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Better workforce planning needed to avert NHS staffing crisis, says GMC

The GMC has called on the government to develop a more robust approach to workforce planning, with many doctors considering career changes and reduced hours.

Research commissioned by the GMC for its 2018 The state of medical education and practice in the UK report highlights the steps which some doctors are feeling the need to take to cope with current NHS pressures.

It suggests the NHS is heading for a future workforce crisis that will be compounded by Brexit and a fragmented approach to the recruitment and retention of doctors.

Many doctors are considering career changes to step away from the heavy workloads in primary and secondary care, the research finds.

Around a third of the 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.

Professor Sir Terence Stephenson, Chair of the GMC, said: “Medicine can be a fantastic career, continues to attract many talented applicants and many doctors remain highly motivated and satisfied. But the costs for some, in terms of their own well-being 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.”

NHS pressures are also influencing practice, with many doctors admitting they make referrals to colleagues which are not strictly necessary but happen due to limited time to address patient concerns. They also order blood tests when they may not always be needed, and bypass clinical checklists in order to get through workload.

RCP president Prof Andrew Goddard commented: “The GMC report says we are at a ‘critical juncture’, that staff shortages are ‘severe’ in some places, the pressures on the medical workforce are ‘huge’, that strategies we are having to take to cope are ‘risky or unsustainable’, and we are ‘at the brink of a breaking point’.

“When the guardian of patient safety is moved to use such language over and over, the government must take notice. We trust that the imminent long term plan for the NHS will include doubling the number of medical students, the expansion of the Medical Training Initiative, and more support for SAS (Specialty and Associate Specialists) doctors.

“Without such relief, it is clear from this report that the safety of patients and doctors themselves will be increasingly under threat.”

The research comes against a backdrop of uncertainty with the possibility of a ‘no deal’ Brexit. EEA qualified doctors make up 9% of licensed doctors in the UK, and there is currently little clarity on how they will be able to join the register after Brexit.

The GMC said that while the status of EEA qualified doctors already registered in the UK is guaranteed, the tap must not be turned off to enabling EEA doctors to come to the UK after March 2019.

GMC proposals on workforce planning include:

  • 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 the GMC testing centre.
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