Cap on medical training places should double, says Reform

21 Sep 17

The government should double the cap on medical students being trained each year as part of its drive to improve health and social care integration, according to a report from Reform.

Raising the maximum number of places in medical schools each year from just over 6,000 to 12,000 would cost an additional £140m a year, the independent think-tank said. 

But this would pay for itself in the future by helping to save on the £1.3bn the NHS spends on agency doctors each year, said a report from Reform, released last week. 

In Getting into shape: delivering a workforce for integrated care, the independent research centre said the NHS workforce needs to undergo a process of deregulation to address the imbalance between the acute sector and community care.

Currently there are almost three times as many doctors and four times more nurses in the former than the latter.

In addition, a Freedom of Information request sent by Reform to 61 NHS trusts revealed only 6% of consultants work in the community at least one session per week.

This is while the number of consultants has risen by a third since 2009 and GP numbers have fallen, the report noted. 

Researchers argued that getting rid of the cap would help the NHS train enough individuals to fill its vacancies.

The report states: “The aim of the cap has been to control costs by limiting the number of doctors in training.

“The result, however, has been an inadequate pool of labour, difficult working conditions and a powerful staff body, many of whom choose to work for expensive agencies.”

The report also suggests charging trained doctors to pay back taxpayer-funded costs of medical training if they decide not to work for the NHS.

It calls on students to pay back £11,700 per year, for a maximum of ten years, for each year spent working for a non-NHS employer or locum agency.

“In other professions, such as accountancy, it is normal for employers to pay for the cost for training, but for trainees to take on that cost should they leave the firm during training,” the report states.

The document also suggest that the Sustainability and Transformation Partnerships should be given greater powers regarding decision-making over the workforce.

STPs should have the freedom to develop innovative ways to attract, train and retain staff, according to Reform.

The study said the present system of workforce regulation in the NHS contributes to a siloed and disjointed system.

It said: “This leads to an old-fashioned model of care in which patients are referred around the system to different regulated professionals, when care could be delivered by a smaller number of clinical staff working in one place.”

In October last year health secretary Jeremy Hunt pledged to increase the cap on just over 6,000 medical training places by 1,500 from the academic year 2018/19.

Hunt said at the time: "By dramatically expanding our supply of home-grown doctors, we will ensure the NHS always has the doctors it needs."

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