Recruitment Crisis Research Articles

There is a cure

Solutions to crises in the NHS exist, if only we are brave enough to try them, says Luke Allen

What will the budget hold for the NHS?

With services overstretched and a dire recruitment crisis on the horizon, will the Chancellor listen to the NHS?

Coaching Nephrology Trainees Who Struggle with Clinical Performance.

Amid the recruitment crisis currently facing nephrology, there is concern among nephrology educators that a proportion of fellows will struggle with clinical performance. In a recent survey of nephrology program leaders conducted by the American Society of Nephrology Workforce and Training Committee

GP recruitment and medical education: part of the solution?

The current crisis in recruitment to general practice in the U.K. is likely, in part, to be caused by students’ and recent graduates’ negative perceptions of this career choice, perceptions which may have their roots in their experiences of general practice teaching and the effect of the ‘hidden curriculum’ in medical schools. There is some evidence that the expansion of the contribution of general practice in medical school curricula has stalled, and may even be shrinking, and of the diminishing visibility of general practice departments. Coupled with negative media and professional perceptions of general practice, the profession faces significant challenges in re-invigorating and re-inventing itself as an attractive career choice for students and recent graduates. General practice teachers and researchers in medical schools have significant opportunities to influence and improve many of these difficulties.

'Golden hellos' could ease recruitment crisis, says peer.

The author of an influential report into the future of nursing has called for 'golden hello' incentive payments to boost recruitment to the profession.

Bad Medicine: Good medicine — the GP paramedic

I am old school. I think that craft beers taste like urine, tofu tastes like polystyrene, and that posting your life all over social media is tasteless. I feel lucky to be a doctor; it’s a privilege not a burden. I also don’t buy into the idea that doctors are the most gifted and caring people in our society, because it just isn’t true. Becoming a doctor is much more about privilege than ability. The attributes of care, intelligence, and commitment are common among the wider population — which brings me to the GP recruitment crisis. Most doctors don’t want to be GPs because of the profession’s low status — and this is not going to change any time soon. In fact, the …

Identifying high-frequency attendees in general practice.

Primary care is critical to the effectiveness and sustainability of the health system in the UK. This is recognised in the current transformation of health care that aims to provide care and treatment in the community rather than through hospital-centred services.1,2 The effects of an ageing population with complex multiple morbidities, coupled with increased consumerism, have placed an unprecedented demand for access to general practice. Combined with specific supply-side factors, including diminished funding of general practice and an imminent recruitment crisis, this brings to the fore the need for new approaches to delivering primary care. One area that has received little attention within the context of transformation is the phenomenon of a proportion of the registered practice population consulting their GP frequently.3–5 Gill and Sharpe’s 1999 systematic review of frequent consulters in general practice concluded that there were two general approaches used to define a frequently consulting group. One approach is to identify a cut-off point in the distribution of consultation activity (for example, top quartile). The other approach is based on a minimum number of consultations (for example, a cut-off of 9–14 consultations per annum). These patients have highly complex health problems, including combinations of multimorbidity, frailty, dementia, polypharmacy, and problems requiring complicated management plans. Personal circumstances and health anxiety are also prevalent. Practitioner behaviours also contribute to regular consultations by frequently attending patients. A welcoming approach with positive regard maintains interaction. Hence, when a patient is …

‘Benchmark for terms and conditions is long overdue’

The crisis in early years recruitment has come at a time when the sector needs to expand capacity to meet demand for 30 hours. In this Q&A, Deborah Lawson, general secretary at Voice, addresses the challenges.

Nature works: why don't we? How living systems can inform the design of effective primary care.

I have always found denial an excellent strategy. For years I had listened with scepticism to reports of a crisis in UK general practice. In my surgery things were ticking over reasonably well. Then in May 2015 I had a bit of a crisis of my own. In transition to a new partnership structure I faced a few months of relentless on-call. I noticed myself become less caring towards my patients, less diagnostically curious, and less assiduous with my clinical records. My partners confronted the issue in a supportive way, the staffing issues resolved, and I regained my equilibrium, and with it a keener sense that all is far from well in UK primary care. Doran et al’ s paper in the BJGP gives a sobering account of why so many GPs are getting the hell out of practice, citing impossible workloads, degradation of the doctor–patient relationship, and negative media portrayals.1 These troubles are the cause and the effect of a recruitment crisis. A friend is a rural GP. With one partner down and a second due to retire, he simply cannot recruit. A dynamic training practice is on the brink of closure. In his patch, only three out of 15 GP training posts are filled. Now that is a crisis. Our quandary has elicited a valiant response from the RCGP and research is underway to anatomise the nature of GPs’ occupational stress. Initiatives are aimed at emphasising the good bits, supporting ailing GPs, and campaigning for better funding. But might there be things so fundamentally wrong with general medical care that no amount of good money or good will can fix it? And in the face of such anomalies, is now a time for some fresh thinking? This essay seeks inspiration from a system that works blisteringly well. …

Delivering the workforce strategy

Government's early years workforce strategy proposes raft of measures to tackle recruitment crisis

Addressing the crisis of GP recruitment and retention: a systematic review.

The numbers of GPs and training places in general practice are declining, and retaining GPs in their practices is an increasing problem. To identify evidence on different approaches to retention and recruitment of GPs, such as intrinsic versus extrinsic motivational determinants. Synthesis of qualitative and quantitative research using seven electronic databases from 1990 onwards (Medline, Embase, Cochrane Library, Health Management Information Consortium [HMIC], Cumulative Index to Nursing and Allied Health Literature (Cinahl), PsycINFO, and the Turning Research Into Practice [TRIP] database). A qualitative approach to reviewing the literature on recruitment and retention of GPs was used. The studies included were English-language studies from Organisation for Economic Cooperation and Development countries. The titles and abstracts of 138 articles were reviewed and analysed by the research team. Some of the most important determinants to increase recruitment in primary care were early exposure to primary care practice, the fit between skills and attributes, and a significant experience in a primary care setting. Factors that seemed to influence retention were subspecialisation and portfolio careers, and job satisfaction. The most important determinants of recruitment and retention were intrinsic and idiosyncratic factors, such as recognition, rather than extrinsic factors, such as income. Although the published evidence relating to GP recruitment and retention is limited, and most focused on attracting GPs to rural areas, the authors found that there are clear overlaps between strategies to increase recruitment and retention. Indeed, the most influential factors are idiosyncratic and intrinsic to the individuals.

Graduate Entry Medicine - An Antidote to the Recruitment Crisis in Medicine?

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Boost GP recruitment by training medical students in practices, say researchers

Medical students who receive their primary care training in general practice rather than a classroom are more likely to choose to enter the profession, researchers have found. The researchers said that their findings showed that more medical undergraduate funding should be directed towards general practice placements “to address the crisis in recruitment in primary medical care.”1 In a paper published in the British Journal of General Practice , researchers from Newcastle Medical School said that they had found “an association between the quantity of clinical general practice teaching at medical school and later …

The influence of placements on adult nursing graduates' choice of first post.

This article presents findings from a study that sought to explore the extent to which clinical placements have an impact on nursing students' decisions regarding their first staff nurse post. Within the UK, nursing is facing a recruitment crisis with particular difficulty recruiting to areas such as primary care and care of older people. Transitioning into a new role is challenging in any occupation, but it is a particular problem in nursing where the realities of professional practice often differ from students' perception of the staff nurse role as shaped by their clinical placements. This pilot study aimed to explore the influence of practice placements on final-year adult nursing students' career decisions. Qualitative and quantitative data were collected in a single phase using a questionnaire distributed to nursing students on the final day of their course. A total of 35 completed questionnaires were returned (response rate 57%). Half of the participants entered the course with preconceived preferences for clinical specialisms. However, only five participants (14%) applied for first-destination posts in that specialism. The overall importance of placements in career choice increased across the three years of the programme. Although placements in all three years are important, the experiences in year 3 are pivotal, with 74% ranking these as 'significantly influential' in their decision-making process. Analysis of the data obtained from the free-text responses from the questionnaire suggested that working environment; the level of support provided by mentors and clinical staff; the opportunity to make a difference to patients' lives and the variety of placements, were key influences on nursing students' decision regarding their first staff nurse post. This study highlights the key role of practice placements in the career choices of student nurses, particularly during the final year of their programme. It shows that students are likely to apply for posts in the placement area they found to be most supportive and developmental.

From revered to commiserated: the changing role of the medical registrar

The role of the medical registrar has changed significantly over the last few years, and in many respects this has not been for the better. Both the perception and the realities of the general internal medicine component of higher specialist training have led to significant pressures on recruitment to specialty training posts. Core trainees do not feel prepared to become the medical registrar and those in the role highlight substantial problems that impact on the quality of care they can deliver. This article aims to explore some of these difficulties and where possible suggest potential solutions; there needs to be urgent action undertaken to stave off a potential crisis in registrar recruitment and retention. Despite this, the role of the medical registrar remains a hugely fulfilling part of a physician's career, and there is much to be celebrated and embraced about the qualities a registrar brings to the successful functioning of both general and specialist medical teams.

Why I am pursuing a career in general practice

It is well known that there is a recruitment crisis in General Practice. Dr Peter Edwards, an Academic Foundation Year Two doctor in Bristol, presents an interesting discussion on this crisis, and why medical students should be wary of the negative stigma and attitudes towards this important, but often undervalued, specialty.

Unions demand recognition of teacher recruitment crisis

In a strongly worded joint submission to the STRB, six education unions have attacked the DfE and demanded action on teachers' pay

GCSE requirements fuel growing recruitment crisis

As the workforce continues to shrink, The National Day Nurseries Association's latest statistics underline the need for a Government u-turn on A to C grades. A new strategy is urgently required, says its chief executive, Purnima Tanuku.

Teacher recruitment targets hit in just four secondary subjects

Recruitment crisis: New figures show DfE has missed its overall ITT target for the fourth year running, with key EBacc subjects hit hard

Goodwill is not a development path

A recruitment and retention crisis in the early years that could reach epic proportions is currently within sight unless the government can come up with a robust and practical workforce strategy.