Intended for healthcare professionals

Education And Debate The hospital of the future

Staffing of hospitals: future needs, future provision

BMJ 1999; 319 doi: (Published 30 October 1999) Cite this as: BMJ 1999;319:1193
  1. Robin Dowie, senior research fellow (,
  2. Michael Langman, professorb
  1. a Health Economics Research Group, Brunel University, Middlesex UB8 3PH
  2. b University of Birmingham, Department of Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH
  1. Correspondence to: R Dowie

    This is the fifth in a series of seven articles.

    The government's programme for modernising the United Kingdom's health services has given workforce planning and management a prominence not hitherto observed. The whole subject of workforce planning and the behaviour of labour markets in British health care has been neglected by researchers and is poorly understood. Therefore, although problems can be easily diagnosed, in many cases the solutions have not been identified. This is changing. In September 1998 the aim of securing a quality workforce in the NHS was declared.1 By April 2000 each employer should have in place training and development plans for most professional staff, as well as an annual workforce plan. Also, each employer should be able to show improvement in retention of all health professional staff. To strengthen research on human resources in the NHS, the Department of Health launched a £2.5m research initiative in December 1998.

    Summary points

    Increased numbers of doctors and nurses are required to meet increasing demands in service and management.

    Expanded numbers of medical students will not enhance numbers of trained doctors for 6-7 years.

    Only limited evidence suggests that quality of care is improved as numbers of cases treated increase.

    Larger district general hospitals may be more cost effective in serving the needs of the population, but evidence is lacking.

    There is considerable scope for making better use of nursing staff in specialist roles.

    Workforce factors

    Workforce planning has been in place for some time but not within an integrated framework. The Medical Workforce Standing Advisory Committee (the Campbell committee) investigates factors relevant to future needs for doctors in the NHS, and the Specialty Workforce Advisory Group advises on the numbers necessary in training grades to ensure adequate supplies of consultants and general practitioners in England and Wales. For non-medical professions, workforce planning …

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