Figures obtained by the BBC and published at the end of February 2016 revealed that more than two-thirds of trusts and health boards in the UK are actively trying to recruit from overseas. There are currently almost 6000 vacant medical posts in the UK and many millions of pounds are being spent each month on locum cover to fill these gaps in service delivery. The difficulties with overstretched provision in the NHS sadly make our own UK graduates look to opportunities elsewhere, and 2015 saw the highest ever number of UK graduates apply to the GMC for the paperwork that allows them to apply for jobs in other countries.
Whilst the staffing problem is UK wide, significant regional differences exist with rural areas and areas which are perhaps perceived as less glamorous being the hardest hit. Cumbria is one such area with some services and hospitals on the very limits of viability. According to the NHS Success Regime – North, West and East Cumbria Progress Report (February 2016) the region has ‘a workforce recruitment and retention problem that presents a major barrier to improved quality, performance and sustainability’ and this is a long standing problem. The fact remains that it is much more difficult to attract staff to some parts of the country whether they have been trained in the UK or elsewhere. Many initiatives have been trialled to improve recruitment in these areas including financial incentives, but none have yet met with sustained success.
There is however evidence from more than one country to suggest that doctors tend to look for work in areas where they have been trained. According to a report from the Higher Education Careers Services Unit (HECSU), for the UK as whole, 71% of employed graduates remain close to their home regions for work. The same study also found that outside London, the North West retains more domiciled graduates and more students who studied locally than any other English region. The University of Central Lancashire (UCLan) has already demonstrated that this holds true for dentistry. In recent years UCLan created a dental course unlike any other in the country with dental students living and studying in regional centres rather than remaining in a central city base. Around 63% of students trained in this way have chosen to continue to practice in the region following graduation suggesting that this model of education is helpful in assisting regional recruitment of skilled NHS professionals.
The medical School at UCLan has recently developed an MBBS with the first cohort of students joining the school in 2015. The course makes use of UCLan campus sites in Preston,East Lancs and West Cumbria and has worked closely with the NHS Trusts and GPs in these areas to develop partnerships to further develop medical education and research in their locality. The NHS Trusts, all of whom have challenges with medical recruitment, believe that the close working relationship with the medical school will help in the recruitment and retention medical staff moving forward. All hope that graduates from the school will see the benefits of working in the area and will seek employment with the Trusts on graduation. However, due to restrictions on numbers of UK funded medical student places the school is currently only able to accept self funding international students and is unable to take either UK or EU students and it is likely that many of the graduates will return to their home countries on graduation.
We work very closely with our partner NHS Trusts to look at ways to assist with their recruitment challenges and have already developed a number of initiatives to recruit high calibre staff to the areas such as joint NHS / university posts and opportunities for career development in research and education. In West Cumbria we have worked with all NHS stakeholders to develop the West Cumbria Medical Education Centre (WCMEC) with the aim of becoming a centre of excellence in remote and rural medical education and research. All our partnership Trusts are of the belief that the inclusion of UK students on our course would greatly assist in the sustainability of their medical workforce in years to come and actively supporting all our efforts in helping to bring this about.
However, whilst we are only able to educate self funded non-EU students the problems with staff recruitment and retention in these severely challenged areas are likely to remain. After graduation UCLan international medical graduates are unlikely to remain in the area for the long-term, meaning the positive impact they have on the region is likely to be temporary.
We hope the decision-makers will agree that where students are trained influences where they seek future employment and will feel able to allow UCLan to train a number of UK students in these “Cinderella” areas to help ensure that these severely challenged Trusts have some equity in the staffing supply of high calibre medical graduates to their region.
Cathy Jackson, head of medical school, University of Central Lancashire
Higher Education Careers Services Unit (HECSU) in Graduate Market Trends