How our results inform workforce planning
Since the establishment of the NHS in 1948, medical workforce planning and forecasting have made fundamental contributions to the organisation of medical education, postgraduate training and medical staffing in the UK. The provision to the Medical Workforce Standing Advisory Committee (MWSAC) and others of reliable information about the careers pursued and the career choices made by UK graduates is important to facilitate this planning and forecasting function. Our studies provide a comparative basis on which to establish indicators of change. The updating of the information by the re-surveying of existing cohorts and the periodic introduction of additional cohorts is a necessary activity if trends in career choices and employment among young doctors are to be identified and policy is to be adapted.
The data collected in the studies fall into three broad types: employment-related; choices and intentions; and reasons, views and attitudes. Each of these types of data makes a specific contribution to planning, forecasting and policy review.
Some of the simple employment data, those on jobs held, from our studies might be thought to add little more than added precision to what is known from the central NHS workforce records. However, we have demonstrated that there are particular areas of employment within the NHS which do not appear in the Department of Health records - for example, much locum work is excluded, but is notified to us by our respondents. Movement within the NHS in the UK, for example between Scotland and England and vice versa, is reported to us. Respondents also give details of UK medical employment which is outside the NHS, in the UK public sector or in the UK non-public sector. We also know about medical work undertaken abroad, including that in Her Majesty's Armed Forces, and non-medical work and periods of unemployment. The studies enable a much more complete picture of career destinations to be assembled than is possible from Department of Health sources; and also provide information about doctors outside the NHS for which no other national datasets exist. Combination of Department of Health data with our own data allows more accurate estimates of loss from the NHS to be calculated than is possible from either data source alone.
Information about choices and intentions is needed on a continuing basis because it provides input to the forecasting process. The degree of conformity between early career choice and later employment can be established in older cohorts, enabling the eventual outcome of a particular level of early choices in a younger cohort to be estimated. Knowledge of changes to the dynamics of career choices is important when planning postgraduate training quotas.
Information about the views and attitudes of doctors, and their reasons and motivations for career decisions, provide a greater understanding of observed changes in the workforce, which can inform human resources policy in the NHS. The MCRG studies have succeeded over many years in securing and maintaining the confidence of our respondents. This has been reflected in the large number of doctors who have felt able to express themselves freely to us and to write of their concerns about their own careers and training and wider issues affecting the NHS.