Agenda item

To receive a report which sets out the detail of the plans which have been produced local and the progress that has been made in relation to the General Practice Incentive Scheme.

The Managing Director, Leicester City Clinical Commissioning Group submitted a report which set out the detail of the plans which have been produced locally and the progress that has been made in relation to the General Practice Incentive Scheme.

Members noted the following comments:-

a)         There was a national and local shortage of GPs and a number of initiatives were being undertaken to address these shortages.

b)         Professor Farooqi was the CCG’s representative on the Leicester, Leicestershire and Rutland (LLR) General Practice Delivery Group, which was overseeing a 10 point plan to support the recruitment of GPs, which was outlined on the report.

c)         The Government had made a commitment to train an additional 5,000 GPs by 2020, but current evidence suggested that there were insufficient numbers on GP training programmes to achieve this.

d)         Currently 30% of places on the East Midlands GP training scheme were unfilled.

e)         Locally issues under consideration were:-

            i)          Selling the East Midlands as a place to work for GPs.

ii)         Encouraging GP’s to take medical students from local universities to provide an introduction to and experience of primary care provision.

iii)        Encouraging GPs trained in Leicester to remain in Leicester.  Feedback from young doctors indicates that Leicester is not seen as an attractive place to work for a number of reasons, although there were a number of highly committed GPs who valued the chance to work in an area of high need. 

iv)        Incentive schemes including financial and non-financial elements were seen as useful in recruiting more GPs.  Non-financial elements could include offering young GPs the opportunity of various experiences as part of their employment, including research opportunities, specialist work experience in hospitals, working in 2-3 GP practices, protected learning time within the contract of employment etc.  The Council’s Public Health directorate could also look at offering opportunities for experience and development.

Following Members’ questions and comments it was stated that:-

a)         It was more difficult for non-EU doctors to be recruited to the health services.  It may be worthwhile to engage local immigrant communities to see if qualified medical practitioners could be retrained as GPs.  The LLR General Practice Delivery Group currently had no data on potential numbers etc so any information in relation to this would be welcomed.

b)         The current Membership of the Royal College of General Practitioners (MRCGP) training programme was more rigorous than ever before in assessing clinical skills and knowledge.  The current failure rate was 15-20% but this reflected the high quality expected from doctors passing the qualification.

c)         Approximately 250 medical places were available at Leicester University and yet few medical students chose to stay in Leicester when they qualified.  This differed from a significant proportion of existing doctors in Leicester, aged in their 40’s, who had stayed following their training at local universities.

d)         A number of GP practices relied on the employment of locums to meet patient’s needs and more work needed to be done in the short term to encourage these locums to become permanent members of the practice. 

Members’ made the following observations and comments:-

a)         The issue of GP recruitment was an issue that needed to be addressed by everyone engaged in providing services across the health economy.

b)         The recently established, Children’s Services Improvement Board, comprising representatives of health, the Council and the Police had recently looked at the issue of Leicester as a place to work and were developing initiatives and this could be further developed to support the recruitment and retention of GPs and other NHs staff locally. 

c)         In relation to Leicester being seen as too challenging a place to work the LLR General Practice Delivery Group could also look at the success of the Teach First programme in addressing educational disadvantage issues in England and Wales.

d)         It would be interesting to map out where recent cohorts of locally trained medical students took up employment as part of the work to understand why they did not stay locally.

e)         Joint work to produce promotional material publicising Leicester as a place to live and work was fully supported together with the possibility of having joint funding from all organisations interested in this issue so that a better outcome could be achieved by pooling resources rather than each organisation producing its own material.

f)          The issue of newly qualified doctors not wishing to stay in Leicester was part of a wider issue of graduate retention in the City generally, which the Council was trying to address.

g)         It was felt that if 20 newly qualified medical students from one cohort could be encouraged to stay and practice in Leicester then this would make a big difference to local GP practices.  If the cohort then encouraged and influenced students in following cohorts to stay the cumulative effect would soon change the current situation dramatically.   

RESOLVED:

That Board members be thanked for their helpful contributions and that the CCG consider the suggestions made at the meeting to contribute towards the enhancement of the General Practice Incentive Scheme.