Research

Staffing and human resources in the NHS

Professor Nick Bosanquet, Andrew Haldenby, Henry de Zoete, Roger Fox

Key defects of central manpower planning

There are clear defects to the system of centralised planning which has governed staffing resources in the National Health Service. These include:

An emphasis on increasing numbers of single categories of staff rather than building teams;
A lack of emphasis on costs;
An emphasis on quantity rather than quality.

Human resource planning by silo rather than by team

A sensible and successful manpower strategy will seek to create teams based on both senior doctors and supporting staff. This has been achieved more successfully in primary care, where there is more scope for local initiative in staffing, than in secondary care.

The chosen mix in primary care is now very different from the hospital service with fewer doctors and more practice nurses and support staff. In the past ten years, the number of GPs has risen by 12 per cent. In contrast, the number of consultants has risen by 70 per cent and the number of hospital doctors in training has increased by 50 per cent.