“If General Practice fails, the NHS fails” (Roland 2016)

90% of the work of the NHS is done within the General Practice setting. The RCGP/BMA estimates that we need 10,000 more GPs to meet growing demand, being one part of an expansion of the primary care workforce capacity. It has never been a more important time to attract people in to a career in General Practice and support them to stay.

Academic Primary Care has a significant role to play in meeting this challenge. 15% of the undergraduate medical curriculum is delivered by academic primary care/within the primary care setting. The academic primary care community provides important role models that attract people in to, and to stay in General Practice. APC provides the evidence base that supports the necessary evolution of professional practice to meet the challenges of a new century.

The need to address the crisis in the General Practice workforce is now publically recognised. A recent report from a taskforce chaired by Professor Val Wass makes a number of recommendations for “Supporting medical students towards future careers in general practice”. A key role for APC, and for the SAPC, is noted within the report. Here we summarise Professor Wass’s recommendations and outline the work SAPC is doing in response.

By choice – not by chance

With the General Practice workforce in crisis, a number of initiatives are in place to improve recruitment and retention. However to date, there had been little focus on the potential role of medical schools in promoting primary care as a career. Health Education England and the Medical Schools Council therefore jointly sponsored this taskforce, led by Professor Wass, to investigate what could be done in medical schools to promote General Practice careers.

The report notes a complex and variable situation. All contributing to a lack of a clear vision of, and positive profile for, General Practice within medical schools. Whilst medical students want a GP career that will offer intellectual challenge, academic status and diversity, too often their experience at medical school doesn’t meet this expectation. The report therefore makes a number of recommendations to address these problems. The academic primary care community, and specifically SAPC, are recognised as partners in a number of them. Here we list the recommendations, and SAPC initial response to those where we are specifically named.

Report Recommendations

1. Enhance and ensure equity in resource distribution (including funding) across the health system to enhance equity and quality of educational experience

SAPC response: Both HOTS and HODS are actively engaged in these negotiations

2. Develop, promote and disseminate positive, realistic awareness and understanding of General Practice to pupils in primary/secondary education.

SAPC response: Medical Educators in Medical Schools across the SAPC community are working to develop these resources 

3. Improve access to, and quality of, GP work experience for prospective medical students.

SAPC response: again this is ongoing work involving Medical Educators from across the Society

4. All medical schools to ensure that GPs contribute significantly to student selection processes.

5. All medical schools to revise their curricula to reflect the complex reality of a more integrated less specialty organised health service.

6. The formal curriculum should better inform students about the breadth and complexity of general practice care, and the stimulus of the intellectual challenge. The career options of general practice (partner/salaried/locum and GPwSI options) should be clear

SAPC response: SAPC is working on developing resources to raise the profile of portfolio GP careers involving scholarship (education, research, and innovation) as well as shining a light on the everyday scholarship (intellectual challenge) within daily practice. Research within the APC community also supports better understanding of the delivery and teaching of this form of practice.

7. General Practice should be recognised as a specialty in its own right

8. To enhance the impact of the informal curriculum through improving the quality, content, timing and variety of GP placements.

SAPC response: work that SAPC HOTS and individual Educators are tackling urgently

9. Positive and enthusiastic role models made visible across medical schools.

SAPC response: is in supporting development of resources that shine a light on the array of GP career options, and the successes of those working within them

10. Evaluate the role of UG GP Societies to optimise their role and impact

SAPC response: primary care academics across the Society are involved in this work.

11. Work to tackle the undermining of general practice as a career across all medical school settings including primary care.

12. Make academic training opportunities more accessible across the GP career path

SAPC response: HODS, SAPC Exec and key senior primary care academics are engaged in ongoing discussions with relevant groups including NIHR to monitor and address this issue

13. Collaborate across institutions to raise the profile of academic general practice by ensuring students have access to, and are rewarded for, engaging in scholarly activity; that senior academic GP profiles are visible and promoted; and that collaboration between RCGP and SAPC is promoted.

SAPC response: SAPC welcomes this recommendation which recognises ongoing collaborative work between SAPC and RCGP to raise the visibility and impact of GP scholarship

14. Increasing awareness of, and support for, portfolio careers.

SAPC response: the APC is actively involved in this work – both in supporting portfolios that include academic work, and in researching the implementation and impact of innovative portfolio options

15. Career information should support informed career decision making, but where appropriate also champion the vision of a GP career as an intellectually challenging and rewarding career

SAPC response: a vision that is reflected in many of the responses above

Summary of actions

SAPC welcomes this report, and the opportunity it brings to strengthen collaborative working across the general practice/primary care/academic primary care communities to support the future development of this key workforce.

Specific tasks for SAPC include continued leadership and engagement with national and local policy negotiations (enhancing impact through collaboration); work to enhance the profile of GP, academic GP and GP scholarship; and to support workforce development  and training (through education and research activities). All tasks that align with SAPC core principles and priorities for action.

SAPC is working to establish a GP Scholarship group with a remit to both oversee and guide the SAPC contribution in this area; and to develop and deliver specific resources and activities that support action. The work is being planned in collaboration with RCGP and we will post updates on this website.