MEDICAL WORKFORCE ISSUES IN THE UK

Professor Terence Stephenson

Chairman, Academy of Medical Royal Colleges

Nuffield Professor, Institute of Child Health, University College London

The Academy of Medical Royal Colleges

• Represents almost all the 220,000 licensed doctors in the UK• Acts for patients by setting professional standards of care and determining postgraduate training of tomorrow’s doctors

• NOT a trade union (British Medical Association) • NOT a regulatory or licencing organisation (General Medical Council)• NOT a medical protection organisation (MDU, MPS)• INDEPENDENT of government and industry – a charitable organisation

funded by members’ subscriptions

UK Medical Workforce

Consultants 35,950Trainees 51,502Staff and Associate Specialists 10,178Other 2,998GPs 40,269Total doctors 140,897

Qualified nursing staff 417,164

Total staff 1,431,996

The CENTRE FOR WORKFORCE INTELLIGENCE

It was never going to be easy

The number of people over 65 years will increase by 65 per cent in the next 25 years to more than 16.4 million in 2033

The number of over 85s in the UK is set to double in the next 20 years and nearly treble in the next 30.

People aged over 60 make up nearly a quarter of Britain’s population

Half of those currently aged over 60 have a chronic illness

Nearly two-thirds of patients admitted to hospital are over 65 years old

On average, each patient has 3 different conditions

Paediatrics – 2004 survey

• Trainees: 70% women; 20% P/T

• 1997: 90,000 NHS Drs• 2008: 133,000 NHS Drs

• 50% train < F/T; 21% work P/T most of career; 80% want to take a career break

• Need to increase from 1733 wte to 2331 Acute Paeds Cons; 637 to 915 Comm Paeds; 731 to 1123 Specialist Cons

1. ED Attendances increased by 1 million in last 3 years and 250,000 in last 12 months

2. Average number of consultants = 7. Need minimum of 10 to provide sustainable cover 16hrs per day 7 days per week

3. 196 ED departments therefore almost 600 consultants short

4. Trainee recruitment into ST4 posts has been @ 50% for last 3 years.

5. Last year over 50 consultants emigrated (5% of the workforce) in previous years it was about 1%

Paediatrics – 2004 survey

• Trainees: 70% women; 20% P/T

• 1997: 90,000 NHS Drs• 2008: 133,000 NHS Drs

• 50% train < F/T; 21% work P/T most of career; 80% want to take a career break

• Need to increase from 1733 wte to 2331 Acute Paeds Cons; 637 to 915 Comm Paeds; 731 to 1123 Specialist Cons

% of children with diabetes admitted with ketoacdosis over last 5 yrs – 7 fold variation

Service change

7 day service – 3 meanings

Paediatrics

• 1997: 90,000 NHS Drs• 2008: 133,000 NHS Drs

To meet RCPCH standards of care:• Need to increase from 1733 wte to

2331 Acute Paediatric Consultants; • 637 to 915 Community Paediatric

Consultants; • 731 to 1123 Specialist Paediatric

Consultants

1. There is no voluntary medical unemployment in England

2. There are specialties with vacancies for trainees and consultants

3. Taking 1 and 2 together, there is currently no surfeit of doctors

4. The NHS aspires to be the best in the world but has fewer doctors per 1000 population than most OECD countries

5. The demand for doctors will increase with an ageing population and a 7 day consultant present service

6. Producing more CCT holders than retiring consultants is NOT = Producing too many doctors

Thank you

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