2. Supporting Recruitment in Rural Areas
Dr Peter Saul
Associate Dean
Wales Deanery / Cardiff University

3. Rural GP Crisis
2009 GPs in Wales (7% more than in 2006) 441 Practices (11.1% less in 2006) 52.4% female (was 34% in 200)

4. BUT! Increased LTFT working More clinical activity
Greater multimorbidity
Larger population

5. “Is there a job for my partner”

6. Rural Perceptions Connectivity (mobile phone/broadband) Transport
Fragility of support services 
Workload (including the 24 hour commitment) 
Professional development 
Education and Training 
Professional and social isolation, including 
Adverse effects on family life 

8. GP Training in Wales 3 year programme
136 posts (not changed in >13 years)
Throughout the country
> 8 years since last fully recruited
F2 doctors in GP
24% Wales
55% National UK
95% NW England

9. The Concerns Ageing workforce Unfilled vacancies
Demographic shift in GPs
Perceived unpopularity of Rural Areas
Ageing population
Multimorbidity
Centralisation of secondary care services
Insufficient exposure of students and young doctors to Rural GP

10. Agenda for Rural Health
Catch them young.
Expose students to, and locate in rural environments.
F2 Rural GP placements.
Incentivise training in rural environments.
Support established practitioners
Address wider issues.

11. Financial incentives
Recruiting rural students.
Rural placements for students
Rural postgraduate training
Peer `Group Support
Marketing
Social media
Academic Opportunities
Returner and retainer schemes

12. Cardiff University
‘Aspects of Rural Medical Practice’. A three-day residential programme based in rural Wales which offers an insight into rural practice from local practitioners, with the opportunity to view a Community Hospital in Mid Wales and visit air ambulance.
Community and Rural Education Route YR3 year in Rural GP
Fun an important factor.
Mentoring aspiring students

13. Swansea University 4 year Graduate Programme
Target Welsh Students increased interviews
GP Experience for Y11,12
RRHIME (Rural and Remote Health in Medical Education) a clearly defined Rural and Remote Health Track embedded throughout the GEM curriculum which allows selected students the opportunity to focus elements of their education on rural and remote health. A crucial, evidence-based element of RRHIME is that students experience more prolonged immersion in rural health environments and/or focused on rural and remote health issues. For RRHIME these include rural General Practice and District Hospitals, as well as rural secondary care in Aberystwyth and Haverfordwest.

14. Bangor University/BCU Health Board
work in deprived and rural practices in North Wales
enhance their professional development.
Provide support for practices to develop patient care
Learnt the principles and skills of medical research
Learn to teach
Gain a post graduate qualification to Masters level.

15. RCGP Wales Mentoring and support for school students.
Careers conferences.
Supporting Student placements

16. Educational Support Rural Doctors’ Conference Paediatrics Haematology
Whistleblowing
Respiratory
Dermatology
Ophthalmology
Minor Surgery
ECG
Skills workshops; Trauma, CMAT, Neurology, Palliative Care, BLS, Diabetes

17. Local Medical Societies
Education
Networking
Support

18. Wales Deanery
Responsible for recruitment and postgraduate training of doctors in Wales.
GP section largest number
136 per year
“Overall satisfaction (which is often considered to be the acid test of trainee satisfactions) in Wales is the highest of all the 4 home nations in This score reflects an ongoing trend in the level of trainee satisfaction with the score increasing for the fifth consecutive year.
The Wales Deanery is the only postgraduate medical education organisation which does not have any overall ‘red flags’ for major training concerns, when the combined results of our core and specialty training programmes are bench marked against the other 15 UK regional organisations. In addition, the feedback for local teaching, regional teaching and access to education resources has improved this year with all three indicators being reported in the top quartile.”

19. Current initiatives Network of training practices
Further Training practices
I&R Programme
£20,000 incentives from Welsh Government
Expansion of F2 in GP Nationwide
Support for CPD Nationwide
Network of training programmes and training practices everywhere.
Recruitment centre in North Wales

20. Have financial incentives worked?
2017 Round 1
2016 Round 1
Round 1
Scheme
Number of Candidates in Schemes
Bridgend 14
Neath Port Talbot 1
Swansea 16
Gwent 13
Bangor 4
Dyffryn Clwyd 7
Wrexham
Cardiff
Glam Valleys 10
Carmarthen 5
Pembrokeshire
Aberystwyth
TOTAL 93
NOT FOR CIRUCLATION
Scheme
Number of posts advertised for R1 2017
Numbers actually starting in August 2017 (incs R deferrals, R deferrals and August 2017 R1)
Posts Full/Left over (inc any GHF posts not filled)
Aberystwyth
5 (plus 1 GHF)
#REF! 3
Bangor 8 6 2
Bridgend 16 17
FULL
Cardiff 18
Carmarthen
9 (plus 1 GHF)
Dyffryn Clwyd 7
Glamorgan Valleys
15 (plus 1 GHF) 13 1
Gwent
Neath Port Talbot 4
Pembrokeshire
Swansea 15
Wrexham
7 (plus 1 GHF)
136 26