Abstract
I have been a GP partner since about 2014 and became a trainer soon after. Looking back, becoming a partner was a big step for me. I was taking on a significant financial commitment and new responsibility in joining a rural practice at the height of a GP recruitment crisis, with a workload driven by a rising tide of frail patients. At the time however, my decision making was driven by one ambition: to become a GP trainer.
I had completed my GP training in Greater Manchester and returned to my native West Wales. I already had some idea of the training landscape I was so keen to join through family connections. I had moved around practices in the hope of an opportunity to be involved in training. I started attending the local meetings as a prospective trainer, volunteered to run sessions and took on teaching responsibilities as much as I could. At the time opportunities to get involved were limited by the low number of trainees coming through our scheme. Those limited opportunities pushed me towards a job where there was a trainer vacancy and I was lucky to discover a fantastic group of like-minded colleagues where I found my niche.
In that time, being a GP trainer allowed me to gain some experience as a foundation programme director and complete my post-graduate certificate in medical education. Along with my partners we have trained GPs who have come to West Wales from across the globe. For those who have stayed, it has been a great privilege to see them develop into fantastic GPs for our communities.
In many ways over the last 10 years the training landscape for our local scheme has improved. We have a bigger scheme than ever and have expanded our remit to bring trainees into GP posts at ST1 level. Our local trainers’ group has recruited new practices to train and our trainers’ group is increasingly diverse, with new perspectives on GP training emerging from new service delivery models in our practices.
The strength of the GP schemes in West Wales has remained a constant inspiration to me and I see nothing that has dimmed my conviction that we have created a centre of excellence for training.
While the inspiration remains, it would be wrong for me to skirt over the numerous challenges facing our profession both locally and nationally. We have been through what can only be described as a work force planning debacle. We are grappling with an intense recruitment crisis with GP shortages leading to practice closures followed by an unemployment and underemployment crisis. Despite overwhelming evidence that strong healthcare systems are built on strong primary care, we have seen the number of GPs in the UK flatline while the number of specialists continues to rise.
Practices do their best to remain sustainable but are unable to recruit and retain the GPs they train. Other developed nations attract them overseas in increasing numbers where their excellent skills are highly prized.
So, this has changed my outlook. While I am a proud contributor to the grand tradition of GP training in West Wales (and the UK) I can see action is needed to reverse the trends that keep an already insufficient number of well-trained GPs away from their patients.
As a longstanding advocate for the values of the RCGP, I am very proud this month to have been elected Chair of the Welsh Council. This marks a profound change of course for my career. I am seeing fewer patients and sharing the responsibility for training in our practice with new partners. My motivation has slowly shifted from a desire to be part of the fabric and tradition of excellence in UK GP training towards a role in which I can advocate for a renaissance of training and fight for the long-overlooked recognition in our system that it needs and deserves.
The situation in Wales is mirrored across all our four nations where we are at the point of maximum risk and reward in general practice. Policy in all nations points towards a community-based solution to the systems problems. Strong GP training and leadership are the key to developing solutions. A new challenge awaits in joining system leaders from across the UK to campaign for the preservation and strengthening of UK GP training.
