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General practice teaching ‘seriously underfunded’

Study shows wide variations across the UK

Jo Carlowe

Tuesday, 22 October 2019

The cost of undergraduate placements in general practice is considerably greater than the funding currently available, new research* shows.

Although there is a standard national tariff for undergraduate teaching in hospitals, arrangements for teaching students in general practice are made locally, and vary widely across the UK. 

Published in the British Journal of General Practice, Joe Rosenthal, professor of primary care education at the Department of Primary Care and Population Health, University College London, and colleagues collected data from 25 English medical schools on the costs of student placements in general practice and found them to be considerably greater than the available funding and broadly comparable with secondary care (hospital) funding. 

The actual cost of placing a medical student full time in general practice for a 37 week academic year was £40,700 compared with the average payment rate of only £22,000 per year. The authors of the study comment that if this under-resourcing is allowed to continue there will be further attrition in placement capacity, with serious consequences for the NHS workforce.

Author Joe Rosenthal said: “NHS General practices are really struggling to find the time and space to provide medical students with the authentic clinical experience they badly need. This study confirms that the funding currently available to GP undergraduate placement providers is far below the cost to the practice, and also far below the payment available to hospital placement providers.  A more realistic and equitable tariff for primary care education funding is needed as a matter of urgency.”

Commenting on the findings, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: “It is unacceptable that despite our persistent calls for change and the desperate need for more family doctors, undergraduate general practice teaching continues to be severely under-resourced.

“This research highlights that GP practices which offer undergraduate teaching currently receive over 40% less in funding on average than the actual costs, and around 40% less than is available to their secondary care equivalents. This is simply not sustainable, especially at a time when we need to encourage a new generation of family doctors into the NHS and plug a major workforce gap.”

She added: “I have written to the secretary of state for health and social care about this a number of times over the past two years because having to ‘make do’ with inadequate funding to host students is simply not sustainable.  Unless primary care funding tariffs are properly funded and brought in line with other areas of medical training, we will simply struggle to secure the growth which our profession so desperately needs.”

A Department of Health and Social Care spokesperson said: “We have seen a record number of aspiring GPs enter training and we expect that trend to continue this year. Through our NHS Long Term Plan we are investing an extra £4.5 billion a year by 2023/24 into primary and community care, including funding up to 20,000 extra staff in GP practices – helping to free up doctors’ time.

“We are working with stakeholders to consider a national primary care tariff that better reflects the costs of GP education.” 


*Rosenthal J, McKinley RK, Smyth C, et al. The real costs of teaching medical students in general practice: a cost-collection survey of teaching practices across England. British Journal of General Practice, 21 October 2019; bjgp19X706553. DOI: 10.3399/bjgp19X706553

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