The government's boast that the NHS has been swelled by thousands of extra clinical staff masks wide regional variations and a flattening in the number of nurses and GPs.
The latest NHS workforce census, published by the Information Centre, was hailed by the Department of Health as showing a "continued upward trend" in the number of frontline workers.
The figures showed there was a 0.9 per cent increase in professionally qualified clinical staff and a 0.5 per cent reduction in the overall NHS workforce from 2006 to 2007.
The census, which is an annual snapshot of staff carried out each September, showed the number of managers and senior managers dropped by 252, compared with a decrease of 2,640 the previous year
Health minister Ann Keen said: "Thanks to yet another year of record investment, we have 6,625 more clinical staff working on the front lines of the NHS."
But closer examination reveals numbers of professionally qualified clinical staff dropped in four of the 10 strategic health authorities (see table). A spokesperson for one of the four said there was a slight decrease in the clinical workforce, particularly nurses. "This is attributed to one geographical area in the East Midlands and we are currently working with those trusts to understand the reasons for this," they added.
There was no rise in full-time equivalent qualified nursing staff. Royal College of Nursing senior employment relations adviser Karen Didovich said this was a concern. "This is a response to financial constraints," she claimed.
She said providers had responded to targets by recruiting certain staff, such as theatre nurses, at the expense of other groups. Community nursing and long-term care had been left short-staffed as more nurses were attracted to the flexible working offered by the private sector.
The number of GPs has gone up from 30,931 to 30,936 - a rise of just five full-time equivalents, excluding registrars and retainers, of whom the latter only work enough hours to keep their skills up to date.
This suggests the DH is unlikely to meet projected demand, which it put at 32,000 GPs by 2010-11 in a draft workforce strategy leaked to HSJ in January 2007.
Dr Richard Vautrey, deputy chairman of the British Medical Association's GPs committee, said practices were reluctant to advertise for jobs due to "financial uncertainties" caused by the general medical services contract row. "The government has pronounced that there is an increasing need for GPs, but newly qualified GPs are struggling to find jobs," he said.
A DH spokeswoman said local variations in workforce numbers were to be expected as it was for NHS organisations to determine local needs. Headcount numbers for nurses increased by almost 1,300 from 2006 to 2007, she said.
The figures come as a Faculty of Public Health survey showed a drop in the number of public health specialists from 22.2 per million population in the UK in 2003 to 15.5 in 2007. President Dr Alan Maryon-Davies said this was "perverse", given the government's position on issues such as obesity and health inequalities.