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UK-wide workforce planning needed to avert NHS staffing crisis

Current workforce crisis could be compounded by Brexit, GMC warns

Ingrid Torjesen

Wednesday, 05 December 2018

Workforce crisis due to fragmented approach to the recruitment and retention of doctors could be compounded by Brexit, a report commissioned by the General Medical Council (GMC) warns.

The report, The state of medical education and practice in the UK, paints a stark picture of unabated pressure on health services, and also highlights the steps which 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. This includes making referrals to other doctors which 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.

The report indicates many doctors are considering career changes to step away from the heavy workload. 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% 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 9% of 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 has submitted proposals related to workforce planning to the government’s consultation on the NHS long-term plan. 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; and 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.

Danny Mortimer, co-convenor of the Cavendish Coalition, a coalition of 36 health and social care organisations, and chief executive of NHS Employers, said: “It is disheartening to hear of the pressures and compromised clinical decisions doctors and their teams face.”

He added: “Although we welcome the recent expansion in medical school places, we will need to keep relying on international doctors to help us deliver services and complement our homegrown talent.

“It is of paramount importance that any future immigration system is responsive and agile, with as little red tape as possible, and that it uses public service value as a key factor in assessing skill levels and setting entry requirements rather than just salary. This will help tackle the often misleading assumption that the salary paid to a migrant worker is the prime indication of the value of their work to the health and wealth of the UK.”

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