How to extend GP training and improve urgent and emergency primary care.

Abstract

Extension to GP training is needed but progress is slow given current financial constraints. A 6-month mandatory period of training in urgent and emergency primary care in the fourth year of an extended training scheme would offer the prospect of making financial savings while addressing training needs that are now inadequately met in the current training programme. Good primary medical care is central to the provision of high-quality, equitable, and cost-effective health services.1 The strong tradition of general medical practice in the UK is a major component of the high performance of the UK healthcare system, which ranked second out of seven in a recent systematic comparison by the Commonwealth Institute.2 The UK has one of the shortest periods of postgraduate training for general medical practitioners among the advanced economies. The Royal College of General Practitioners (RCGP) has published a detailed case for the extension of training to 4 or 5 years, and detailed proposals for the form that such an extension might take.3 Extension of training is perceived by many as vital if UK general practice is to retain its internationally acknowledged strengths. The proportion of medical graduates training in general practice is too low for projected NHS workforce requirements. Plans are in place to increase the number of training places in general practice training schemes, but current negative perceptions of the future for primary care have led to recent under-recruitment to existing training schemes. The NHS now faces several years of standstill funding, a situation unprecedented in its 65-year history. Every sector of the service is tasked by government with finding ways to do more with less. The prospects for the necessary funding for an extension of GP training seem remote under these circumstances. Increased pressure on hospital emergency services is a major concern for …