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Doctor numbers rise while 'serious shortage' in nursing looms

Latest workforce figures seen by Nursing Times reveal a plunge in nurse numbers while doctors continue to increase, sparking claims that the NHS is becoming “over doctored” at the expense of nursing.

The figures have fuelled concerns about a serious nursing workforce shortage at a time when posts are also being cut, and renewed calls for the government to clarify its education and training plans.

The most recent internal NHS workforce analysis, distributed to a Department of Health advisory group and seen by Nursing Times, shows a net fall of 3,647 nurses between May 2010 and July this year. In the same period the number of doctors increased by 2,303.

The document is called the Core Brief and was prepared for the DH by the NHS Information Centre. It states that the increase in the medical workforce is “mainly due to doctors starting to take up foundation level 1 posts after coming out of medical school”.

The report suggests a growing trend developing since separate figures, published by the Information Centre in March, showed that last year nursing numbers fell for the first time in more than a decade. This initial decrease was small – a drop of just 650 compared to 2009.

However, the chief executive of one hospital trust told Nursing Times the decline was the beginning of a “serious workforce shortage”, which would lead to “problems ranging from moderate to severe” for the NHS.

Royal College of Nursing policy director Howard Catton told Nursing Times the difference was in part due to reductions in the number of nurse training posts, which began several years ago. However, he said trusts could also be spending less money on nurses because they were under pressure to employ too many trainee doctors.

He said: “Shouldn’t the increase be in nursing, given what we know about the aging population and increasing numbers of patients with long term conditions?

“Are we over-training doctors and now having to make cutbacks elsewhere? The question is whether we are over-doctoring the system,” he said.

Southampton University chair of health services research Peter Griffiths said decisions to commission fewer nurse trainees in recent years were likely to be proved wrong. He said they were based on “untested assumptions” about replacing nurses with healthcare assistants and demand for hospitals dropping.

He said the trends could reflect doctors’ stronger voice in workforce planning. “There is a sense there is a stronger power base arguing the case for protecting medical numbers and defining the need for doctors,” he said.

Professor Griffiths said there was also less pressure on trusts to employ all newly qualified nurses than doctors. He said: “There is an assumption nurses will flex to accommodate. With the medical workforce there is not quite the same view.”

Mr Catton added that the figures demonstrated why the government needed to quickly clarify its plans for changes to education and training planning and funding.

Under the plans, a new body Health Education England will be created to oversee a system of provider-led networks. Mr Catton said the organisation had the “chance to get to grips” with workforce numbers because it would bring together national planning for all professions.

But he said it was unclear whether it would have sufficient representation from non-medical professions. For example, he noted that the current doctors’ training body, Medical Education England, would form the basis for Health Education England.

Council of Deans of Health policy director Matthew Hamilton also said the contrasting trends in the nursing and medical workforce demonstrated the need to plan for all professions together, and for Health Education England to be strong.

He said for nursing there was currently “little of the national oversight that you get in relation to medical education and training and figures”. Currently Medical Education England works at a national level while nurse planning is done regionally.

Mr Hamilton said: “HEE will be effective if it has this oversight. It will be important for it to have some teeth otherwise who will be thinking about why, for example, the number of doctors are going up and nurses are going down?”

Readers' comments (8)

  • Not surprising. The Trust I work for is appointing new Consultants at an amazing rate - then cutting nursing and support posts as it needs to save cash. Nuff said...

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  • There has been a need for a rise in Doctors because of the European Working Time Directive which means that Doctors work shifts. It has not had anything to do with nursing posts going. In fact lots of posts are being created for nurses and demoted posts, which are doing away with Doctors. e.g Advanced practioners, Physicians assistants. This is another example of something being misreported in the media and nurses not understanding the real situation. Frankly, nursing is losing out because we have not looked at these issues soon enough and not being able to demonstrate our worth. Nursing is an easy target as we are the biggest workforce in the NHS, do not act professionally and our nurse leaders are weak. If we want to be treated as professionals we need to act and nurse professionally. We have been very lucky as it is one of the very few higher education courses that are supported financially and what do we do? Provide a very unsuitable training that is not fit for purpose. Please do what education is meant to teach us and read the whole story and critically assess all the information. I am increasingly worried about a lot of the reporting in the Nursing Times. It is not a taboid newspaper.

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  • The trust were I work is now cutting staff on a late shift to 1 trained and 1 untrained.We used to have 2 trained and 1 untrained.This is so dangerous as there are 16 patients in rooms of there own and we have patients back from theatre after major ops Its frightening!

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  • welcome to your new tory nhs!!

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  • the problem is not restricted to hospitals. In general practice there is now a growing shortage of nurses with the appropriate training and skills to take over from the existing workforce who are generally aged over 45yrs. There has been no investment in training for many years unlike the programme to increase GP numbers. Where will the next generation come from??

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  • In my Trust in the last ten years in my depatment the number of consultants has increased from 2 to 5,(at high salaries), staff grades or registrars from 3 to 10(with decreased qualifications). Meanwhile the number of nursing staff and skill mix has decreased by 25%. But let us add the number of managers has also increased dramatically. Wonder what it it will be next- no nurses just doctors and support workers?

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  • I have got no problem with more Doctors being hired at all, as others have said a lot of it is down to European Working Time Directives and so on. More Doctors can only be a good thing.

    HOWEVER, the cutting of Nurse posts and the dangerous and what should be illegal staffing levels for Nurses is a very serious issue indeed. It has nothing to do with more Doctors being hired on the whole, but it does need to be sorted urgently. We cannot carry on with the staffing numbers we have, and it is a ridiculous situation when there are so many Nurses struggling to find work! What the hell is going on???

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  • I agree Mike, having worked closely with some excellent consultants whose workload was phenomenal. More doctors hopefully will mean more time with those patients who need it, the newly diagnosed patient for example. And if push comes to shove and there are no nurses around, the doctors will have time to resume those tasks such as taking bloods, inserting catheters etc!

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