Welcome to this introductory guide which aims to support practices exploring how to develop their clinical teams and create a way of working that is better able to meet their population needs for both urgent and routine primary care. This guide is intended for general practice and primary care teams who are thinking about introducing new clinicians into their multidisciplinary team and need some help and support. It is aimed at supporting GPs in clinical supervisor roles. Whilst this guide has been applied to an England context, many of the principles and ideas can be applied across the UK.

Expanding practice teams brings the opportunity to embed new skills into primary care, widens the range of services offered by general practice and works towards resolving some of the challenges currently faced in primary care. We know that general practice across the UK is facing change, with significant GP workforce shortages. This has been impacted by several factors, including fewer doctors choosing general practice, problems retaining newly qualified GPs and middle-aged GPs retiring early. 1,2,3,4

This coupled with changing population demographics in the UK, an ageing population and the shift of care from secondary into primary care; has led to an increase in primary care workload. In 2016 the Nuffield Trust expert seminar identified significant potential in all areas of NHS service for workforce change, but particularly in primary and community services.5

RCGP will be publishing a workforce roadmap in 2019 as part of the Fit for the Future: a vision for general practice.


  1. Primary care Workforce Commission. The future of primary care: creating teams for tomorrow. The Roland Commission 2015.
  2. Royal College of General Practitioners. Patient safety implications of general practice workload, 2015.
  3. Smith J, Holder H NE, Maybin J, Parker H, Rosen R, et al. Securing the future of general practice: New models of primary care. London: King's Fund and Nuffield Trust. 2013
  4. Nuffield Trust Policy Briefing. Health and social care priorities for the Government: 2015–2020. 2015
  5. Imison C, Castle-Clarke S and Watson R (2016) Reshaping the workforce to deliver the care patients need. Research Report. Nuffield Trust.