklees and Greater Huddersfield Clinical Commissioning Group
- Blackpool, Morecambe Bay and West Lancashire Clinical Commissioning Group
- Weston and Worle Locality (locality within Bristol, North Somerset and South Gloucestershire CCG)
- Isle of Wight Clinical Commissioning Group
- Newham Health Collaborative Ltd (North East London)
A plan of action will be developed in consultation with local GPs and system leaders for each site following in-depth analysis of the particular issues being faced within the locality. Implementation will closely be linked to existing national programmes of work being taken forward via the General Practice Forward View – including the Releasing Time for Care Programme – supported by initiatives locally to tackle the challenges faced.
The programme will be based on rapid action and learning so that quick wins and failures can be shared between and beyond the seven intensive support sites.
Sites have been selected using a variety of criteria, including the level of challenge that the area currently faces in recruiting and retaining GPs in the local workforce, the scale of impact and the level of engagement among local stakeholders.
Examples of local retention initiatives from the GP Career Plus pilot.
Queries should be addressed to firstname.lastname@example.org.
NHS England is grateful for the guidance and experience of all those organisations and individuals that have contributed to both these retention initiatives. Special thanks goes to the BMA, RCGP and HEE and individuals such as Lucy Henshall who have helped provide valuable contributions of expertise and time to this area of work.