News / BMA report shows high cost of doctors leaving NHS

23 April 2024 Richard Gardham

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Losing doctors early from the NHS is costing taxpayers in England up to £2.4bn a year at the current rate, according to a British Medical Association (BMA) report. This could rise to £5bn a year if action isn’t taken to retain doctors’ services within the NHS, the report added.

The union estimates that between 15,000 and 23,000 doctors left the NHS between September 2022 and September 2023. Replacing them and their expertise will cost between £1.6bn and £2.4bn according to the BMA, which went on to warn that the number of doctors indicating that they intend to leave the NHS is rising.

The BMA report, When a doctor leaves: tackling the cost of attrition in the UK’s health services, set out a four-pronged approach to retaining doctors within the NHS.

First, it said that pay and debt must be tackled, with years of real-terms pay erosion reversed. This, the BMA said, will show doctors they are valued and prevent them from leaving for better paid jobs. Additionally, writing off student debt for those doctors working in the NHS would provide a strong incentive to stay. Second, better working conditions are needed, according to the report, with workload pressures and work-life balance being key areas in need of improvement. 

Diversity and inclusion was the third area under focus, with the report stressing that action needs to be taken to better tackle discrimination and support those with additional needs. Finally, development and support needs to improve. The BMA said the ‘relentlessly pressured environment’ within the NHS means doctors are given little time for learning and development, which can stunt their professional progress. 

These figures come in spite of the NHS long-term workforce plan claiming that since 2010, the number of doctors employed within the NHS has increased by 42,000, including an estimated 4,600 more general practice doctors. The plan has targeted an extra 60,000 to 74,000 doctors being employed within the NHS by 2036/37. It also announced plans to work with the government to modernise the NHS Pension Scheme, to ‘ensure doctors are not disincentivised from continuing their NHS work or taking on extra hours or responsibilities’, while also committing to better training and a reduced workload being provided for doctors. 

The BMA acknowledged that the overall number of doctors is growing, but that attrition was ‘severely affecting’ the rate of increase. ‘For every two doctors that joined the UK medical register in 2022, one doctor left, the report said. ‘It’s two steps forward and one step back,’ it added.

In spite of the BMA’s findings, the number of vacancies for doctors in the NHS has shown a general trend of shrinking over the past six years, though there has been some fluctuation. The NHS vacancy figure for doctors in England in June 2018 was 12,205 (representing 9.6% of the planned medical workforce). By December 2023, that number had come down to 8,758, or 5.7% of the medical workforce. The lowest number of vacancies in this time period came in March 2021, with 6,634, or 4.8% of the planned workforce level.  

Latifa Patel (pictured), BMA representative body chair and workforce lead, said: ‘It’s no secret that the NHS does not have enough doctors to meet our patients’ needs, and the ones that we do have are increasingly saying they do not want to stay.’

Latifa Patel, BMA

She went on to warn that the goodwill of doctors is ‘running dry’ where the NHS is concerned, adding: ‘In a year where strikes have already estimated to have cost £1.2bn, when you add the cost of losing more doctors, the government’s argument that it is unaffordable to properly value and support doctors falls completely flat.

‘It is not enough to focus exclusively on recruitment. It takes a long time to train a doctor and there is a risk that we’re training more doctors only for them to leave. There’s no point turning on the taps to fill a bath if there’s no plug in the drain.’

Saffron Cordery, deputy chief executive at NHS Providers, said: ‘For the long-term workforce plan for the NHS to succeed we need the government to tackle longstanding challenges throughout the health and care system, including more action to recruit and retain staff backed by appropriate training and support.

‘Patient care will suffer if we keep losing NHS staff due to burnout, stress and excessive workloads.’