Workforce Research

Workforce Research

Workforce Research

Primary Care Group

School of Community-based Medicine

Professor Bonnie Sibbald

National Primary Care Research

And Development Centre

Labour substitution

Skill Mix

Improving cost-effectiveness

– Nurse-doctor substitution & supplementation

– Moving care from hospitals into the community

New professional roles

– Community pharmacists

– Rehabilitation assistants

– Primary care mental health workers

Medical Workforce Supply

Reducing inequalities in GP distribution

Monitoring & explaining inequalities

– Secondary analysis of NHS medical census

– National ‘worklife’ surveys

Finding solutions

– Job redesign

– Financial / non-financial inducements

– International medical migration


• Labour substitution is safe but may not

reduce costs

• Professional, financial & regulatory

frameworks limit scope for substitution

• Job dissatisfaction increases quit rate; but

satisfaction does not ‘protect’ against quits

• Job redesign & financial inducements can

improve recruitment to underserved areas

UK Policy Impacts

• More nurses, fewer doctors

• “Care Closer to Home” policy reshaped

• National GP pay awards

• “Golden hello” in underserved areas

• GP salaried contracts reshaped

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