The staffing challenges facing the UK’s National Health Service are no secret. Hospitals are seriously underpowered and doctors and nurses are woefully overstretched. And yet in some specialisms there are qualified doctors who cannot find jobs, and there are would-be specialists who can’t even secure training places.

This apparent contradiction reflects a mismatch between workforce need and funded capacity. Training specialists requires the clinical capacity to free up consultants to supervise them, while employing them requires capacity in the departmental budget. Both are often lacking, so the number of available posts does not always keep pace with either demand for training or the NHS’ wider workforce needs. This situation serves neither patients nor professionals.

But the solution is certainly not to train fewer doctors. The long-term workforce shortage is real. Our health service will never be able to return to strength if we do not train enough people to staff it. And it takes five years before a new medical student even reaches the foundation-training bottleneck, so cutting places now wouldn’t solve today’s problem and would only store up a bigger one later.

Successive governments have recognised this. The called for a significant increase in medical school places. And the government’s reinforced the need to grow medical education capacity, widen participation and train more doctors in areas of workforce need.

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That need is not evenly distributed across the country, however. Many patients – especially those outside large metropolitan areas – feel they face a postcode lottery in health provision. And this is where regional universities come in.

There is evidence that medical graduates are more likely than other graduates to stay in the area where they study and train. that half (49.6 per cent) of UK hospital trainees and two-thirds (67.9 per cent) of GP trainees obtained their first career post in the same region as their training.

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Nor is the phenomenon confined to the UK. In Japan, the number of doctors increased significantly where a medical school had been built, with the effect lasting for more than 20 years, found. Even more striking, the researchers found evidence suggesting that the establishment of university hospitals may lead to a reduction in the overall mortality rate, especially among the elderly.

In Brazil, meanwhile, found an increase in the number of doctors per 1,000 people in places with new medical schools. Municipalities without a new medical school saw the number increase by 0.2 between 2007 and 2016, while those with a new school saw it increase by 0.6: three times faster.

In the UK, certain places are especially adversely impacted by staffing shortages. The East of England, where I am based, has only 2.5 doctors per 1,000 people, compared with 3.2 nationally. In Germany that number is 4.5. This means the East of England has about 22 per cent fewer doctors per head than the England average, and about 36 per cent fewer doctors per head than the EU average of 3.9 per 1,000.

Set that against a regional population that is growing faster than England’s average – by 4.8 per cent over the past five years, compared with 4.3 per cent nationally – and it’s clear that the East of England faces a perfect storm in terms of doctor availability.  

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Against this backdrop, the University of Hertfordshire has opened a medical school. This will help build a sustainable local workforce pipeline, with students trained alongside NHS partners and undertaking placements throughout the region. Its focus is not simply on increasing medical student numbers but on developing doctors with strong connections to Hertfordshire and the East of England.

Admittedly, like all new medical schools, Hertfordshire’s first cohort, starting this year, will be confined to international students: it can only open places for UK students when government funding allows.

But even if many of the international students don’t remain in the UK after graduation, our medical school will still provide local NHS trusts with a stream of eager student clinicians who, during up to seven years of training, will be able to help with tasks such as taking medical histories and patient observations. By its fifth year, up to 350 medical students will be supporting health practitioners in hospitals, GP surgeries and community health services across the East of England.

The national challenge in NHS staffing requires both long- and short-term solutions, driven both from the top down and from the bottom up. One of those is the Medical Training Prioritisation Act 2026, which gives graduates of UK universities prioritisation for specialist training places.

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That seems right. But it also matters where those UK graduates are. The evidence is clear: if we train doctors locally, we’ll retain doctors locally. And that is why part of the solution should also be to direct government funding into medical schools at universities in the regions where the need is greatest.

Irene Ctori is professor of optometry and dean of the School of Health, Medicine and Life Sciences at the University of Hertfordshire.

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