Expansion of generalists roles in NHS backed in DH-commissioned report

A DH-backed report on overhauling medical training has supported calls for greater emphasis to be placed on generalist doctors.

BMA junior doctor committee chair Dr Jeeves Wijesuriya
BMA junior doctor committee chair Dr Jeeves Wijesuriya

A report published this week by the UK Shape of Training Steering Group – consisting of medical experts convened by health ministers – has called for medical training to be overhauled to improve GP training and facilitate doctors from other specialties to take on a more generalised role.

It follows on from the Shape of Training Review, published in 2013, that made 19 recommendations and warned there was ‘a clear need for change’ in medical education.

One of the review's main themes was ‘changing the balance between specialists and generalists’, warning that greater emphasis on generalist care will be needed to meet the developing needs of patients.

The current report outlines a ‘pragmatic, proportionate and practical way’ to implement the key themes of the earlier report.

The ageing population reveals ‘a clear patient need for more generalists’ in the future – and training must be changed to accommodate this, the report said.

GP training

There is also a requirement to ‘enhance the training of general practitioners’ as part of this, it added – and GPs will require ‘appropriate support and resource’ to allow them opportunities to enhance their skills in a range of areas.

In addition to GPs, ‘many more doctors will be equipped with the skills to work beyond the traditional hospital setting’, it added.

Several medical colleges have indicated interest in linking with the RCGP to offer post-CCT modules or fellowships.

Dr Jeeves Wijesuriya, BMA junior doctor committee chair, said: ‘We welcome a pragmatic approach from today's report from the UK Shape of Training Steering Group, which has listened to, rather than undermined, professional bodies for doctors in the UK.

‘We want to reassure patients and doctors that we continue to oppose any changes which devalue the high standard of medical training in the UK or compromise patient care.

‘The BMA has resisted attempts to move the point of registration, which would require significant changes to undergraduate medical curricula, compromising the quality of doctors' training and patients' care.

‘We have argued robustly to preserve the current specialty training structure, and for maintaining the Certificate of Completion of Training (CCT). We insisted that amendments to training pathways, if needed, should be made by the Royal Colleges and Faculties.

‘We have also argued for a model of credentialing that does not undermine the CCT or the coherence of training programmes. Any move that weakens the current standard of specialty training risks reducing the quality of patient care, and is therefore unacceptable to doctors.’

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