GP workforce predictions: through a glass darkly?

Dr. Conor Teljeur

Prof. Tom O'Dowd

Prof. Fergus O’Kelly

Dr. Aisling Ní Shúilleabháin

Dept. of Public Health & Primary Care,Trinity College Dublin

AUDGPI, 27th February 2009

Aims of the workshop:

• Estimate numbers of GPs needed to

2021

• To identify interventions that will

address workforce issues

Agenda

• What do we know?

• What do we forecast?

• How might we deal with the issues?

Sources of information

Age profile of GPs

Buttimer Report (2006), recommendation

47:

"the HSE should implement the policy

previously adopted by the Department of

Health and Children to increase the annual

intake of GP Trainees from the current 88

to 150 by 2008."

Training places

• Approximately 10% of trained GPs do not

practice as GPs – that represents an

investment of ~ €2.3m lost each year

• Intention to retire early:

– 13% intend to retire before 60

– 43% intend to retire before 65

Attrition

Agenda

• What do we know?

• What do we forecast?

• How might we deal with the issues?

• No change in patient behaviour – that is,

total demand will be in proportion to the

age-sex distribution of the population

• Demography of trainees to remain stable

• Sessions and retirement age of GPs to

remain stable

Assumptions

GP numbers – demand

2,500

2,600

2,700

2,800

2,900

3,000

3,100

2008 2010 2012 2014 2016 2018 2020 2022

Year

Nu

mb

er o

f G

Ps

Demand

GP numbers – fixed intake/120 per annum

2,500

2,600

2,700

2,800

2,900

3,000

3,100

2008 2010 2012 2014 2016 2018 2020 2022

Year

Nu

mb

er o

f G

Ps

Demand

Stable intake

GP numbers – reduced drop-out to 5%

2,500

2,600

2,700

2,800

2,900

3,000

3,100

2008 2010 2012 2014 2016 2018 2020 2022

Year

Nu

mb

er o

f G

Ps

Demand

Stable intake

Stable intake +reduced drop-out

GP numbers – increase intake to 150 annually

2,500

2,600

2,700

2,800

2,900

3,000

3,100

2008 2010 2012 2014 2016 2018 2020 2022

Year

Nu

mb

er o

f G

Ps

Demand

Stable intake

Stable intake +reduced drop-out

Increased intake

GP numbers – increased intake + reduced drop-out

2,500

2,600

2,700

2,800

2,900

3,000

3,100

2008 2010 2012 2014 2016 2018 2020 2022

Year

Nu

mb

er o

f G

Ps

Demand

Stable intake

Stable intake +reduced drop-out

Increased intake

Increased intake +reduced drop-out

3.0%

3.5%

4.0%

4.5%

5.0%

5.5%

2008 2010 2012 2014 2016 2018 2020 2022

Year

% s

essi

on

s p

rovi

ded

by

trai

nee

s

existing intake

increased intake

Trainee contribution to sessions

0.0

0.5

1.0

1.5

2.0

2.5

2008 2010 2012 2014 2016 2018 2020 2022

Year

Rat

io o

f m

ale:

fem

ale

GP

sRatio of male:female GPs

Impact of M:F ratio on sessions

7

8

9

10

2008 2010 2012 2014 2016 2018 2020 2022

Year

Av

era

ge

se

ss

ion

s p

er

GP

Agenda

• What do we know?

• What do we forecast?

• How might we deal with the issues?

Options for additional training places

• Increase role substitution - nurses

• Clinical pharmacy - bigger role

• Recognition of prior hospital experience

• Recruitment from EU & Non EU countries

• Anything else?...

Other options