Future gaps in workforce pose an impending crisis for the NHS, report warns

BMJ 2013; 347 doi: (Published 25 July 2013) Cite this as: BMJ 2013;347:f4696
  1. Gareth Iacobucci
  1. 1BMJ

The NHS is facing a workforce crisis unless urgent action is taken to tackle impending staff shortages and shift the deployment of training resources, health policy experts have warned.

A report by health think tank the King’s Fund1said that the current NHS workforce was ill equipped to meet the future challenges of an ageing population with more complex needs, and warned of a mismatch between the supply and skills of different parts of the workforce and the needs of those using the service.

The paper argued that the impending shortages of general practitioners and nurses will run contrary to the need for more community based care. And while there is a forecasted oversupply of hospital doctors, the report said that shortages of specialists in emergency medicine, geriatrics, and psychiatry would create “significant issues”—as these were the areas of greatest and fastest growing need.

It warned, “Workforce redesign is needed not only because of a potentially dwindling workforce, but because the nature of healthcare is changing and the skills of the current workforce are not well matched to future needs.”

The report also urged the government to shift the way the £5bn (€5.8bn; $7.7bn) NHS training budget is deployed, and give “much greater priority” to developing the current workforce, in order to meet the increasingly complex needs of patients. It noted that just 5% of the current training budget is spent on the continuing professional development of the existing workforce, while the rest is allocated to securing professional qualifications for new recruits.

It added that the government should consider reversing the current policy of spending 60% of the NHS workforce training budget on the most highly paid professionals, and instead commit more resources to training lower qualified workers such as healthcare assistants.

While previous investments have been “heavily weighted to individual professional groups” such as medical and nursing staff, the report agued that developing multidisciplinary teams will become more important in the future— for example, in primary care with extended teams of general practitioners working alongside nurse practitioners and healthcare assistants.

The report also called for current pay and reward strategies to be reviewed to examine how to make certain career options more attractive. It said, “Rigid pay scales for the different ‘types’ of worker are powerful barriers to change...they restrict capacity to address recruitment in specific geographies or service area.”

It added that uniform pay scales “fail to align staff incentives to the type of work required,” and said that consideration should be given to introducing “mixed models of pay”— including the payment of team incentives.

The report concluded, “The potential shortages in the formal and informal workforce faced by the health and social care system are breathtaking and will pose challenges to the implementation of new models of care. At the same time more than three million people in the existing health and social care workforce need to be equipped with new skills. The scale and urgency of the task is immense. It demands action at national and local level.”

Chaand Nagpaul, chairman of the BMA’s General Practitioners Committee, said, “This is a time when new government agencies are taking responsibility for the organisation of NHS staff planning. These bodies must act swiftly to work with healthcare professionals and patients to find a solution to the workforce crisis. This must include looking at how we align staffing levels to match the changing demands of patients and addressing issues that might be deterring medical graduates from choosing certain career paths.”


Cite this as: BMJ 2013;347f4696


View Abstract

Sign in

Log in through your institution