It’s the workforce, stupidBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1510 (Published 17 March 2016) Cite this as: BMJ 2016;352:i1510
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In my varied past in Public Health Medicine, I developed and ran a workforce model for the UK.  The model used current and historic data (individually linked) to enable the correct output number of qualified Consultants, for national needs. The input was the number of trainees recruited annually. The modelling took account of: individual behaviour, diversity and life course. Life, training and work satisfaction all changed people’s behaviour.
To ensure the future Consultant workforce, unfolding life paths, professional development and job satisfaction together determine retention. Unlike current planning, we must achieve realistic recognition that work patterns inevitably change over a career. A happy doctor serves longer. Caring professionals need to be cared for.
 The Report of the Committee of Inquiry into the Future Development of the Public Health Function. HMSO, 1988.
Competing interests: No competing interests
Clearly, NHS workforce planning has not been fit-for-purpose for some time.1 I read with interest today’s Feature that highlighted “human factors” in understanding the needs of the medical workforce.2 Across many occupations, ethnicity, gender and marital status segment the workforce and fracture its development. This Feature happened to come out on St. Patrick’s Day, as I was reading the memoirs of an inspiring Irish doctor, Dame Beulah Bewley.3 Dr. Bewley moved from Dublin to junior medical jobs in England as: an Immigrant, a Woman and soon, a Wife & Mother. The BMJ roundtable featured considered: because doctors have long working lives “we should do more to encourage portfolio careers”.2 If people want an exemplar of a long and varied life, committed to serving the public, do read Beulah Bewley’s book (edited by her medical daughter, Susan Bewley). Three statements stand out for me, giving hope that humanity might mend a fractured profession:
“Each of us has a personal history of the NHS.”
“I do, and don’t, regret the way my career took twist and turns.”
“Women are better than men when it comes to negotiating, and maybe we can help our colleagues when it comes to improve the situation.”3
Perhaps medical leadership that could resuscitate the workforce needs the right mix of Experience, and Hope?
1. Hockly A, Caan W. Is Workforce Planning in Primary Care alienating General Practitioners? Journal of Public Mental Health 2012; 11 (2): 50-53.
2. Iacobucci, G. (2016) “It’s the workforce, stupid”, BMJ 2016;352:i1510 (accessed online 17 March 2016)
3. Bewley B, Bewley S. My life as a woman and doctor. Bristol:Silverwood, 2016.
Competing interests: I have been fortunate to know the Bewley family over many years.