UK-wide workforce planning needed to avert NHS staffing crisis, says GMC

New research has laid bare a future workforce crisis that could be compounded by Brexit amid a fragmented approach to the recruitment and retention of doctors.

Research commissioned by the General Medical Council (GMC) for its 2018 The state of medical education and practice in the UK report paints a stark picture of unabated pressure on health services. The report also shines a light on steps that some doctors are feeling the need to take to cope with patient numbers, some of which may be piling more pressure on other parts of the system. 

Among those measures are making referrals to other doctors that are not strictly necessary but happen due to limited time to address patient concerns, ordering blood tests when they may not always be needed, and bypassing clinical checklists in order to get through workload.

"Doctors are telling us clearly that the strain that the system is under is having a direct effect on them, and on their plans to continue working in that system."

Professor Sir Terence Stephenson

Chair of the GMC

The research indicates many doctors are considering career changes to step away from the heavy workload placed upon doctors in primary and secondary care. Around a third of 2,600 doctors surveyed are considering reducing their hours in the next three years. A fifth are planning go part time and a further fifth plan to leave the UK to work abroad. Of particular concern is that 21 per cent of 45–54 year old doctors and two-thirds of 55–64 year olds intend to take early retirement by 2021.

The figures come against a backdrop of uncertainty with a possible Brexit ‘no deal’ around how EEA qualified doctors, who make up nine per cent of licensed doctors in the UK, will be able to join the UK medical register after Brexit.

As the UK medical regulator, the GMC is doing everything possible to prepare for the various scenarios possible in March 2019. The status of EEA qualified doctors already registered in the UK is guaranteed. But it is crucial that in whatever scenario we face after March 2019, the tap is not turned off in enabling EEA doctors to come and work in the UK in future. 

Professor Sir Terence Stephenson, Chair of the GMC, said:

‘Doctors are telling us clearly that the strain that the system is under is having a direct effect on them, and on their plans to continue working in that system. We’ve heard from doctors who are referring patients on to other parts of the system because they don’t have the time to deal with their issues, understandably moving the pressure on to other parts of the service.

‘There are different challenges in each of the four countries of the UK but the NHS is at a critical juncture; without a long-term UK-wide plan to ensure it has a workforce with the right skills in the right places and without the right support, doctors will come under even greater strain.’

The GMC can help with the solutions to this potential future workforce crisis and has submitted proposals to the government’s consultation on the NHS long-term plan. These proposals set out how GMC data, insights and revised processes for enabling non-UK doctors to work here can be used to improve the supply and retention of the medical workforce across all four countries of the UK over the next ten years.

Among the proposals are:

  • building insight into the distribution of doctors and the skills they have across the UK by contributing to a national database of which doctors have what skills, and in which locations
  • legislative change to give more flexibility in processes for joining the GP and specialist registers, providing a wider range of options to demonstrate the skills and experience needed to do so
  • accommodating the rise in international doctors wishing to sit the two part test of skills and language needed to work in the UK by increasing capacity at our testing centre.

Professor Stephenson added:

‘Medicine can be a fantastic career, continues to attract many talented applicants and many doctors remain highly motivated and satisfied. Most are able to provide good, often superb, levels of care to patients despite the pressures. But the costs for some – in terms of their own wellbeing and work-life balance – are not sustainable.

‘All healthcare leaders have acknowledged this: now is the time to act. That means being prepared to change long-established paradigms of what it means to educate and train doctors and what it means to have a sustained career in the profession. Failure to turn wringing hands into helping hands risks undermining 70 years of work to create a world leading healthcare system.’