GMC says nationwide workforce planning is needed to avoid NHS staffing crisis

Service at ‘breaking point’ as many doctors considering cutting their hours or quitting due to strain on system

The General Medical Council (GMC) has called for UK-wide workforce planning to avoid a future crisis after a poll revealed many doctors are considering quitting the NHS or cutting their hours because they feel stressed or overburdened.

A poll of 2,600 doctors found many were examining other career options beyond working full-time. Of the practicing doctors surveyed, two in five (38 per cent) were considering either going part-time or reducing the hours they work, a fifth (23 per cent) said they had thought about practicing abroad, and 14 per cent considered moving to the private sector. 

Of those considering a career change, more than a quarter (28 per cent) said it was because the current system presented “too many barriers to patient care”, and a similar proportion (27 per cent) said their role demanded “too much of them”.

Professor Sir Terence Stephenson, chair of the GMC, said there were different challenges in each part of the UK, but that as a whole the NHS was 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,” said Stephenson. 

He added healthcare leaders need to be “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”.  

Another particular concern, said the GMC, was the revelation that 21 per cent of 45-55 year old doctors and two-thirds (66 per cent) of 55-64 year olds reported they intended to take early retirement by 2021.  

The report said that in 2017, more than half (57 per cent) of doctors retiring from the profession were 50 or younger, similar to the proportion in 2012 (53 per cent).  

Danny Mortimer, co-convenor of the Cavendish Coalition and chief executive of NHS Employers, said it was “disheartening” to hear about the pressures doctors face.

Mortimer also warned that future changes to the immigration system may put greater strain on NHS recruitment. “It is of paramount importance 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,” he said.  

He explained this change would help tackle the “often misleading assumption” that the salary paid to a migrant worker is the prime indication of the value of their work. 

Earlier this year, the Cavendish Coalition – which was set up to examine the effects of Brexit on staffing in the health and social care system – forecast a shortage of between 5,000 to 10,000 nurses by 2021. This was on top of existing vacancies, which currently stand at 41,722. 

The Coalition warned heath and social care services relied heavily on staff from the European Economic Area (EEA). It estimated more than 5 per cent of the regulated nursing profession, 5 per cent of allied health professionals, 9 per cent of doctors and 16 per cent of dentists came from inside the bloc. 

Its report recommended international recruitment should form part of a costed workforce strategy.

Similarly, the GMC today indicated the UK should consider migrant workers in future workforce planning. It said non-UK workers presented opportunities for supporting NHS locations that are short of doctors as migrants joining the workforce may have higher mobility when they first come to the UK.

It added their choice of location could be influenced through the use of incentives.

The UK experienced a relatively high inflow of migrant doctors in 2017-2018, the report said. Of more than 14,000 doctors that joined the medical register in 2018, around half graduated outside the UK, up from 44 per cent in 2012. 

The report also proposed increasing the capacity of testing centres to accommodate the rise in the number of international doctors wishing to sit the two-part language and skills test needed to work in the UK.

The NHS should also contribute to a national database recording where skilled doctors are located in order to build insight into the distribution of where doctors are and where particular skills are needed, it added.