Incentivising general practice: a review of the Scottish targeted enhanced recruitment scheme (TERS)

Background One of the challenges facing UK general practice is the dwindling workforce, particularly in deprived or remote areas. One solution is to increase trainee’s exposures to these environments by incentivising training in these locations. The Scottish Targeted Enhanced Recruitment Scheme (TERS) offered a one-time grant to general practice specialty trainees (GPSTs) in historically under-subscribed training programmes from 2017-2023.

Aim To evaluate the impact of the TERS grant on GPST recruitment across Scotland and within the targeted programmes.

Design & setting Analytical observational study of recruitment and training data from NHS Education for Scotland.

Method Recruitment data from 2015-2023 was provided by NHS Education for Scotland. Odds ratios of recruitment rates were calculated before and after the introduction of TERS, as well as between programmes based on their eligibility for TERS.

Results The targeted enhanced recruitment scheme recruited 734 individuals to GP specialty training posts across Scotland. 1522 individuals were recruited to programmes not eligible for TERS in the same timeframe. The odds ratio of the effect of the TERS grant on recruitment across all programmes was 4.81 (95% confidence interval OR 3.87–5.99). The OR for the TERS grant on recruitment within eligible programmes was 2.33 (95% CI OR 1.74–3.12).

Conclusions We found a one-off £20 000 conditional grant was associated with a doubling of the odds of recruitment to historically under-filled GP specialty training programmes. Further work is needed to explore the effect of the TERS grant, and its withdrawal in 2024, on retention and the GP workforce.