Enabling Staff Retention in the Primary Care Workforce Across Professions

NHS England (London) held the bi-monthly London Primary Care Regional Retention Steering Group with key stakeholders this week, which included some excellent presentations relating to retention in primary care. Speakers presented informative workforce data connected to training pipelines, retention of GPs, nurses, APs and non-clinical roles in primary care, with further highlights shared from SEL ICB recent Practice Manager, GP and Practice Nurse Focus Groups. Digital transformation and digital enablers for Primary care which impact staff retention and wellbeing, inspiring staff to stay working in general practice were also discussed.

See below for highlights and key themes from discussions.

Highlight on numbers:

  • London GP FTE turnover rate fell from 8.55% from Sept. 2023 to 6.2% in Sept. 2024; equating to 160 less GPs leaving general practice in London, compared to previous year. (Percentage includes GP locums and excludes GPs in training)
  • 2451 additional placement hours in 23/24 vs 22/23 for Pre-Registration Nursing in primary care
  • Total of 545 SPIN GP and GPN London fellows on programme in 2023/24 & 114 GPs on London Retainer Scheme to bolster retention
  • 182 (total headcount) Advanced Practitioner trainees across Nursing, Pharmacy, Paramedicine and Occupational Therapy
  • 427 FTE employed Advanced Practitioner (AP) workforce across Nursing, Pharmacy, Paramedicine, Physiotherapy, Dietetics & Podiatry

Themes from SEL ICB Practice Manager, GP and Practice Nurse Focus Groups held:

Retaining SEL nurses in primary care:

  • Involve nurses in practice meetings and decision-making
  • Proactively plan for development, new models and succession planning and have enough nurses to mentor new nurses
  • Improvement of standard T&Cs and salary for cost of living in London (also pending national GP contract negotiations and the collective action outcomes)
  • Address the expectation to train/ undertake additional training in own time, and the importance of ‘feeling appreciated’.

Why NQ/early career GPs are leaving SEL:

  • 10 minutes is too little time for an appointment and need longer to address complex needs
  • GPs wanting flex in their lives and not wanting to stay in one place for their whole career
  • Portfolio working remains important
  • Training of GPs does not equip them for GP partnership role
  • Many would stay if worked in supportive practices e.g. manageable workloads in career transitions etc

Changes Practice Managers would like to see in their practice to improve retention, recruitment, and staff development:

  • One small thing; make sure everyone gets a real break at lunchtime
  • More attractive staff packages, with opportunities to progress, and pay rises on recognition
  • Training for reception managers to take on management role for that team
  • One day to work away from GP land and focus on important info. and have time for innovation
  • ICB staff to spend time in practices, as disconnect between the front line and the system e.g. act on what we say and not what fits existing plans

How digital transformation in primary care is impacting staff retention and wellbeing:

  • Automating manual administrative processes using digital automation, has significantly reduced workload improving practice administrative staff morale and wellbeing
  • Use of Coaching apps has actively encouraged practice staff wellbeing and access to learning and development opportunities
  • Use of AI Scribe tool (with appropriate training and clinical oversight) reduces clinician cognitive burden and administrative workload, saving GP clinicians up to an hour each working day, helping them achieve a better work/life balance.