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Abstract
Cumbria suffers recruitment and retention challenges, detrimentally effecting patient care and educational outcomes. It is understood that incentivising enables beneficial change in doctor’s fill rates, highlighted in HEE’s ‘Training in Smaller Places’ report.
Evidence for long-term impact of enhanced recruitment is maturing; opinions remain divided. Providing financial incentive where training schemes are specifically targeted to promote retention of future medical workforce is novel and we are the only UK integrated healthcare system using TERS on a regional footprint for all specialties.
In 2018, HEE NE provided a TERS payment of £7000 for trainees taking up a 12-month Specialty Training or Foundation Post in North Cumbria. Since 2019, the Local Education Provider has continued the scheme.
Post Fill rates TERS resulted in a 20% increase in fill rate across training grades. The lower 2018/19 FY2 fill rate was a result of the low FY1 fill rate in 2017/18 before the introduction of TERS.
Application Score TERS has dramatically improved the average Foundation Programme (FP) application score since 2018, from 71.6 to 77.5 in 2020. During the same time period the average score for the North East has gone from 79.2 to 80.
Surveys 100% reported TERS positively influenced their decision making, 42% ranked Cumbria higher in selection rankings, 74% that £7000 was the right amount and 63% felt TERS positively influenced their decision to stay in Cumbria.
Financial benefits TERS has cost £941,597 to date in direct expenditure however we anticipate it has had improvements in overall locum spend, requirement for Trust grade positions and excess hours fines, figures we are looking to finalise imminently.
Conclusion TERS attracts more doctors of a higher calibre to Cumbria, benefiting our services and reducing disadvantage to our population. We plan to continue the scheme and further analyse its impact.