'The Long Term Workforce plan is not fit for purpose’, says College Chair

The Royal College of GPs has joined forces with other health bodies to urge the Public Accounts Committee to re-open its inquiry into the NHS England Long Term Workforce Plan citing ‘significant concerns’ about some of the assumptions the LTWP is predicated on.  

The College has written to the new Chair of the Committee alongside the Royal College of Physicians and the Royal College of Nursing amongst others [full list of signatories below] calling for the inquiry - opened earlier this year but abandoned before it could conclude, due to the General Election – to be re-started and its findings published ahead of the Government’s forthcoming 10-year plan for the NHS, announced earlier this week.  

The letter points to the National Audit Office’s report ‘NHS England’s Modelling for the Long Term Workforce Plan’ that found ‘optimistic’ and ‘unrealistic’ assumptions throughout the LTWP, especially around the retention of health professionals across the NHS. The analysis found that by 2036-37, there could be a 3% difference between the best and worst outcomes on staff retention, which means the NHS could end up with 73,000 more or fewer staff.   

The RCGP has separately raised significant concerns – including in its own submission to the inquiry – on the NAO’s projection that the LTWP only plans to increase the number of fully-qualified GPs by 4% by 2037, compared to a 49% growth in hospital consultants. 

Polling by the College has found over 40% of GPs across the UK said it was unlikely that they would be working in general practice in the next five years – many citing stress and burnout for reasons - this figure has grown from 31% in 2019.  

In its submission to the Budget, which will take place next week, the RCGP is calling for increased and ringfenced funding for GP retention efforts at both national and local levels to support GPs at every career stage, including new practice fellowships for the newly qualified, career support for mid-career GPs and an emeritus scheme for those approaching retirement. 

The letter to the PAC is being sent as the RCGP launches a new report ‘Retention: Looking after the GPs of today to safeguard the workforce of tomorrow’ laying bare the challenges of retaining qualified GPs at all stages of their careers and making tangible recommendations for the Government to address them.   

It outlines how in September 2024, the NHS in England had the equivalent of 1,557 fewer full-time fully qualified GPs than in September 2015, despite the demand for care increasing, and patients’ health needs becoming more complex. 

Training a GP costs around half a million pounds, and without proper retention support, the government risks losing their investment and wasting public money. In England, the financial cost to the public purse for losing and replacing a single experienced NHS GP has been estimated at a minimum of nearly £300,000. 

To avoid this, the report recommends: 

• A comprehensive review of the Long Term Workforce Plan with a focus on GP retention. 
• The development of a National Retention Strategy for General Practice including national ringfenced funding, oversight and guidance. 
• Protected learning time be written in the GP contract and funding be guaranteed for Practitioner Health services 
• The Home Office guarantee international medical graduates the right to apply for Indefinite Leave to Remain upon completion of training as a GP.

Professor Kamila Hawthorne, Chair of the Royal College of GPs said: “The current Long Term Workforce plan is not fit for purpose – and that signatories representing different sectors of the health service have signed this letter, demonstrates widespread concern that must be addressed.  The Public Accounts Committee inquiry would be the ideal vehicle to do this, and its findings should feed into the NHS 10-year plan.  

“Retention of doctors – right across the NHS, but not least in general practice - is the principle missing element. We absolutely need more doctors across the board, but with the new government’s clear ambition to move more care out of hospitals and into the community, it makes no sense that the current LTWP for the NHS contains such stark disparity between the projected increase of GPs to that of hospital consultants.  

“Our new report, published today, sets out the reality of the situation: if more is not done to retain our current GP workforce, our already chronically understaffed general practice service will be woefully unprepared for the future. We’re in a vicious cycle, with workload pressures rising to unsustainable levels, driving GPs out of the profession, and further putting the pressure on remaining staff. 

“At a time when patients are crying out for appointments, losing a single GP from the frontline is a major loss, and it is our patients who are bearing the brunt. The government must turn its attention to doing everything possible to retain our valued and experienced colleagues – and the recommendations laid out in our report are where it needs to start. 

“It makes sense to want to shift more care into the community. General practice delivers cost effective care, close to home where patients want to be treated – and in doing so, it alleviates pressures across the health service. But to do this effectively, resources – including staff – must follow. 

“It is vital that action is taken to retain the GPs we have today to ensure we safeguard the workforce of tomorrow. This will require resource, absolutely – and we hope next week’s Budget includes ringfenced funding for a National Retention Strategy – but we also need a change in mindset, that gives as much focus to keeping experienced, qualified doctors in the profession, as it does to bringing new ones in. One does not work without the other. 

"The current situation is dire, but with the right investment and realistic initiatives to recruit and retain more GPs, we can turn things around and deliver on the government’s ambitions to move care where patients want it – into their communities.” 

Letter

Further information

RCGP press office: 0203 188 7659
press@rcgp.org.uk

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.