The NHS workforce is under mounting pressure from rising demand, the elective care backlog, constrained finances and ongoing staff shortages all which make ‘fixing’ the NHS a tall order.
The latest vacancy statistics show that the total full time equivalent (FTE) vacancy rate for England is at 107,865 – a 7.3% vacancy rate – with a shortage of 31,773 nurses, midwives and health visitors (7.5% vacancy rate) and 7, 768 medical vacancies (4.9% vacancy rate).
Since the introduction of ICBs in July 2022, the primary care workforce has been a constant challenge. ICBs have had to deal with practices and primary care networks PCNs being unable to recruit GPs and practice nurses, pharmacists being taken away from community pharmacies to work in general practice, issues around lack of surgery premises to house new staff and now a crisis around GPs being unemployed.
The big disruption in the primary care workforce came in the form of the additional roles reimbursement scheme (ARRS), introduced at the same time as PCNs in the 2019 GP contract. ICBs were given responsibility for managing the scheme. There have been positives and negatives: it has certainly increased the general practice workforce, but GP practices haven’t always been on board.
When problems do occur, ICB leaders bear the brunt of it. This has been compounded by the GP unemployment crisis, with some practices questioning why they can’t recruit while there are GPs out of work.
There has been acknowledgement from the Government around this situation. In one of his first acts as health secretary, Wes Streeting announced that newly-qualified GPs would be added to the additional roles reimbursement scheme to prevent a cohort of doctors starting their career unemployed – something that ICBs again have had to manage.
ICBs are having to juggle budgets and manage expectations at the same time as they themselves are coping with their own dwindling workforce.
We have asked ICB primary care directors about their views on the general practice workforce and the ARRS. And we are looking at what solutions ICBs are putting in place with regards to the primary care workforce.
This report System working: Train, retain and reform the primary care workforce is based on Healthcare Leader’s freedom of information investigation (see chapter 3) and a major new white paper from the publishers of Healthcare Leader, Cogora, on the changing general practice workforce in England, in conjunction with the Rebuild General Practice campaign group.
Alongside our sister titles – Pulse, Pulse PCN, Management in Practice, Nursing in Practice and The Pharmacist – we have surveyed around 2,500 general practice professionals, interviewed more than 100 frontline practitioners, analysed hundreds of data for every practice in England and brought together all the editorial expertise within our titles to produce the white paper which will be launched at a Parliamentary event (today) Thursday 23 January attended by MPs, GP, nursing, pharmacy and practice manager leaders, and numerous frontline GPs.
Download our General Practice Workforce White Paper here.
