NHS officials doubled in two years as GP workforce dropped

Staff employed by NHS England and the DHSC doubled in two years from the start of the COVID-19 pandemic while the GP workforce dropped by 1%, doctors' leaders have warned.

Whitehall street sign
(Photo: John Lamb/Getty Images)

Figures in a report by the Policy Exchange think tank show that the number of staff employed by NHS England grew by 67% from 6,102 to 10,215 between February 2020 and February 2022, while the staff headcount at the DHSC rose by 141% over the same period.

Numbers of senior roles at NHS England rose particularly sharply, increasing from just under 800 to around 1,800 over the two-year period.

Rising numbers of NHS officials are in stark contrast to the continuing decline in numbers of GPs - with the full-time equivalent (FTE) fully qualified GP workforce falling by 247 over the two years from March 2020 to March 2022, a fall of 1%.

NHS bureaucracy

The wage bill at the DHSC has more than tripled to more than £30m a year, while NHS England's wage bill has more than doubled to over £55m, the report found.

Its authors wrote that 'both DHSC and NHS England should commit to undertaking a review of their workforce, with the intention to reduce headcount at the centre'. The report called for a drive to increase 'alignment' between the DHSC and NHS England, including 'running joint policy programmes, to streamline the policies, strategies, and guidance from the centre'.

BMA deputy chair Dr David Wrigley said: 'At a time when we have a severely depleted and exhausted health and care workforce who have spent the last two years battling a pandemic only to now face another enormous challenge of tackling the record backlog in care left in its wake, many will feel frustrated that such a huge amount of money is being spent on bureaucracy and backroom functions, rather than reaching the front line.

'While any organisation the size of NHS England requires high-quality, accountable management, especially during a pandemic, this must provide value for money for the taxpayer and crucially must not be at the expense of funding for services and frontline staff.

Frontline staff

'These figures will therefore be particularly galling to our colleagues as the government continues to refuse to prioritise the very people who keep health and care services running: the doctors, nurses and other health and care professionals looking after people in our hospitals and GP practices each day.

'The report notes a doubling in NHS England staff in two years - at the same time as nursing numbers only increased by seven per cent. The picture is no better for doctors, with the number of full-time equivalent hospital doctors in England increasing by just 9% between January 2020 and January 20221, while we have actually lost the equivalent of 247 full-time, fully-qualified GPs over a similar period - a fall of almost 1% - continuing a worrying trend that has long pre-dated the pandemic.

'The government says it won’t offer doctors a fair pay rise that both reflects the spiralling cost of living and corrects years of pay erosion, because it can’t afford to do so. Neither will ministers scrap damaging pension rules that drive senior doctors away from the health service early. But they seemingly have enough money to double what they’re spending on management and red tape.'

GPonline reported earlier this year that the GP workforce had slumped by more than 350 doctors in the year to March 2022, while appointments continued to surge.

A DHSC spokesperson said: 'We needed to attract, recruit and retain highly-skilled staff to respond to the unprecedented demands of the pandemic – this enabled us to build a testing system from scratch and deliver a world-leading vaccine programme that has saved countless lives.

'We are committed to delivering value for money for the taxpayer and operating as efficiently as possible.'

The spokesperson said there were 'over 1,400 more doctors working in general practice compared to three years ago' - although this figure includes GP trainees who cannot practise independently. Over the period March 2019 to March 2022 the number of full-time equivalent fully qualified GPs fell by 717.

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