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Medical profession at ‘crunch point,’ warns GMC

The medical profession in the UK is at “crunch point” according to a new report by the General Medical Council (GMC), published today.

In the annual ‘State of medical education and practice’ report, which analyses medical workforce data across the UK, NHS bosses were warned that the profession will continue to suffer increasing pressure over the next 20 years if action is not taken.

The GMC has said that four ‘warning signs’ stand out in the report. One is that the supply of new doctors has not kept up with increased demand. The number of registered doctors in the UK has grown by 2% since 2012, whilst A&E attendances and GP appointments have risen sharply, with England seeing a 27% increase in A&E visits.

Dependence on doctors from outside of the UK has also increased, ranging from 18% in the south west to 43% in the east of England, yet the UK is still at risk of becoming a less attractive place for overseas doctors to work in.

There is continuing pressure on doctors involved in training and a greater desire for more flexibility in how they work and train.

Today’s report follows the launch of a consultation by Health Education England (HEE) on future workforce provision for the health service.

The GMC has said that although there is ongoing work to address the issues and pressures on doctors, such as increasing medical school places, the growth of health and care associate roles and drives to boost overseas recruitment, their impact will not be let for some time, and more needs to be done.

Charlie Massey, chief executive of the GMC, said that this is a “crunch point” in the development of the medical workforce in the UK.

“The decisions that we make over the next five years will determine whether it can meet these extra demands,” he warned.

Massey said that each country must consider how many doctors are needed and what expertise is required of them so that they can work as flexibly as possible, as well as where they should be located, taking into account 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,” he added.

The four priorities set out in the report include maintaining a healthy supply of good doctors, helping the UK medical profession to evolve to meet future healthcare needs, reducing the pressures felt by doctors where possible, and improving workplace cultures, making employment and training more flexible.

Massey explained: “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.”

He concluded: “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.”

Director of policy and strategy at NHS Providers (NHSP), Saffron Cordery, welcomed the report, which she said echoes the concerns raised in NHSP’s recent workforce report.

“Worries over staff shortages and skills are the number one concern for leaders of NHS trusts,” she explained.

Cordery also said that the GMC has a key role to play in ensuring that there is a medical workforce which is fit to meet the challenges of increasing demand and new approaches to caring for patients.

She continued: “We welcome the commitment to making medicine a more attractive and fulfilling career, which should help us all make the NHS a great place to work. And we strongly endorse the importance of the NHS being able to recruit successfully overseas.

“The draft workforce strategy, published last week by Health Education England, set out a long-term framework to address NHS workforce needs, for consultation in advance of a final strategy next July. These findings from the GMC are a helpful contribution to that process.”

Jane Dacre, president of the Royal College of Physicians (RCP) described the findings as “encouraging.”

She said: “The efforts and recommendations echo much of our own work and come at a time when there is a renewed drive from organisations such as Health Education England and the GMC to improve the working conditions of the NHS workforce.”

Dacre highlighted the RCP’s concerns, particularly geriatric medicine and acute internal medicine.

“The fact that our population is ageing rapidly, with individuals often having many complex diseases, there needs to be incentives to encourage many more of our physicians into these specialties, especially in parts of the UK where skilled medical professionals are particularly scarce,” she stated.

Whilst she agreed that the UK’s reliance on overseas doctors should be reduced in the long term, she stressed that in the short term it is important to fill the “significant gaps” in the workforce, and welcomed the GMC’s support for the expansion on the Medical Training Initiative.

And Danny Mortimer, NHS Employers’ chief executive, said that the report provides “more evidence of NHS services under increasing pressure.”

He added: “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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AJ Pope   20/12/2017 at 20:59

Trust need to work much harder to retain their senior consultants, especially in acute specialties. With the government attack on pensions, Trust's increasingly inflexible position on retire & return and flexible/part-time working for the over 60's then we are going to lose many senior doctors in the next few years with little likelihood of adequately replacing them.

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