Address ‘significant issues’ before reshaping NHS workforce, think tank warns
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Efforts to reshape the NHS workforce with emerging non-medical roles like physician associates have come before “significant issues have been addressed”, a think tank has warned. The Nuffield Trust urged the health service to heed lessons from history, and called for a “proactive approach” to addressing challenges in order to prevent “negative consequences” for patients, staff and productivity.
The new report, commissioned by NHS Employers, highlights the history of how different roles – including physician associates (PAs), nursing associates and advanced nurse practitioners – have been brought into the NHS. It also explores how the mix of staff skills in England’s health service compares to other countries and what issues should be tackled if Government plans to expand the NHS workforce are to succeed.
The report said the “scale of change in the NHS has at times been dramatic”. Its research found the number of nurses per doctor in hospital has fallen from 4.3 in the year 2000 to 2.8 in 2024. Meanwhile, in general practice, the ratio of fully qualified permanent family doctors to other clinicians has fallen from 1:1.1 in September 2015 to 1:2.6 now.
Dr Billy Palmer, senior policy fellow at Nuffield Trust, said: “Introducing new and different staff roles to work alongside doctors and nurses has been a well-worn path for the NHS for decades. “But in recent years, there has been a particularly dramatic shift in the size and shape of the NHS workforce, and future plans to expand staff numbers rest heavily on new and emerging roles.”.
