The must-read stories and debate in health policy and leadership.

Domestic medics upended

Some interesting data was released as part of the General Medical Council’s first workforce focused report today, which revealed more non-UK medical graduates are joining the register than British-trained.

Its chief executive Charlie Massey told HSJ the regulator expects out of 19,000 medical graduates, 10,000 would be international, 2,000 from Europe and 7,500 from UK medical schools. And this trend is expected to continue.

However, despite the UK’s increasing reliance on international doctors, Mr Massey warned they are facing many more challenges in terms of “landing well” in the health service and said we are “inconsistent” in the way these doctors are supported.

He stressed the importance of improving the retention of this group of doctors – and indeed doctors more generally, as increasing numbers of doctors over the age of 55 are retiring from the health service.

The GMC wouldn’t be drawn into the pensions crisis debate but Mr Massey said he believed pressures in the NHS to be a significant factor in what is prompting these early retirements.

The report also indicated this pressure is pushing NHS staff towards the private sector, as data found most docs made this move to offer better patient care, rather than financial reward (or did they just prefer the more selfless reason?).

Our outgoing quality and safety correspondent, Shaun Lintern, has done a major analysis of the patterns in fill rates of nursing and care assistant shifts in acute hospitals all the way back to 2014.

It is not terribly pretty – with the share of daytime nursing shifts going unfilled broadly increasing over the years. There’s been a slight improvement between June 2018 and June 2019 – perhaps a reason for hope, perhaps a blip.

Raw numbers of the actually staffed daytime registered nursing shifts staying broadly stable over the five years; while unregistered healthcare assistant shifts – showing a gradual but significant change in the skill mix in acute hospitals.