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‘A lack of NHS staff will continue to limit COVID-19 recovery plans’

RCP Cymru Wales launches findings from recent work with specialty (SAS) doctors and calls on health boards to take a fresh approach to filling hospital rota gaps and bringing down waiting lists.

RCP Cymru Wales has published findings from a recent virtual workshop of staff, associate specialist and specialty (SAS) doctors in Wales, calling for a fresh approach to recruiting doctors and bringing down hospital waiting lists.

SAS doctors are a significant and experienced part of the medical workforce. They work in non-training senior roles with at least 4 years of postgraduate medical training. There are SAS doctors in every hospital specialty, as well as in primary and community care. In Wales, there are approximately 800 SAS doctors making up almost 20% of the NHS hospital workforce (rising to 30% when locally employed doctors are included). While the planned increase in medical student numbers in Wales is extremely welcome, it takes more than a decade to train a senior doctor, and in the meantime, the NHS Wales spend on agency and locum staff is eye-watering – potentially as much as £200 million a year, or around 2% of the entire health and social services budget.

This is a huge opportunity to harness the potential of experienced doctors who have decided to make a positive career choice to opt out of the postgraduate training pathway. But health boards and trusts must think outside the box. The RCP is now calling on health boards to ensure that SAS doctors have protected time for career development, education and research, and that their workload and clinical experience is formally recognised.

NHS bodies should also audit their implementation of the SAS charter, support SAS tutors, advocates and CESR leads to establish SAS doctor forums, and work closely with Health Education and Improvement Wales (HEIW) to bring together SAS doctors from different specialties, directorates and teams in local networks.

Dr Olwen Williams, RCP vice president for Wales said:

‘With a significant and growing NHS recruitment crisis in Wales, health boards and trusts must think differently about how they can fill hospital rota gaps. One solution is to design new specialty (SAS) jobs, giving doctors to opportunity to create their own job plan and pursue their clinical and teaching interests.

‘We are spending hundreds of millions of pounds on locum doctors in Wales, yet 59% of advertised consultant physician posts in Wales were not filled this year. That’s 3 in every 5 posts remaining empty – and in 63% of those cases, it was because there were no applicants at all. There are some very difficult choices ahead to try and reduce waiting lists and put the NHS back on a sustainable footing. But what is clear is that a lack of workforce across all professions will continue to limit the pandemic recovery plan. Increased investment in the NHS cannot improve patient care if we don’t have the staff to treat patients.’