Barriers preventing thousands of doctors from being deployed to meet areas of high patient demand must be removed if NHS challenges are to be addressed, the General Medical Council (GMC) has warned.
The regulator is calling for a relaxation of rules so the fastest-growing part of the medical workforce – skilled doctors in non-training roles – can undertake a wider range of work, such as in primary care.
According to the GMC’s The state of medical education and practice in the UK: workforce report 2022, the number of doctors in those roles is growing at six times the rate of GPs. By 2030 they could be the largest group in the medical workforce.
But existing rules, such as the Performers List* – which details practitioners approved to work in primary care – restrict the roles those doctors, known as specialty and associate specialist (SAS) and locally employed (LE) doctors, can fulfil.
GMC Chief Executive Charlie Massey said many wanted better and more flexible career opportunities: "Lots of these doctors tell us they want better career development and progression, and to have more flexibility in the positions open to them. But there are barriers that hinder their development, and rules that prevent them fulfilling some important roles.
"They are a fantastic resource of experienced and skilled doctors. If, for example, they could use those skills to complement the existing GP workforce it would begin to address some of the difficulties patients have accessing primary care, without lowering standards."
Between 2017 and 2021 the number of licensed doctors in SAS and LE roles rose by around 40%, from 45,578 to 63,740. In the same period the number of GPs rose by just 7%, from 60,690 to 65,160.
"These are skilled doctors who do hands on work but are not in training to become a consultant or a GP. Many have made a positive choice to work in non-training and non-specialist roles in secondary care, where they do hugely valuable work," said Massey.
"But we know there are significant numbers who want wider opportunities. Systems must adapt to make the most of their talents. We need fresh thinking about how these doctors are deployed, and how they can be best used to benefit patients."
The GMC’s report shows that SAS and LE doctors, many of whom come to the UK after qualifying in medicine abroad, are more likely to leave after relatively short spells working in the NHS. Providing wider career opportunities may also help retention.
"The UK’s health services are yet to properly understand how to make the most of these talented and able doctors. At a time when patients face unprecedented waits for care, now is the time to discard dated ideas and to tap into the skills and experience these doctors provide," Massey concluded.
The GMC’s The state of medical education and practice in the UK: workforce report 2022 is available online.
* Each of the UK’s four countries has its own Performers List regulations.