Prescribing place: retaining doctors, reframing community health
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This is a Re:State Scholar publication by Dr Jennifer Creese.
The NHS faces a double challenge: retain a medical workforce under growing strain, while building a health service that is more preventative, more rooted in neighbourhoods and better connected to the communities it serves.
Yet resident doctors, formerly known as junior doctors, and in many ways the backbone of the health system, can spend years moving repeatedly between hospitals and places, making it harder to establish stable lives, develop local relationships, or build a deep understanding of the communities in which they work.
Prescribing place, a new Re:State Scholars paper by Dr Jennifer Creese, asks what would happen if place became a more important part of medical workforce policy, particularly for resident doctors. Drawing on six years of research and examples from Australia, New Zealand, Canada and the USA, the paper explores how greater geographical stability could be combined with high-quality medical training, while giving doctors stronger connections to local communities and a greater role in improving the services around them.
The paper proposes a new model of place-based medical training, including ‘home training hubs’ that reduce routine geographical relocation; a mandatory Community Health and Prevention component during medical training; pilots of incentives to encourage doctors to put down roots in areas with persistent workforce shortages; and greater protected time and formal opportunities for resident doctors to contribute to service improvement and reform.
Together, these ideas point towards a different relationship between doctors and place: one in which resident doctors have greater opportunity to establish lives in the communities they serve, understand the health needs and assets around them, and become long-term partners in improving local health. With medical training and the organisation of NHS services both undergoing significant change, Prescribing Place argues that workforce retention and neighbourhood health should be designed together.