The number of doctors in England has fallen even further behind comparable European Union nations, with an estimated shortfall of 50,000 doctors ahead of what is expected to be one of the worst winters on record for the health service in terms of demand and backlog of care.1
England has a much lower doctor to population ratio than comparable EU countries, with just 2.8 doctors per 1,000 people, in comparison to an EU average of 3.7.
BMA research at the start of the summer showed that meeting this average would require scaling up our medical workforce by an additional 31% - or an additional 49,162 full-time equivalent (FTE) doctors. Now, latest data shows the situation has further deteriorated, with falling primary and secondary care doctor numbers pushing the shortage up to 50,191 FTE doctors. This reflects a loss of 1,029 FTE doctors - 919 in primary care and 110 in secondary care - over two months.
Workforce is a theme running through the BMA’s Annual Representative Meeting (ARM), which begins today. The BMA has already been lobbying for amendments on workforce provision in the upcoming Health and Social Care Bill. The Bill proposes a requirement for the Health Secretary to publish a report detailing workforce planning every five years, but the BMA wants this to go further, arguing that any staffing assessments must be ‘ongoing, accurate and transparent’ so as to adequately meet health and care service staffing needs, now and in the future.
As well as this, the BMA is also calling for increased Treasury investment into the medical workforce to fund increases in medical school, foundation programme and specialty training places, alongside investment in the staff and infrastructure to deliver this. The Association also wants to see investment in retention initiatives, including removing punitive pension taxation rules so older doctors can remain in work flexibly.
The ongoing workforce crisis means staff are exhausting themselves working longer hours to keep up with patient demand. Some even feel as though they have no choice but to leave the NHS altogether to get the respite they need. This further depletes the workforce and puts even more pressure on those that remain.
In addition to the Association’s findings on workforce, a recent survey of BMA members in England found that significantly more doctors worked extra unpaid hours (45%) than paid (24%) in August, and nearly two thirds of respondents feel the NHS is heading in the wrong direction.
Dr Chaand Nagpaul, BMA council chair, said: “It’s frightening to see that the gap between the number of doctors in England and comparable EU nations is widening at such pace. Even more worryingly, having failed to reverse this damaging trend in the decade prior to the pandemic, the Government now has a much bigger, and incredibly urgent, task ahead of it.
“That so many colleagues told the BMA in our survey that they think the NHS is heading in the wrong direction is unsurprising: the current draft of the Health and Social Care Bill carries significant risks and fails to properly address the problems the NHS is currently facing
“For those still working in the NHS, who knows how long we’ve got them for. Rather than actively retaining staff, Government has stood by as doctors work themselves to the point of exhaustion, with many now considering leaving the NHS, further depleting us of expert, talented colleagues.
“Winter is an incredibly difficult time for the health service, and we just about made it through last year with the demands of Covid-19 on top of usual pressures. With flu season on the horizon and even fewer staff this time round, it’s a total unknown as to how well our services will cope – if they even cope at all. And this is before we even consider the enormous backlog of care generated by the pandemic.
“Alarm bells should have sounded when we struggled to staff the Nightingale hospitals, so Government really cannot afford to put this off any longer. Since then, we’ve seen hospital waiting lists in England grow to 5.61 million, high numbers of A&E patients waiting longer than four hours, and staff morale hit rock-bottom – all of which pose real and regular risks to patient care and safety.
“Despite recent funding announcements, the BMA estimates that core health spending is still £10bn short, rising to £154.9bn in 2023/24 rather than the £164.9bn we called for to ensure that the NHS can cope. This funding must not only go towards helping us tackle the backlog, for which the Government has announced additional money separately. It must also reduce ongoing pressures and – crucially – help us retain and recruit more staff.”
Notes to editors
The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- In the absence of an official baseline against which to quantify the medical workforce shortage, our analysis takes the average doctor to population ratio (doctors per 1,000 people) in those OECD EU countries for which data is available as its baseline. These data were taken directly from the OECD. We calculated the ratio for England (as OECD only supply this figure for the United Kingdom, not its constituent countries) using NHS Digital General Practice and Secondary Care workforce statistics and the latest available ONS population estimates (2018).