Last updated: 28 March 2025
The NHS has a chronic workforce crisis, driven by years of inadequate workforce planning, lack of accountability for workforce issues and recurrent failure to value and invest in staff. Without action to better train and retain the doctors the NHS needs, staffing levels with continue to fall short of demand, further impacting working conditions, waiting lists and care quality.
Additional information is available on the general practice workforce, and workforce issues across Scotland, Wales and Northern Ireland.
The latest medical care workforce trends for England are set out below and are regularly updated with new data on topics such as workforce numbers, vacancies and retention rates.
FTE / headcount
Workforce data can be measured in either headcount or FTE (full time equivalent). Headcount refers to the number of individual doctors, while FTE is the proportion of full-time contracted hours that the postholder is contracted to work. 1 FTE would indicate they work full-time hours, 0.5 FTE indicates working half that time.
As FTE reflects the true number of clinical hours the NHS has at its disposal, FTE is used throughout this page, unless otherwise stated. Full-time is taken to be 37.5 hours - the FTE definition used by NHS Digital. This calculation is for illustrative purposes only, as we recognise employed doctor contracts can be 40 hours.
OECD (Organisation for Economic Co-operation and Development) comparisons
For international comparisons we use OECD data. However, this should be interpreted with caution due to international differences in how doctors are defined and differences between definitions, such as 'practising' and 'professionally active', that may create variation across countries.
We have calculated the doctor to population ratio for England ourselves (as OECD only supply this figure for the United Kingdom, not its constituent countries) using NHS Digital general practice and secondary care workforce statistics and mid-2022 ONS population estimates.
England has fewer doctors per capita than other comparable countries
The average number of doctors per 1,000 people across the EU members of the OECD, for which data is available, is currently 3.9. Germany has 4.5. England, by comparison, has just 3.2 and would need an additional 40,000 doctors to reach the OECD EU average.
There is also significant regional variation in the distribution of doctors, with some areas falling even further below the OECD EU average. The East of England, for example, has just 2.5 doctors per 1000 people.
The medical workforce is growing but unevenly and at a rate that lags behind rising demand for care
Overall, the number of doctors working in the NHS is steadily increasing, with growth concentrated in secondary care settings. In November 2024 (latest data), NHS secondary care had 46,378 more FTE doctors than September 2015 – a 42% increase. The rate of change has increased in recent years, reaching an annual growth rate of over 5% in 2024.
This level of secondary care workforce growth, however, has not been sufficient to meet demand, which is also rising, and vacancy levels remain stubbornly high as a result. There are currently 8,330 secondary care medical vacancies in England, amounting to 5.2% of all medical posts. Deficiencies in the way vacancies are recorded mean this is likely to underestimate the true shortfall of staffing.
In spite of overall NHS workforce growth, general practice has seen a decline in the number of fully qualified GPs during the same period. There were the equivalent of 1,116 fewer fully qualified full-time GPs in January 2025 (latest data) than there were in September 2015 (when the current data collection method began). Yet, the number of patients during this time has risen by 17%. A single full-time GP is now responsible for an average of 2,257 patients, 319 more than in September 2015. Full detail can be found on our pressures in general practice analysis page.
The NHS hasn’t trained enough doctors domestically and a large proportion of recent workforce growth has been driven by international recruitment
A key factor contributing to the workforce shortfall has been a failure to train a sufficient number of doctors. To fill the resultant workforce gaps, the health service has relied heavily on international recruitment. From 2019-2023, the proportion of doctors working in England with their primary medical qualification from a non-UK country grew by 38%, whereas growth for those with a UK-qualification grew by only 10%.
The NHS would not be able to function without international medical graduates (IMGs), who provide an invaluable contribution. As well as numbers, IMGs bring a diverse range of skills, knowledge and experience to their medical practice in the UK, which has been beneficial to patients and the NHS.
However, in recognition of the risks of becoming overly reliant on international recruitment at a time of global workforce shortages, the NHS aims to reduce international recruitment from its current rate of 24% to 9.0-10.5% by 2036/37, and do so by increasing the number of domestically trained medical staff.
So far key commitments to achieve this aim, such as the expansion of medical school places, lack funding and a plan to deliver in practice. There are currently no proposals to expand the remainder of the training pipeline, including speciality training places which are already significantly oversubscribed.
A failure to value the doctors we already have means that too many are pushed to leave the NHS early
Unless there is immediate action to better retain staff by properly valuing doctors and their contribution, plans to abate the workforce crisis will fall short.
Alongside a failure to train enough doctors, the health service is struggling to hold onto the doctors it has. For every doctor that leaves, pressures worsen for those who stay, increasing the likelihood that they too will leave the profession.
In the year to March 2024, a total of 20,771 secondary care doctors (headcount) left NHS organisations, significantly more than the 15,577 doctors who left in the year up to March 2015. During this time-period, for every 10 HCHS doctors that joined an NHS organisation around 7 doctors left.
These figures represent staff both leaving and those moving within the NHS.
While some doctors leave to retire, or for other unavoidable reasons, too many doctors are pushed to leave the NHS early. Since 2011, there has been a growing number of doctors citing largely preventable reasons for leaving NHS organisations, including health concerns, work life balance, working relationships and their reward package.
The high rate of doctors leaving due to concerns about health and work/life balance is perhaps unsurprising given that persistent staff shortages mean excessive workloads for those who remain. The 2024 NHS staff survey reported that 42.19% of medical and dental staff experience work-related stress and 30.24% felt burnt out because of their work. The GMC’s Workplace experiences 2024 report found that more than a third of doctors (38%) in England felt unable to cope with their workload at least once a week and 65% regularly worked beyond their rostered hours.
At the same time as mounting pressures, doctors are left chronically undervalued and underpaid. Pensions taxation, meanwhile, too often means doctors are disincentivised from working additional hours. The 2024 NHS staff survey reported that only 32.05% of NHS staff were satisfied with their level of pay, and less than half (44.4%) were satisfied with the way their organisation values their work.
What the BMA is calling for
The BMA is calling on the government to take action to improve medical retention, by addressing the longstanding failure to properly value and support doctors. Our report, 'When a doctor leaves', sets out what should be done.
