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General practice: Non-nurse and non-doctor clinicians could double by 2030

General practice: Non-nurse and non-doctor clinicians could double by 2030

The number of general practice clinical staff who are not GPs or nurses could nearly double by 2030 if current trends remain consistent, while the nurse shortfall in the sector is set to rise, a report has warned.

The workforce projections, from the Health Foundation, predict the nurse shortfall will reach 6,400 full-time equivalent posts by the end of the decade – accounting for 29% of the projected general practice nurse demand, with GP numbers also expected to hit 8,800 in the same time scale.

In a more pessimistic scenario, nurse supply in general practice is projected to decline by around 28% to around 12,000 by 2030/31 – resulting in a shortfall of around 10,100.

To make up the nurse and GP shortfall, in line with current policy action focused on PCNs and the additional roles reimbursement (ARRS) scheme, the number of direct patient care (DPC) staff (excluding GPs and practice nurses) could grow from around 25,400 FTE in 2021/22 to 55,300.

The Health Foundation projections also set out an ‘optimistic’ scenario where DPC staff could grow to 72,000 in the same time period if ‘additional policy action facilitates increased use of a bigger and broader general practice workforce team’.

But it warned that if the PCN and ARRS initiatives fail to realise their potential, with no further workforce measures put in place beyond 2023/24, the number of DPC staff could reach only 40,000 by the end of the decade.

This ‘pessimistic’ scenario would also see the Government fail to deliver on its manifesto pledge to hire 26,000 additional general practice staff by 2023/34.

The projections anticipate that the Government will also fail in all three scenarios to deliver on its pledge to deploy 6,000 GPs by 2023/34.

The Health Foundation said its projections ‘highlight the inherent uncertainty’ in how DPC staff numbers will grow beyond 2023/24, given ‘the current lack of integrated workforce planning across general practice’.

It warned that its worst-case scenario would see the ongoing policy push towards multidisciplinary general practice teams falter after this point, with newer ARRS-funded recruits ineffectively embedded in their team, leading to increased staff turnover and vacancy rates overall.

Practices and PCNs ‘need support to manage organisational and team working changes’ as they become more multidisciplinary, it said, including more effective supervision and greater clarity on non-clinical work staff are expected to take up.

The Health Foundation said: ‘Overall, our report lays bare the scale of the challenge facing policymakers in addressing endemic NHS workforce shortages. Although there is no ‘silver bullet’ solution to England’s workforce shortages, this report adds to a growing body of evidence signalling the need for a comprehensive, fully funded and long-term workforce strategy.’

The report also found that healthcare services in England could face shortfalls of up to 38,000 nurses even if the Government makes good on its promise to recruit an extra 50,000 nurses,as previously covered by Nursing in Practice. 

A version of this story was originally published in our sister publication Pulse.