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What is the solution to the GP Workforce crisis?

By Puja Verma, GPST1

There are not enough GPs to meet the current demand. Not enough junior doctors are choosing general practice and an increasing number GPs are leaving full time practice.  The Government plans to meet the increasing demand on our National Health Service by transferring care into primary and community settings, but without more GPs this will not be possible. So how do we inspire a new generation of junior doctors to enter General practice? With a positive recruitment video? With a letter outlining the positive aspects of the profession?  These are both recruitment strategies suggested by the £10 million10 point plan by NHS England.
 
 I undertook a systematic review of strategies used to recruit and retain family doctors. I found 51 evaluations of 42 interventions implemented across 8 high income countries. Interventions were categorised into thirteen groups including retainer schemes, re-entry schemes, support for professional development or research, well-being or peer support initiatives, and specialised recruiters/ case managers. Most of these interventions were badly evaluated without comparison groups therefore we were unable to form strong conclusions from them. However, we did find weak evidence to support undergraduate and postgraduate placements in primary care in underserved areas. This means trainees who were placed in these areas for their training tended to go on to work there in their future careers.

We also found evidence to support selective recruitment of medical students who were from underserved areas or who had started medical school with a particular interest in general practice, these students tended to go on to become GP trainees. We found mixed evidence for financial incentives. There are many different ways to financially incentivise trainees e.g. paying back there loans, or paying them to work in a hard to staff area. Some of these strategies work better than others. 
 
The future of medical school entry may no longer just be based on good grades and personal statements, we might need to start considering the students background and likelihood of becoming GPs. Medical schools need to emphasise the importance of promoting primary care through positive primary care placements throughout their undergraduate training.  Financial incentives may also be necessary when recruiting in particularly hard to staff areas.

Our research showed there is a multitude of incentives out there but they are poorly evaluated, and therefore we are not learning from them. We need to start thinking outside the box, and implementing novel strategies after rigorous evaluation.

 
Have a read of the full paper here: 

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