NHS 'hasn't got a clue' how many doctors it needs, say experts launching safe staffing plan

Royal College of Physicians proposals will help trusts understand how many staff they need to safely care for patients

The NHS “hasn’t got a clue” how many doctors and other health professionals it needs to safely staff its wards, medical leaders have said at the launch of a new system for manning hospitals.

Patients can expect the workforce to look very different in ten years’ time as shortages of doctors and nurses have forced new roles to be created, the Royal College of Physicians said.

It recommends running wards based on numbers of decision makers, with at least two doctors or other senior clinicians employed to cover a standard 30-person ward and six to eight on a 45 bed acute ward – where care needs are higher.

This is not the number of people on the ward at any one time but how many would be needed to cover it over a regular week, and absorb sicknesses and changes in demand that increase risk to patients.

It comes amid a staffing crisis in the NHS and grim official figures earlier this year that show 100,000 staff posts are currently vacant, with a third of these gaps in nursing.

The college will begin working with NHS trusts to implement the proposals and ensure safe staffing levels across the NHS. But it stopped short of saying how many doctors were needed now as it warned the NHS does not even fully know the size of its existing workforce.

“While the public might think we know how many doctors should be on the ward at any one time, we haven’t got a clue,” Dr Andrew Goddard, a consultant gastroenterologist and president-elect of the RCP, told The Independent.

“This is highlighting the complete lack of data and routine collection, and saying for the first time ever ‘this is how many doctors at different levels as well as other health professionals at other levels the NHS needs to provide safe care'.”

Dr Goddard said it would also help to address pressures on junior doctors which are causing many of them leave the NHS even before finishing their training, and allow for the influx of new roles like physician associates (PAs).

The NHS is training thousands of PAs: science graduates who have trained for two years and can diagnose and recommend treatments to patients under supervision but have been criticised as “doctors on the cheap”.

“We want to know there are professionals there with the skills to look after us, care for us and provide effective treatment,” Dr Goddard said.

“The reason we are training a thousand physician associates a year is because of the demand.

“We have a big shortage of doctors at the moment, there’s lots of evidence to support that. There is also a need for other types of health professional.”

The changes were welcomed by the Care Quality Commission and the hospitals watchdog NHS Improvement.

"Having the right medical staff with the right skills in the right place and at the right time is vital for providing patients with high quality, responsive care,” Dr Kathy Mclean, executive medical director at NHS Improvement, said.