Intended for healthcare professionals


Planning a consultant delivered NHS

BMJ 2010; 341 doi: (Published 16 November 2010) Cite this as: BMJ 2010;341:c6034
  1. Andrew F Goddard, director
  1. 1Medical Work Force Unit, Royal College of Physicians, London NW1 4LE, UK
  1. andrew.goddard{at}

Patient care is at risk unless workforce planning accounts for policy and financial limitations

A crisis in the global healthcare workforce is currently looming.1 In Europe, the problem is so great that the Belgian European Union presidency made “investing in Europe’s health workforce of tomorrow” the subject of their ministerial conference recently held in Brussels. That conference, following on from an EU green paper,2 showed that EU countries have very different perspectives on the needs of their workforces, but they all face similar problems—an ageing population; increasing public expectations; an increasing proportion of women (who are more likely to work part time) in the workforce; increasing worker mobility; and, most importantly, limited finances. The history of workforce planning in the NHS shows how difficult planning can be for an individual country and that seemingly well made plans can soon become inadequate with changes in policy and finances.3


The NHS has traditionally relied on junior doctors to deliver most acute services, and, until recently, many of these doctors had been trained abroad. Between 1992 and 2003, 42% of doctors entering the NHS workforce came from overseas, with most being international medical graduates.4 In the late 1990s, the number of places at medical school increased so that the UK could become self sufficient with respect to its workforce. To …

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