BMA members vote to help fix ‘failed’ NHS workforce plan

BMA members have called on their union to join forces with royal colleges and faculties to develop workforce plans, amid growing concerns over the NHS’s ‘failed’ planning up to now. 

The association has been urged to lobby government to develop plans that commit to the expansion of consultant and SAS posts to meet patient demand, as well as increasing funding to general practice for both principal and salaried GPs.

Alongside calls to fund more senior doctors, the motion calls for the BMA to lobby to ‘significantly increase’ the number of training posts for resident doctors, and ensure that doctor shortages are filled with doctors, not other healthcare workers. 

Members at the association’s annual representative meeting in Liverpool heard that a lack of workforce planning from NHS England has led to rising workloads and shrinking numbers of training posts.

This, coupled with increasing complexity of patients and recruitment freezes has left the system creaking under significant pressure at the detriment to patients. 

Emergency medicine consultant Kiara Vincent, who tabled the motion, said: ‘The NHS has a workforce crisis. We’ve had years of disjointed workforce planning with a failure to invest in medically trained staff and training for the next generation. We’ve fewer doctors per patient than other comparable countries and with the ever-increasing complexity of patients this has caused significant pressure across the health service.

‘Recruitment freezes in recent years have also exacerbated the situation. In general practice, there are over 1,000 fewer fully-qualified GPs in April this year compared to September 2015. Worse still, up to 1,000 newly-qualified GPs this summer could be left without jobs when they finish.

Dr Vincent  noted how more than 20,000 secondary care doctors left NHS organisations in March 2024, and that the Nuffield Trust estimates that there are 1,400 unfilled doctor vacancies on any given day. 

‘Secondary care trainees completing their training this year are finding limited consultant jobs available to them despite there being gaps in rotas and increased spending on locum work,’ she said. 

‘Shrinking numbers of training posts for resident doctors is another area of concern with competition ratios soaring with around five applicants for posts in core surgical training and almost 12 per post for clinical radiology. Even the traditionally undersubscribed specialties have stiff competition for places now. 

‘We can’t expect our healthcare system to thrive if we don’t invest in its most valuable asset – it’s people.

‘We’ve seen concerning trends with the introduction of non-doctor roles, which are replacing doctors filing doctor rota gaps and leading to an alarming trend of patients not having access to a doctor and not knowing who is treating them. This has led to poor standards of care and catastrophic errors. It’s essential that patients have access to high-quality, doctor-led care. The current workforce plan has failed.

Dr Vincent said: ‘General practice, the backbone of our healthcare system, needs increased funding so we can attract and retain talented GPs ensuring patients can access a GP when they need to. 

‘It’s crucial that doctor shortages are addressed by recruiting qualified doctors, not other healthcare professionals. They may play a vital role but they cannot replace the expertise and training of doctors. We need to commit to ensuring that non-doctor healthcare professionals filling doctor roles are being replaced by doctors. 

‘Resident doctors training posts were essential for developing the next generation of healthcare professionals to ensure they’re well-prepared to meet the demands of the current healthcare system.’

The motion carried comfortably, while the association’s representative body voted down a separate motion that called for the BMA to produce its own ‘realistic workforce plan’ using its own data and expertise. 

GP Alex Freeman, who proposed the motion, called out NHS England’s ‘abject failure’ in producing a feasible workforce plan and argued that the association has its own data and expertise to draw up its own document. 

But treasurer Trevor Pickersgill said that the BMA was not the body to produce such a document as it could not directly influence NHS workforce planning. He argued that the association’s resources and expertise would be better spent lobbying and could still help frame workforce policy from its current position as an interested party.