Planning the medical workforce
BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7209.2 (Published 28 August 1999) Cite this as: BMJ 1999;319:S2-7209
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This is a very important and interesting article.
With all the complexities in secondary care, this seems an "easy" task
compared to primary care!
As PCG/Ts and HA struggle with planning for primary care, is there any
hope of a similar National solution, or similar software?
Competing interests: No competing interests
I ought to declare that I have no financial interest nor receive any
remuneration from any organisation mentioned in my article.
I do, however, have an interest in promoting the use of the
'Intrepid' software as the best solution currently available to store the
data that Deans are required to record. It has been suggested from time
to time that a national solution may be imposed on Deans as their database
software at some time in the future. I believe that this would be wrong
and it would have a seriously detrimental effect on the day to day running
of the South Thames Deanery.
Competing interests: No competing interests
Medical workforce planning cannot overlook primary care
Medical workforce problems could arguably be said to constitute one
of the major threats to the continuing effectiveness of the NHS. The
article 'Planning the medical workforce'1 in Career Focus was therefore
well timed and made a good case for supporting workforce planning with
centralised databases. However, it is disappointing that primary care was
mentioned only once within the context of a national overview of supply
and demand for doctors.
Ryde's assertion that databases developed between deaneries and
trusts - relying solely on trusts entering data on doctors that they
employ - can facilitate planning of the "entire medical workforce" is over
-simplistic. This would not encompass doctors working in primary care, and
even though most GP principals have relatively stable employment there is
a large population of non-principals who are highly mobile both in terms
of geography and career status. Moreover, the incorporation and tracking
of hospital locum doctors - who also follow less uniform career paths -
may prove problematic.
It has been well established that there are large numbers of doctors
working as non-principals in general practice (mainly as locums, deputies,
assistants and retainers)2. The National Association of Non-Principals
estimate that there are approximately 7,500 non-principals working as GPs
in the UK3 and a recent report from the Audit Commission stated that 3,500
doctors work as hospital locums in the UK every day4.
Currently the only constant doctor identifier in use is the GMC
number, which is issued to doctors on registration and retained throughout
their professional life in the UK. We believe that any database used to
track doctors and their careers for medical workforce purposes should
therefore incorporate the GMC number.
In conclusion, it must be recognised that primary and secondary care
are interdependent. It is not possible to rob Peter to pay Paul in terms
of the medical workforce without causing grave problems to the
infrastructure of the NHS. Any database or software system must therefore
be able to monitor effectively the medical workforce in both primary and
secondary care, including non-mainstream doctors such as GP non-principals
and hospital locums.
1. Ryde, K. Planning the medical workforce, BMJ 1999; 319
2. National Health Service Executive. Medical Careers in Trent Region:
Support and Salvage, NHSE Trent, 1999
3. National Association of Non-principals. Non-principals: An NHS
Resource, NANP, 1999
4. Audit Commission. Trusts should ensure closer scrutiny and support for
locum doctors, London: Audit Commission Publications, 1999
Competing interests: No competing interests