Planning the medical workforce

The problems of planning the medical workforce are chronic and recurring. The national overview of supply and demand for doctors in both primary and secondary care has consistently been found to be inaccurate. This has led to many problems, such as wild swings in the planning of opportunities for specialist registrars. Some specialties have seen substantial increases in training placements demanded one year followed by equally large decreases the next year. Against this background, one has to consider whether the ideal of effective workforce planning is a realistic proposition. There is a clear need for national coordination in data collection, yet there seems to be a reluctance to provide it. Planned consultant expansion, as recent experience in obstetrics and gynaecology has shown, cannot be achieved in the absence of policy and funding to support it. Planning merely on the basis of a “wish list” is ineffective. Planning the make up of tomorrow's medical workforce is a complex business. The challenge is to decide the optimum mix of skills that should be in place and then monitor continuously to ensure that this mix remains sustainable in a constantly changing healthcare environment. This can be achieved only through effective management of information, with a computer database being used to provide the necessary “snapshot” overviews for planning purposes. Yet the criteria for a suitable system are exacting because of the complexity of the many different variables involved. These variables encompass both the numbers of doctors in training (the supply) and the numbers of qualified doctors in service (the demand). It is important to remember that trainees provide a great deal of the service no matter how often they move around for educational purposes. Other key factors for consideration include the number of known and projected consultant vacancies and how many posts are filled …