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Medical profession at ‘crunch point’ warns GMC

Annual report calls for action on workforce

Jo Carlowe

Tuesday, 19 December 2017

The UK’s medical profession is at “a crunch point” and will suffer increasing pressure over the next 20 years unless action is taken.

The warning comes in the General Medical Council’s (GMC’s) State of Medical Education and Practice in the UK report, published today.

The annual report, analyses data on the medical workforce across the UK. The report highlights the following “warning signs”:

  • Supply of new doctors into the UK’s medical workforce has failed to keep pace with changes in demand – the number of doctors on the medical register has grown by 2% since 2012, while in contrast A&E attendances and GP appointments have risen sharply. In England, there has been a 27% increase in A&E attendances in that time, while Northern Ireland saw a 10% increase.
  • Dependence on non-UK qualified doctors has increased, ranging from 18% in the south-west to 43% in the east of England.
  • The UK is at risk of becoming a less attractive place for overseas doctors to work in. 
  • Continuing pressure on doctors involved in training and a greater desire for more flexibility in how they work and train.

Charlie Massey, chief executive of the GMC, said: “We have reached a crucial moment – a crunch point – in the development of the UK’s medical workforce. The decisions that we make over the next five years will determine whether it can meet these extra demands.

“Each country needs to think carefully about how many doctors are needed, what expertise we need them to have so they can work as flexibly as possible, and where they should be located given the changes and movement in population expected.

“We are a professional regulator, not a workforce planning body, but we want to be an active partner in helping each country of the UK to address these priorities.”

The report sets out four key priorities for workforce planning, including:

  • maintaining a healthy supply of good doctors into UK practice,
  • helping the UK medical profession to evolve to meet the future needs of patients and healthcare,
  • reducing the pressure and burden on doctors wherever possible,
  • improving the culture of the workplace, making employment and training more supportive and flexible.

Charlie Massey added: “The underlying challenge for all in healthcare is how we retain the good doctors we have right now. Everything we hear from the profession tells us that we need to value them more; nurture cultures that are safe and supportive, and do what we can to help staff achieve the right balance between their professional and personal lives through more flexible working arrangements.

“The pressure on our health services shows no signs of letting up. It’s on all of us to understand why doctors are making different choices about their lives and careers.”

Commenting on today’s report, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "This wide-ranging report shines a light on the very real workforce pressures we are facing in general practice and ultimately, makes a loud and clear statement that we need more GPs.

"GPs deliver the vast majority of patient care in the NHS for less than 9% of the overall budget. Our workload has risen 16% over the last seven years, but investment in our service has fallen over the last decade and our workforce has not risen at pace with demand.

"We are incredibly grateful for the work overseas GPs contribute to delivering care to over a million patients everyday - and any appropriately trained doctor who wants to join us is welcome, and should continue to be made to feel so - but we should not have to solely rely on their skills and dedication.”

She added: "It is clear we need to be training more doctors here in the UK - and we have welcomed the government's commitment to increase medical school places. But we also need to ensure that a high proportion of medical students and foundation doctors choose general practice…Overall, today's report hammers home just how essential it is that NHS England's GP Forward View, pledging £2.4 billion extra a year and 5,000 more full-time equivalent GPs by 2020, to be delivered urgently and in full, and for equivalent promises to be made and delivered in each of the devolved nations. This is the only way we will secure a GP workforce fit for the future and able to deliver the care our patients need and deserve.”

A Department of Health spokesman told OnMedica: “The NHS currently has a record number of doctors - 14,900 more since May 2010 - and we are committed to supporting them by expanding the number of doctor training places by 25%. We are also making sure we retain those already working in the NHS by improving doctors' work-life balance and supporting flexible working.”

Responding to the GMC’s The state of medical education and practice in the UK 2017 report, Danny Mortimer, chief executive of NHS Employers, said: "This report provides more evidence of NHS services under increasing pressure. We need to make sure the UK remains an attractive prospect for the brightest and best from the EEA and the rest of the world, as we know we won't be able to fill gaps with domestic recruitment in the short to medium term. 

"The draft NHS Workforce Strategy is an opportunity for the NHS to address some of the challenges facing our medical workforce including those identified by those responding to the GMC survey."

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