Dipesh Gopal Profile picture
Jul 21, 2021 18 tweets 9 min read Read on X
🧵 THREAD on @TheBMA report on medical staffing in England which did not get much airtime last week:

bma.org.uk/advice-and-sup…

Whilst the numbers are increasing, we just don't have enough doctors, esp GPs. #NHS #medtwitter

Here's the evidence:

@sbattrawden
@ShaunLintern
2/

We have some the lowest number of doctors per population in Europe. Image
3/

Whilst the number of hospital doctors is rising, the numbers of GPs has not despite record numbers of new trainees.

With more and more work being diverted to primary care without resourcing and funding, can we be surprised? Image
4/

🗣️ "Due to these workforce shortages, on average, each FTE doctor in the NHS currently does 1.3 FTE roles.

That is an additional 11-12 hrs extra per week per FTE doctor.

This is 1-2 hrs above working time regulations cap for average weekly hours." (I think it's more) Image
5/

We are falling short of doctors - but this is a local, national and global problem. But compared to the world we are falling short and will continue to do so at this rate.

@lizzie_toberty @wanderingwelch ImageImage
6/

– Compared to September 2015, there are:

⬇️ 22% GP partners

⬆️ 24% salaried and sessional (locum) GPs

⬆️ 42% GP trainees

⬆️ 22% increase patients / practice

⬇️ fully qualified GPs per 1000 patients in England from 0.52 (in 2015) to 0.46

@DrSimonHodes @DrNeenaJha Image
7/

💡 We have 1,307 (4.4%) fewer fully qualified FTE GPs than we did in September 2015 - the reason you can't see your GP is not laziness. 💡

There is a trend to more flexible working as workloads escalate.

The real question is whether GP trainees will stay working as NHS GPs. Image
8/

On the flipside in secondary care, numbers of hospital doctors is increasing

"Since 2010, there has been an average annual increase of 2.34% in the secondary care medical workforce."

BUT ... Image
9/

... Since 2010, activity in NHS hospital and community services has increased by 26% Image
10/

Similarly for doctors who:

🧪 make research breakthroughs (academic)

🛡️ keep the population safe (public health)

🧷 treat other doctors (occupational health)

⚠️ We don't have enough ⚠️ ImageImageImage
11/

➡️ "3.5 million more people live in the Midlands than the North West, but they have 4,000 fewer hospital doctors to treat them.

➡️ Not a single area in the country meets the OECD average of 3.7 doctors per 1,000 people." Image
12/

➡️ "The medical workforce is ageing.

➡️ 13% of secondary care doctors and 18% of GPs will be reaching minimum retirement age in the next one to 10 years.

This could equate to a combined loss of 25,494
doctors through natural attrition alone." Image
13/

➡️ 1/3 secondary care doctors in England alone are international medical graduates

➡️ nearly 1/4 GPs gained their Primary Medical
Qualification outside the UK. Image
14/

➡️ "The UK has one of the highest levels of overseas doctors in the OECD

➡️ International recruitment has been, and will remain, an essential pipeline for medical staffing in the NHS." Image
15/

Economic / political decisions as well as higher rates of disciplinary action and being less likely to secure consultant posts all act as deterrents to attracting international graduates to work in the UK.

@RCGPJIC @BAPIOUK
16/

Not forgetting that some doctors are opting to do private work probably as working conditions/pay is much better. Image
17/

Overall we need politicians to listen to this because after this pandemic we will more doctors.

We have not even talked about the rest of the NHS yet.
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1/

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Is this a limitation or manipulation of the data?

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