Changes to workforce education: the issues for GPs, practices and practice staff
The issues for London’s GPs, practices and practice staff which LETBs and AHSNs need to address to ensure provision of a primary care workforce which is fit for the future:Communication:
- Londonwide LMCs is considering the best ways to support these processes in order to ensure that GPs and their primary care teams are represented, including creating a conduit for views to be fed into the AHSNs and LETBs. We are looking into how this will take shape so that the future of General Practice education, training and workforce planning is protected and enhanced.
Context:
- London has a transient labour market, with intra and inter London movement. Disproportionate migration results in London being a net exporter of its medically trained workforce talent pool. This drain causes high levels of vacancies. Future plans must take into consideration this turnover and its impact on productivity. Data suggest potential oversupply of junior doctors and undersupply of GPs. Read the GMC report into medical education and practice in the UK, published September 2012.
National v local policy:
- Changing care settings: planning for integrated care and care closer to home strategies which work across traditional professional boundaries must consider what the training and educational needs will be to deliver this transformational change.
- There is a tension between central direction and local determination which will need to be overcome to ensure that local priorities are not at odds with national plans.
Organisational development:
- The education and training functions of the GP School at the Deanery will need to be protected and hosted somewhere. There continues to be a lack of clarity about where that will be, whether the Deanery will be lifted whole and delivered as part of the shared services function within the LETBs, or whether its work will be divided up.
- Currently, there is considerable variation between the training and education delivered by providers, and there is no national assessment system; there will need to be quality principles embedded into the system.
- Details of how the future primary care workforce will be developed in the short and long term requires investment so that future GPs are fit for purpose in the new world. GPs in future will need to acquire specific skills and attributes and, accordingly, the planning for this needs to happen now; there will need to be a focus on care pathways and multi-professional training. However, little detail is out on how this will be achieved.
- Transition – there is huge concern to ensure that current training programmes and trainees are protected during this transition so the system remains stable. This is made increasingly difficult with the restructuring of several bodies as a result of the Health and Social Care Act which has made it challenging to build and maintain stable and sustainable relationships with people and organisations.
Stakeholders:
- CCGs will have significant influence on delivering and shaping future services. The workforce will be the key enabler to service delivery and transformation, so CCGs will be a major constituent in workforce planning. To get this right needs reciprocal representation - LETB reps on CCGs, and CCG reps on LETBs. CCGs have a duty to promote innovation, but AHSNs must not be under the illusion that CCGs represent all GPs and practices as providers. It is not clear how CCGs will feed into this process and link with LETBs and AHSNs.
- Conflicts of interest: secondary care representation will dominate LETB and AHSN boards, membership groups and advisory councils and there must be transparency so that all stakeholders’ views and needs are equitably considered and that the system is viewed as a whole.