Health CommitteeWritten evidence from Committee of GP Education Directors (ETWP 36)

THE HEALTH COMMITTEE INQUIRY INTO EDUCATION, TRAINING AND WORKFORCE PLANNING

1. The Committee of General Practice Education Directors (COGPED) offers a forum for UK wide Postgraduate GP Directors to meet and share good practice

COGPED’s aim is to encourage and maintain a consistent approach to GP training across the United Kingdom. It is a focal point for communication between the Postgraduate GP Directors and other stakeholders such as Royal College of General Practitioners, BMA, GPC, GMC, NCAS, GMC and various sections of Department of Health.

COGPED has a record of achievement and leading partnership with other stakeholders in meeting its objectives eg National coordination and standard setting of Selection to GP Training, Higher Professional Education for newly qualified GPs, Out of Hours Training arrangement for GP Registrars, quality standards for training practices and a number of other initiatives related to medical education standards and workforce issues.

COGPED members are individually answerable to the postgraduate Deans in COPMED but work collaboratively to provide a national GP perspective. COGPED works both on behalf of, and with, COPMED to address issues in which GP expertise is required.

2. COGPED wishes to submit evidence concerning:

The proposed role, structure, status, size and composition of local Provider Skills Networks///Local Education and Training Boards, including how plans for their authorisation by Health Education England will address issues relating to governance, accountability and potential or perceived conflicts of interest, and how the Boards will relate to Clinical Commissioning Groups and the Commissioning Board;

How funding will be protected and distributed in the new system;

How future healthcare workforce needs are being forecast;

The impact of people retiring from, or otherwise leaving, healthcare professions; and

The place of overseas educated healthcare staff within the workforce.

3. Provider Skills Networks/Local Education and Training Boards. At a COGPED workshop on Provider Skills Networks/Local Education and Training Boards held November 2011 COGPED recommended that:

GP Directors, alongside Postgraduate Deans, should be members of the Executive of the Provider Skills Networks/Local Education and Training Boards.

GP Primary Care provider representation on the boards should be at least 20% of the membership of the board reflecting the fact that almost 50% of fully trained NHS doctors are General Practitioners and because 90%of NHS care is delivered and coordinated from General Practice.

The transition to Provider Skills Networks/Local Education and Training Boards should not disrupt core business of postgraduate deaneries: (i)commissioning suitable training placements and programmes for specialty training (ii) high level quality assurance of postgraduate medical education and training including assuring patient safety in training environments (iii) ensuring successful recruitment to specialty training programmes (iv) management of any performance concerns relating to doctors in training.

The Provider Skills Networks/Local Education and Training Boards should ensure the provision of CPD (Continuing Professional Development) in all providers of NHS services and primary care should receive a transparent and equitable allocation of CPD resources. There is a specific risk in primary care, during transition and beyond as Primary Care Trusts are wound down at the same time as Strategic Health Authorities. Key areas such organizational memory and performance support mechanisms may be lost as the proposed architecture has little detail on this area of workforce support and development across the wide range of professionals providing key services through multidisciplinary teams. CPD is a catalyst for service development and, in primary care, is frequently undertaken at individual practice level involving the wider clinical and administrative teams. There is a risk of increasingly narrow “localism” without input from medical and nursing educators who are currently supported by postgraduate deaneries and PCTs respectively.

Provider Skills networks should continue and develop specific educational initiative supporting the assessment and retraining of UK qualified GPs after significant periods out of the primary care workforce, GPs from the EU and the rest of the world, and those identified as having performance concerns through appraisal or investigation by NCAS or the GMC. There should be a person specification for board members and the GP provider person specification should include: (i) experience of education in primary care (ii) board level experience as a primary care provider (partner or equivalent) (iii) good record of communication with key stakeholders such as Local Medical Committees, educator networks.

There should be input to the Provider Skills Networks/Local Education and Training Boards regarding the population health needs of the population for whom the Provider Skills Networks/Local Education and Training Boards are commissioning the future NHS workforce

4. Funding

COGPED wishes to ensure that there is adequate funding to train the primary care workforce to meet the needs of patients recognising the allocative efficiency of training primary care generalists compared to the high total costs of training secondary care specialists.

5. Future healthcare forecasts

COGPED recognises that current GP training outputs are insufficient to meet the predicted need for GPs. COGPED recommends that training opportunities in oversupplied specialties should be reduced in order to create some push into GP Specialty training.

6. The impact of retirement from General Practice

COGPED has noted the significant proportion of GPs stating an intention to retire within the next two years in the recent BMA survey and has also the age profile of GPs from the NHS Information Centre which shows that the proportion of the GP workforce aged over 50 years has increased significantly in the past decade. COGPED believes that it is possible to increase participation and service contribution in the early years of a GP’s career by extending GP training to better prepare new GPs for their expanded roles and responsibilities in the NHS.

7. The place of overseas educated healthcare staff within the workforce

COGPED has been concerned that poor language skills from European Union graduates with no UK NHS experience have a potentially adverse impact on patient safety. COGPED would support the further development of its robust system that resources and mandates consultation or communication skills training and competence testing in this group of doctors.

December 2011

Prepared 22nd May 2012