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First-ever national shortage of paramedics – but not of nurses

There is no national shortage of nurses or doctors requiring labour from outside of Europe, but there are no longer enough paramedics for the UK’s needs, according to a new report. 

Government advisors have recommended that paramedics should, for the first time, be added to the shortage occupation list (SOL), which would allow positions to be “sensibly” filled using labour from outside Europe. 

However, the Migration Advisory Committee (MAC) said that GPs and nurses should not be added to the SOL. The latest report added that nurses were not recommended for inclusion as the committee “did not receive evidence of a national shortage”. 

The Royal College of Nursing has accused the committee of using “misinterpreted evidence” to reach its conclusion. 

MAC said for paramedics it found that there are “no other short-term solutions to ease the pressure on the existing workforce across the UK”. 

It added that because of changes made to the healthcare system in recent years (for instance the shift in focus to treat people at home rather than in A&E), the nature and volume of job opportunities for paramedics have expanded, resulting in a nationwide shortage of paramedics working in the ambulance service. 

The MAC report highlighted that paramedic vacancy rates are currently running at around 10% (that is, 1,250 vacancies out of a total 12,500 ambulance workforce) and that this could grow in the coming years. 

“Although there has been an expansion of training places to boost labour supply in this occupation, we are told that they will experience a severe shortage for the next four years before the trainees graduate,” the committee added. 

Professor Sir David Metcalf CBE, chair of the MAC, said: “We recognise that there is a shortfall in the numbers of GPs being trained but consider that the solution to this is in the hands of the health service. 

“The health sector told us that, nationally, they do not need any jobs in nursing to be on the shortage list but we agreed with their assessment that there is presently a shortage of skilled paramedics.” 

Richard Webber, a national spokesperson for the College of Paramedics, told NHE: “London Ambulance Service has gone recruiting quite aggressively in Australia, and they have an agreed visa waiver scheme in place with the Borders Agency. They are also about to undergo another recruitment in March, as there aren’t enough UK paramedics. 

“The issue is that there has been a lack of higher education training centres for paramedics and places available, which will create a shortage over time. 

“I believe this latest news is a short-term fix, and really I think we should be training and educating people in the country to do the job. We have a higher education system that churns people out, why are we not churning more people out with vocational degrees that can do the job? We just want to see more higher education places available for paramedics.”

But the Royal College of Nursing (RCN) said it was “deeply disappointed” that the MAC had misrepresented the College’s position in order to “claim there is no shortage”. 

RCN’s chief executive and general secretary Dr Peter Carter said: “We will be contacting the Committee about this as a matter of urgency and would urge them to reconsider their position in the light of this misinterpreted evidence. 

“Let us be very clear: we provided detailed, extensive and unambiguous evidence of the shortage of nurses in the UK and the effect this was having on patients. We have consistently called for both a long term solution to the lack of staff, and for nursing roles to be on the shortage list.”

He added that nurses are stretched to breaking point and will be utterly bemused as to how the conclusion was reached. 

MAC was commissioned in September 2014 to carry out a partial review of the SOL, and when analysing the health sector it paid special attention to the evidence from the Centre for Workforce Intelligence (CfWI). 

Based on the information provided by CfWI, MAC stated that GPs were “considered” for inclusion, but evidence indicates there are enough medical students in the UK and the Department of Health is already considering options to incentivise the role. 

Responding to the latest MAC report, chair of the Royal College of GPs (RCP) Dr Maureen Baker said she was pleased that the MAC had drawn attention to the “chronic shortage” of family doctors in the UK. 

But the RCGP was disappointed at the MCA’s “lack of action” to rectify the problem by unlocking the potential of skilled medical professionals in the many countries that have similar health systems to ours. 

“We have an ageing GP workforce, with many family doctors approaching retirement age but not enough medical students choosing to enter general practice to replace them,” said Dr Baker.  

“GPs across the UK are working harder than ever dealing with increasing patient demand with decreasing resources. It is important that we do all we can to attract and retain GPs and show general practice for the exciting, diverse and challenging career that it is.” 

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