Published: 12/08/2004, Volume II4, No. 5918 Page 26

Flexible working and overseas recruitment help with the drive for extra staff. Claire Grout explains

The medical workforce expansion programme was established in June 2003 to help Greater Manchester achieve its GP and consultant expansion targets.

The local delivery plan employment target of a total of 1,834 consultants for March 2004 was particularly challenging.

The planned expansion of 85 doctors for 2003-04 was greater than usual annual growth, which had averaged 56 for the previous three years.We also had 157 fewer consultants than anticipated at the beginning of the year.This meant we had to add a total of 242 doctors (15.2 per cent).

Meanwhile, GP numbers had increased at an average of about two a year - so the target to recruit an extra 25 in one year was also a significant challenge.

I worked with leads from each trust, nominated by chief executives, to explore the local medical workforce situation and the local and national finance options available to the programme.

We studied recruitment and retention, the flexible careers scheme, bringing posts forward, converting locum posts, bringing back retired doctors, and delayed retirement.

Greater Manchester was at the forefront of the development of the new consultant entry scheme, designed to encourage specialist registrars to take up their first consultant post on a six-month fixed-term contract.

Funding was allocated to support 35 new doctors on three-month development programmes to bring their posts forward; 11 doctors coming back from retirement to provide educational support; and 14 recruitment and retention projects.

Consultant numbers increased by 129 during 2003-04, and GP numbers rose by 41.

Although the consultant target was not met, we increased numbers by 8.1 per cent (129 consultants) - over twice the average annual growth.

Trusts now see the consultant target as a lower priority because a direct correlation between consultant numbers and other performance indicators has not emerged.

Other specialist roles are being created including advanced practitioners, who are taking the workload from doctors in both primary and secondary care.

There has also been a shift of emphasis to primary care.

This workforce is developing substantially; the 2.8 per cent growth in GP numbers exceeded the local delivery plan target, but further growth is needed to meet the GP national average for the local population.

Although the programme has been aimed at finding short-term solutions, it has established groundwork to support ongoing good practice in recruitment and retention.

Claire Grout is business manager for the medical workforce expansion programme at Greater Manchester strategic health authority.