Posts Tagged “gp training”
Jeremy Hunt has called for all GP Practices to ensure their patients can access a 7 day service by 2020, even if they don’t provide the care directly themselves. Responding to a petition calling for a vote of no confidence in him, the health secretary said that doctors would realise 7 day access was “the right thing to do”. At the debate, which was amended to discuss contracts and conditions in the NHS, GPs were told they need to be ‘more flexible’ with regards 7 day access. Meanwhile, one of the Prime Minister’s Challenge Fund 7 day access pilots has been delayed owing to the length of time needed for CCG registration. NHS Cambridgeshire and Peterborough CCG planned to start the pilot in July but it is now expected that early morning and evening appointments will be phased in with most areas covered by late October.
The CQC has announced a change to the way it operates with aims to work ‘in partnership’ with healthcare providers and a ‘lighter touch’ approach. This follows a practice in Bristol which has successfully challenged the ‘needs improvement’ rating it received after its CQC inspection. The regulator admitted ‘due process’ had not been followed and the practice was rated ‘good’ on re-inspection.
A pilot scheme in London will provide careers advice to long-term unemployed patients in a bid to help them overcome health-related barriers to work. The ‘Working Better’ scheme launched at the beginning of September and is a joint venture between Islington Council, Jobcentre Plus and NHS Islington CCG. NHS England has also announced plans for firefighters to carry out basic health checks when visiting people’s homes to carry out safety checks. Pilot schemes will be run in Manchester, Staffordshire and Gloucestershire to test whether falls, broken hips and hospital admissions can be reduced.
London GPs are struggling to cope with demand and cite cuts to community staff, social services, mental health services and both an aging and increasing population as causes for the crisis. There are also 140 practices at risk of closure over the next three years.
Plans to extend GP training to 4 years are in doubt after comments made by Jeremy Hunt at a recent health committee meeting. The health secretary said that four year training would make it more difficult to meet the target of an extra 5,000 GPs by 2020. Meanwhile, the RCGP has called for training places in Northern Ireland to be nearly doubled from 65 to 111 as part of a range of measures it wants the Northern Ireland Government to examine.
NHS England has announced plans for an emergency GP support framework comprised of 21 providers who will be pre-contracted to step in and take over the running of struggling practices at short notice. Amongst the providers 10 are GP-led organisations, there are also 2 NHS foundation trusts, small private companies and social enterprises as well as Virgin Care.
A survey has revealed that fewer than 30% of GPs would hire Physician Associates, with 40% ruling out employing them altogether. This will come as a blow to the Government whose ‘New Deal’ promised 1000 Physican Associates to be working in general practice by 2020. A recent advert for a Community Physician working across GP practices in Shropshire as part of the Government’s Challenge Fund seven-day GP access pilot provoked a backlash as it appeared to invite FY2 doctors to apply and work as an ‘unqualified GP’.
Part of the £1bn fund pledged towards improving GP premises over four years is to be used by NHS England to run the second phase of GP Access pilots. The news come after the fund has also been relieved of £10m to support struggling practices (part of the flagship ‘New Deal’ policy) and £15m to employ pharmacists in practices. Unrealistic expectations from patients and inappropriately booked appointments are adding to GPs workload, according to one GP, who has been asked to prescribe glasses, new shoes and ‘energy boosting medication’.
The health secretary has claimed that he has never met a doctor not in favour of 7 day working. However, he was subsequently challenged by Dr Emon Farrah Malik who told him he was ‘driving GPs out of the country’. Meanwhile, an anaesthetic trainee has started a twitter campaign highlighting that the NHS does run a 7 day service with the #ImInWorkJeremy hashtag. Simon Stevens, head of NHS England, has said that practices should not be forced to open on weekends if there is no demand for appointments.
GP Trainees in Wales are to be employed by the Government throughout their training in a move to encourage more doctors to enter GP Training. A pilot scheme was launched in April 2014 and the changes are set to be implemented as soon as possible. Newly qualified Welsh doctors choosing a career in General Practice will also have their medical school fees reimbursed as part of £4.5m of funding for primary care. Half of GP training places remain unfilled in some areas with a third round of recruitment to follow this year, this is the second year that a third recruitment round has been required. The RCGP has announced that it may allow some trainees to have a fifth attempt at the AKT or CSA in exceptional circumstances and provided candidates had ‘undertaken appropriate additional educational experience’.
Student nurses in Solihull are being offered placements in General Practice in order to generate more interest in the career. Six second-year students are being trained at six local practices to give them an insight into practice nursing and tackle the shortage of practice based nurses.
The controversial CQC inspections have proved beneficial for some practices rated outstanding who used the process as an opportunity to reassess ways of working, identifying weaknesses and ensuring information provided is up-to-date.
Data from the GP Patient Survey has found that just over a quarter of patients in England were unable to see a GP or waited a week or more to see or speak to someone last time they tried. The survery comes amid news that a quarter of 7 day GP access pilots have cut their opening hours owing to lack of demand.
According to a survery carried out by Londonwide LMCs, 1 in ten London practices face closure within the next three years. Various factors were cited as reasons practices were considering closure, including workforce retirement and difficulties recruiting new staff. One GP explained the difficulties her practice faced and the reasons behind the decision she and her colleagues made to quit. Other GPs at the Limehouse Practice were visited by health minister Alisdair Burt, in a hastily arranged visit after reports that a proposed visit by Jeremy Hunt might not take place until after the practice is forced to close later this year. In Scotland, one area has warned that any unexpected illness or leave amongst GPs could lead to practice closures, as 11 full-time posts have been vacant for between three months and two years and a further 14 GPs plan to retire by December 2016.
The Head of NHS England, Simon Stevens, has annouced that the practice-list based model of general practice could be replaced in future. Another GP has suggested practices receive payments based on numbers of consultations in order to relieve the financial pressures they face.
It has transpired that the £7.5m promised by the Government to support community pharmacists will actually be used to give them access to summary care records – a policy originally announced in 2013. As part of the drive to recruit 1000 Physician Associates by 2020, the Government is considering granting them prescribing powers to relieve the pressure on GPs. The NHS is offering £15m to practices who take part in a pilot scheme to bring pharmacists into their surgeries.
In order to save money and reduce medicine wastage, from next year, all medication costing more than £20 will have the price printed on the label. Jeremy Hunt has also said that he supports the idea of charging patients for missed GP appointments and as a first step, patients will be informed how much their missed appointment has cost the NHS.
After two rounds of GP Recruitment earlier this year, official figures show that 20% of GP Training places remain unfilled with a third round to follow later in the year.
Pharmacies are still in the news with worries that the closure of small pharmacies, particularly those in isolated communities, will increase pressure on GPs and A&E. Research shows that GPs prescribed 1.1billion items for patients in 2014, including a wide variety of over-the-counter medicines such as Lemsip and Calpol. Presciptions were also issued for unmedicated products such as toothpaste and suncream.
With more than half of GPs expecting to leave General Practice before the age of 60, NHS England is urging British GPs working abroad to return to the UK. Practices are also to be given incentives to take on GP Returners with an annual grant of £8,000. Incentives are also being offered to GPs to delay their retirement in an attempt to bolster GP numbers.
Golden Hellos are being used more frequently to attract GPs to practices finding it hard to fill posts. Groby Road Practice in Leicester filled a post that had been vacant for two years thanks to the scheme. The RAF is also aiming to recruit GPs and offers a signing bonus of £50,000. Hospitals are also after GPs to help them deliver new models of primary care with some offering salaries of up to £100,000.
Applications to GP Training are down by 6% this year and a third of vacancies remain unfilled after the first round of recruitment. The RCGP has released a video aimed at medical students to promote general practice and increase applications, however, GP leaders have said that students are being told by Medical School Deans that GP is a ‘second-class’ career option.
Despite the everyday pressures of General Practice, for many doctors, it still affords the best chance of a good work life balance. An innovative campaign started by East Cumbria GP Training Programme #GreatBritishConsultations shows the beauty and benefits of rural GP life.