The Healthcare Flexible-Workforce Landscape in the UK

18 Mar 2021 Anne Marie Fogarty

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Globally, there has been considerable growth in flexible working, not excepting the healthcare profession where non-permanent healthcare workers are referred to as locums or as I prefer to refer to as ‘the flexible workforce solution’.


A locum position is a short-mid-term cover for a role by another in the same profession, especially among healthcare professionals. These positions are typically contracted via a healthcare staffing organisation. Locum healthcare professionals are bound by the same regulations and Code of Conduct as those permanently employed. Framework  Workforce Organisations are expected to be aligned and compliant with the Code of Ethics and Standards, Good Medical Practice rules, and the Code of Practice in the employment of flexible healthcare professionals along with all national legislative guidance and NHSE and NHSI.


What is the UK locum market like now? We looked at the facts.

  • From 2013 to 2017, there was an increase of almost 12,000 licensed doctors working as locums. (1)
  • The number of locums has risen by over a third (38%) in just five years from just under 31,500 to nearly 43,500. (1) The number of hospital doctors choosing to work as locums has almost doubled since 2009. (2) There were around 100,000 full-time equivalent advertised vacancies in hospital and community services alone between October and December 2019. This equates to an estimated shortfall of 8.1% (around 1 in 12 posts). (3)


Sourcing from overseas

Many of the doctors who practice for the NHS are International trained. In fact, the UK Office for National Statistics reports that as of 2019, approximately 29% of them are non-British nationals. One in every seven staff members of the NHS is a non-British national.

Despite much effort, the simple truth is that there is a current shortage of nurses and doctors in the UK, and more are needed for decades to come.

It should further be noted that we have a responsibility to ensure that our international colleagues’ onboarding is fit for purpose and allows for sufficient time for an effective transition from one healthcare system to another. It is also most important to ensure that no added pressure transfers to the current workforce who are already at breaking point and overstretched. Furthermore, this does not exclude our responsibility towards ethical matters, and this also includes demonstrating consideration towards sourcing from regions such as South-East Asia and Africa who already face an c11 million shortage as reported by THET.


Need for Staffing Solutions, a priority

  • According to Nuffield Trust analysis of NHS, Digital’s NHS and General Practice Workforce data – there was (February 2020) 34,327 GPs within the NHS and 321,655 Nurses and Midwives with HCHS Doctors accounting for 117, 842 of the NHS workforces. (3)
  • As of February 2020, 1 in 12 posts were vacant in hospital and community services that is 8.1% (3)
  • The highest number of vacancies were in the Nursing and Midwifery area.
  • According to the briefing, titled The health care workforce in England: make or break? the shortage of healthcare staff is put at 100,000 with a possibility to tank even further to 350,000 or more by 2030—this predicament cuts across other healthcare providers such as nursing staff and social care workers.

There remains room to fill up the gaps created by the short-staffed system. By all projections, a great deal of staff would be required in the UK healthcare system to deal with and face the significant impact from Covid-19, as reported by THF. Other factors adding pressure to the system include an insufficient number of graduates, retirement, international colleagues leaving the system, growth in care demand and the evident waiting backlog, which is now expected to be at c15million vs 4 million 12 months ago, this will require a long time to solve. More so, with the ravaging effects of the global COVID-19 pandemic, which the UK is struggling with, the need to fully staff the healthcare system has never been more critical than now. We believe the best solution would be to ‘fix’ if you like, the underpinning problems: intake deficit- at graduate level, we simply need to inspire and attract more post-graduate and then retain them. Retention and wellbeing are two key issues that require intervention if we are to break the cycle of staffing shortages and create a new one.

The NHS has worked tirelessly to address the staffing crisis with the support of staffing organisations and have worked collaboratively with the flexible workforce industry to create a strategy that will align with it is short-mid-and long-term planning agenda to recruit and retain quality staff with a sustainable model.

The government initiative to work in partnership with the staffing solution industry in addressing staffing challenges is something we as experts in healthcare staffing welcome and support. Equally, we will continue our supportive attachment to the NHS as a key solution going forward.

The single biggest challenge ahead for the NHS long term plan is staff shortages. So, market-leading staffing solution organisations such as ProMedical, certainly can and will back up the NHS ambitious plan. I believe, however, that our strategy must be a three-part one:

  • Demanding more from an eroding workforce must stop now as this is not a solution. Instead, it continues to contribute to unprecedented burnout and stress levels continuous improvement of wellbeing and working conditions of current staff must be our priority.
  • Invest and develop ‘effective and efficient partnerships’ with workforce organisations to address the short-mid term workforce challenges.
  • Long term needs can only be resolved through a clear understanding of future care demand, the right level of graduates and improved retention and wellbeing.


We have been providing workforce solutions across the UK at scale and at pace in conjunction with private and public clients for the last 14 years. To discuss how ProMedical can support with your short-mid-term workforce needs, please contact us here.



The locum market trend is on the rise, and it must be accepted as a professional and lifestyle choice by an ever-increasing section of the healthcare workforce. There is scope and opportunity to support the NHS achieve its plan by ensuring we continue to work together in a collaborative fashion to deliver high-quality staffing solutions, but it must be recognised that long term problems cannot be resolved unless we see significant investment in understanding future care demand, the right level of graduates and improved retention and wellbeing.

If you want to sample the flexibility of locum work, register today with us, and we will guide you through a rapid, efficient process of deployment to your Trust of choice.







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