GP recruitment crisis intensifies as vacancies soar to 12.2%

Vacancies for GPs are at their highest ever level, research suggests.

A survey of 860 GPs for Pulse, a news magazine for general practitioners, found 12.2% of positions were currently vacant – up from 11.7% at the same time last year and from 2.1% in 2011, when Pulse started collecting the data.

The findings show 158 GPs (18%) have been unsuccessful in filling a vacancy in the past 12 months. In that period, the average time taken to recruit a GP partner has risen from 6.6 months to 7.4.

Pulse said some practices were having to hire non-GPs to fill the gaps, while others had closed after failing to recruit a GP partner.

A report from the Commons public accounts committee in April found there had been “no progress” in the previous year on increasing the number of GPs, despite a government target to recruit 5,000 more by 2020. The report said the number had actually fallen, from 34,592 full-time equivalent doctors in September 2015 to 34,495 in September 2016.

MPs said more trainees needed to be recruited and that existing GPs should be encouraged to stay on.

Prof Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said of Pulse’s findings: “We know that practices across the country are finding it really difficult to recruit GPs to fill vacant posts, and the degree to which this problem has increased over the last six years is staggering.

“In the most severe cases, not being able to recruit has forced practices to close, and this can be a devastating experience for the patients and staff affected, and the wider NHS.”

Stokes-Lampard added: “At present, UK general practice does not have sufficient resources to deliver the care and services necessary to meet our patients’ changing needs, meaning that GPs and our teams are working under intense pressures, which are simply unsustainable.

“Workload in general practice is escalating – it has increased 16% over the last seven years, according to the latest research – yet investment in our service has steadily declined over the last decade and the number of GPs has not risen in step with patient demand … This must be addressed as a matter of urgency.”

GP recruitment crisis intensifies as vacancies soar to 12.2%

Mental health nurses in short supply as NHS struggles to fill vacancies

Community-based teams care for 97% of mental health patients. And nurses play a pivotal role, building up trust between patients and their families.

However, since 2010 the total number of NHS mental health nurses in England has dropped by 15% – in parts of London, about 20% of job vacancies are unfilled. Helen Gilburt, a fellow in health policy at thinktank the King’s Fund, says: “Community mental health teams are supporting people to stay well, so if you haven’t got sufficient workforce to deliver that care, people are more likely to relapse.”

The nursing shortage is caused partly by an ageing workforce that is not being replaced quickly enough. In 2013, more than 32% of mental health nurses were aged over 50, and the abolition of bursaries for student nurses may also have had an adverse effect on the number of new recruits.

As a result, individual nurses are taking on a higher caseload. Research last year found that some community mental healthcare coordinators – not all of whom are nurses – have caseloads as high as 50 patients.

Ben Hannigan, reader in mental health, learning disabilities and psychosocial care at Cardiff University, who co-authored the study, says: “You will firefight with that number of people – it’s very difficult to do all the things you would aspire to.” Therapeutic care, aimed at helping people to recover, will be harder to provide, he says.

The shortage is affecting the whole service; a 2015 report by the Care Quality Commission revealed that only 14% of mental health patients said they received appropriate care in a crisis. And a review of psychiatric care by the Commission on Acute Adult Psychiatric Care found that 16% of patients per ward could have been treated in an alternate setting, including crisis houses and rehab services, if they had been available.

Trusts are struggling to deal with the shortages. Many, says Neil Brimblecombe, director of nursing at South London and Maudsley NHS foundation trust, are employing agency nurses, meaning that patients “have less opportunity to develop long-term relationships with individual nursing staff”.

Instead of “chasing an increasingly diminishing pool of nurses”, Brimblecombe believes trusts should take a different approach to workforce design. His own trust has joined two neighbouring trusts to develop a new assistant practitioner role to take on some of the work traditionally carried out by registered nurses.

In the long term, Brimblecombe believes the community mental health workforce should include more peer workers with “lived experiences of mental health problems” and more occupational therapists: “There will be an increasing range of new roles. The days when we have doctors, nurses and social workers, and that’s it, have gone.”

Mental health nurses in short supply as NHS struggles to fill vacancies

Indian doctors interviewed on Skype to fill A&E vacancies

The recruitment drive comes amid growing concern about the standards essential for overseas doctors to work in the United kingdom.

Final week a study by University University London found that half of all foreign physicians practising in Britain would fail international competency exams if they have been held to the very same standard as Uk colleagues.

Even so, beneath the new plans, drawn up to tackle urgent employees shortages in casualty units, the recruits from India will be in a position to operate right here with no undergoing the exams.

For the duration of the past three years, 368 of 835 posts for expert instruction have gone unfilled, with escalating numbers of trainees selecting other specialities or emigrating amid warnings from senior colleagues that units are turning into “like war zones”.

Last evening, Britain’s most senior Accident and Emergency medical doctor explained the ideas were desperate – but had been required to conserve the NHS from a spiralling crisis.

Dr Cliff Mann, President of the School of Emergency Medication mentioned: “The pressures are heaped on Accident and Emergency we at present have the worst medical professional to patient ratio that we have ever had, with demand vastly outstripping provide.

“Having failed to recruit for the past 3 many years, I believe we have small selection other than to get methods like this simply because otherwise the situation can only get worse.”

To operate in the United kingdom, medical professionals from outdoors the EU are normally essential to undertake exams set by the Skilled and Linguistics Assessments Board.

Even so, health officials working the programme stated that as medical instruction in India follows the exact same curriculum as in the United kingdom, successful candidates will not have to undergo the exams, despite the fact that they will be required to get language tests.

Peter Walsh, chief executive of security campaigners Action towards Medical Accidents, explained: “I am truly concerned to hear about the exceptions getting produced to the typical principles. I can see that the scenario is urgent, but we actually need to steer clear of becoming forced to consider the sorts of panic measures which could compromise patient safety.”

Senior doctors say Accident and Emergency units are being “overwhelmed” by the number of sufferers arriving as emergency situations when they must have acquired help earlier from GPs and community services.

Dr Mann mentioned many trainee physicians had been turning to other specialities or emigrating because the pressures were as well fantastic.

Final yr, a research found that the amount of youthful doctors skilled in the Uk or Ireland but now doing work in Australian Accident and Emergency departments has risen by 69 per cent in the past five years.

Given that 2010, NHS hospitals have noticed a 60 per cent rise in paying on company physicians, with some locum medics paid up to £3,000 a shift last 12 months.

Interviews via Skype for the new programme are due to begin this week, followed by face-to-encounter interviews in New Delhi following month just before productive candidates begin perform in the Uk in August.

The programme is trying to recruit junior medical professionals who have just completed healthcare college, and trainees who have had two years’ training given that medical college, but have nevertheless to comprehensive professional coaching.

Officials said a lot more than 50 medical doctors could be recruited this yr depending on how numerous “appointable” candidates are found, with decisions yet to be taken about potential recruitment rounds.

Health Education England explained it has also taken steps to enhance the amount of United kingdom trainees getting into specialist instruction, by means of a new “run through” programme which implies medics can specialise earlier.

A spokesman said: “Our recommendations will ensure availability of far more physicians in emergency medicine in 2014, each in terms of appropriately competent middle grade medical professionals and added trainees for the future, to support guarantee that individuals receive consistent, substantial quality, secure and efficient care.”

Indian doctors interviewed on Skype to fill A&E vacancies