We need to address staff shortages across the child health workforce

Staff shortages are among the most high-profile issues facing the NHS today—a scarcity that is felt within the paediatrics workforce.

In recognition of this rising challenge, our latest State of Child Health report has been updated to include a new indicator looking specifically at the paediatric workforce.

Our College membership comprises mostly paediatricians, yet the child health workforce is and needs to be multidisciplinary. Professionals from many disciplines play an important role in keeping children and young people healthy. That’s why we also explored primary care, nursing, and psychiatry. Overall, we wanted to spark a discussion on the numbers behind the headlines.

...we need access to better data to fully understand the capacity of this workforce and where the gaps lie

The good news is that the number of consultants per 10,000 children has grown in every UK nation since 2005. But this rise is offset by a rising demand for paediatric services and trainee attrition. Many paediatric doctors are opting to switch into a new speciality, while others are leaving the medical profession entirely.

And the story is further complicated by changes in working patterns, as many doctors are now working less than full time. This means that simple headcount figures may paint a misleading picture. Instead, it would be better think about aggregating the number of doctors to factor in the amount of time they spend working in paediatrics, using a metric known as whole-time equivalents (WTE). 

This shift in doctors’ working patterns is not a problem, as such. Rather, it reflects a wider societal shift away from the ‘traditional’ career paths that have historically been the norm in the UK. Indeed, we found a similar pattern among the primary care workforce, where WTE figures are also falling. What it does mean, however, is that we need to be smarter when using data to understand workforce shortages.

Speaking of data, trying to understand the story for nurses and psychiatrists was tough. Many useful data points simply don’t exist—others are coded differently across the UK. This made it difficult to draw meaningful conclusions. What we can say is that, again, there are widespread vacancies and WTE reductions. And, again, many capacity increases are offset by rising demand.

Overall, the trends in the child health workforce across the UK pose a challenge. The inclusion of this new chapter was driven by a need, and this need is set to become increasingly relevant if current trends continue. As a starting point, we need access to better data to fully understand the capacity of this workforce and where the gaps lie. 

Beyond that, investment in training to boost workforce numbers, and retention to keep doctors within the profession, is critical. Child health professionals have already sustained their commitment to patients in the face of whole system pressures. Their goodwill and passion can’t be relied on indefinitely—and will not be enough to achieve significant gains in health and care outcomes.