ghp June 2015

ghp June 2015 | 15 With this in mind, Government initiatives to improve access to GPs outside of normal opening hours with the help of a £50m GP Access Fund, as outlined last year, will, in theory, prove to be an advantageous pub- lic health measure. Building on these proposals, in his first major speech since the General Election, David Cameron outlined plans to create a “truly seven-day NHS” by extending GP opening hours. Cameron’s pledge to increase the availability of access to GPs is, on the surface, a very welcome proposition. However, in reality, any increase in patient access to front line services is likely to exacerbate existing GP and Nurse Practitioner shortages. As an organisation which is on the front line of recruit- ment into the NHS, we understand the direct correlation between timely access to healthcare professionals and patient safety. Although plans for seven-day GP opening are still far from fruition, we at MSI Group have already witnessed an increase in demand for locum GPs who can offer ‘wrap-around’ services during evenings and weekends, both in-person and remotely through urgent care centres, walk-in centres and the 111 service. Extending access to GP appointments from five to seven days would effectively mean a 40 per cent increase in demand for talent to plug this gap. And there is simply not an adequate supply of doctors to meet this demand on a permanent basis. An ageing population, retirement cliffs and insufficient talent pipelining have all contrib- uted to an acute shortage of permanent healthcare professionals. While it is imperative that these issues are addressed long-term, we cannot escape the fact that agency nurses and locum doctors provide a valuable service that, for the imminent future, the NHS simply cannot do without. And this acute need for the skills of contract staff to maintain frontline services will increase proportionally in line with service availability. It’s no secret that the NHS is already struggling to recruit enough GPs and other health professionals. According to analysis by health think-tank, The King’s Fund, this shortage can be attributed to more family doctors choosing to take early retirement coupled with fewer GP training posts being filled. Indeed, the Royal College of General Practitioners (RCGP) has estimated a fourfold increase in unfilled posts since 2010 – one in three GP training posts are now empty. Furthermore, the RCGP has warned that more than 500 practices are under threat of closure, because so many doctors are close to retirement age, with too few younger medics stepping in to replace them. New fig- ures from the UK’s medical deaneries show that more than 1,000 GP training posts are currently vacant. In 2013, just 20 per cent of medical students chose to work in general practice on completion of their foundation training. The Government has set a target for 50 per cent to do so by 2016, which would mean recruiting 3,250 GP trainees a year in England. That deadline has already been pushed back a year, after poor take-up rates in 2014. Reasons as to why fewer young professionals are choosing a career in general practice remain a topic of debate. However, GPs are now carrying out 370 million appointments a year, 70 million more than five years ago, so workload may be an issue. According to a ComRes survey of 1,004 GPs in January 2015, 27 per cent of respondents surmised that medical students were shunning this option because of volume of consultations, 19 per cent cited working hours and nine per cent attributed pay to the fall in recruitment. While the use of agency staff within the health service has been met with controversy in the media, it’s important to consider the reasoning behind the use of contractors. Dr David Rosser, medical director of University Hospitals Birmingham, one of England’s biggest trusts, recently went on record to say; “The NHS doesn’t have the number of doctors it needs. The shortage is real. We aren’t training enough doctors in this country, and so we are dependent on foreign-trained doctors. Doctors in more and more branches of medicine report shortages, especially in specialities such as A&E, where it’s tough work.” Meanwhile, an investigation by the Guardian newspaper found that the NHS hired up to 3,000 foreign-trained doctors from at least 27 different coun- tries last year to plug staff shortages. This research is backed by overall figures from the General Medical Council which show that the number of foreign-trained doctors on its register rose by 2,957 between 31 December 2013 and 6 January 2015. Those trained outside of the UK make up two-fifths – 39.4% – of the 7,500 year-on-year increase in the overall number of doctors. Foreign-trained doctors now represent over a third (36.6%) of doctors on the register, a figure that rises to 41.2% among specialist doctors. Aside from qualified doctors, it is also worth noting that the service is suffering from a shortage of UK trained nursing professionals which will also have an impact on seven-day access. A recent survey by Health Education England found that 83 per cent of English NHS Trusts reported that they are experienc- ing qualified nursing workforce supply shortages. And with nurse practitioners now taking a more active role in the delivery of GP services, this additional talent gap must not be overlooked. Furthermore, the Royal College of Nursing’s chief executive, Peter Carter, has