New thinking needed to tackle NHS workforce crisis, says GMC Chief

Hundreds of north east doctors would be better able to meet patient demand if barriers preventing them from working alongside GPs were removed, the Chief Executive of the General Medical Council (GMC) told a conference in Newcastle today (Friday 17 March).

Addressing a Health Education England North East conference, he warned that ‘red tape’ restricts where specialty and associate specialist (SAS) doctors, of which there are around 2,000 in the region, can practise. 

SAS doctors are doctors who do hands-on work but are not in training to become a consultant or a GP. Many choose this route for work life balance and for its focus on direct patient care, but are denied some wider opportunities, including being able to work in primary care. 

The GMC’s most recent annual report into the medical workforce showed SAS and locally employed doctors are the fastest growing group of doctors in the UK and that, by 2030, they could be the largest group in the medical workforce overall.

They’re also highly skilled, with 83% having more than 10 years of clinical experience according to a 2019 survey. Charlie Massey said: ‘This is a dynamic and growing group of highly experienced doctors, one that is already making a massive contribution in the health service.’

However, he warned that SAS doctors ‘should be supported to reach their full potential’. A lack of support leads to many leaving the profession. In the north east alone, 113 SAS doctors left in 2021. He said: ‘This represents a huge waste of talent, one that an increasingly stretched system can ill afford.’

He called upon health leaders to ‘think differently’ to ‘make more of the workforce we already have’ saying ‘there is no cavalry of doctors coming over the hill who we could recruit at scale to alleviate pressure.’

Charlie Massey said: ‘Despite their growing presence and influence in the service, SAS doctors too often suffer from others’ outdated notions about what their careers should look like. Rather than valuing their skills, the focus and the narrative remains skewed towards consultants. Those dated ideas are holding SAS doctors back and patients are being denied their skills in the process.’

He concluded: ‘The stark reality is that while the composition of the medical workforce is changing, the rules and attitudes that govern it aren’t keeping pace. SAS doctors need more support, and more opportunities. And within the wider system, we need more creative thinking that will enable SAS doctors both to develop their skills and encourage them to pursue long careers in UK practice.

‘All of us have a role to play to maximise the abilities and experience of this vital and growing group. There’s much to be done. But the prize - well supported doctors using their skills to meet modern healthcare needs - justifies the effort.’

Charlie Massey’s speech to the Health Education England North East SAS conference can be found in full here. The GMC report The state of medical education and practice in the UK: workforce report 2022.