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More capacity – the best birthday present the NHS could get

The RCP has warned of a worsening staff shortage as the NHS celebrates its 73rd birthday. A new survey reveals that more than a quarter of senior consultant physicians expect to retire within 3 years, many within 18 months, while the majority of trainees entering the NHS (56%) are interested in working part-time.

A fifth of doctors already work part-time, and the new figures from the RCP suggest this trend is set to increase as wider expectations around work/life balance change.

The RCP is calling on new Health and Social Care Secretary Sajid Javid to give the NHS the best birthday present it could ask for – more capacity. It wants a doubling of medical school places to avoid medical staff shortages worsening in the future, with increased funding for social care and action to address health inequalities also needed to reduce demands upon the NHS.

At the end of the most challenging year in its history, 43% of doctors have not reverted to their original working pattern, according to the RCP’s survey, with well over half of respondents (57%) now working from home at least some of the time. Over two thirds (67%) said working from home has improved their work/life balance.

Doctors would like this shift to more remote working during the pandemic to become the norm. More than 60% (72% of trainees) want opportunities for remote IT access, online meetings and remote working to be available in the future.

While almost two thirds (65%) reported that their organisation had made changes to enable more flexible working during the pandemic, just as many of those who wanted to work more flexibly thought this would be difficult or impossible (36%) as thought it would be easy (35%).

The key challenge stymieing more flexible working patterns is not the willingness of NHS trusts, but a lack of workforce, with 79% of those expecting flexible working to be difficult citing “not enough medical staff”. While 59% of doctors thought their department would support a request to work more flexibly, 41% didn’t think so, with more than three quarters (76%) citing not enough medical staff as the reason.

Andrew Goddard, president of the Royal College of Physicians, said: “It is right that we should celebrate the achievements of healthcare staff during the pandemic as we mark the NHS’s birthday, but the pressures we have faced have been greater than they needed to be because of existing staffing shortages. If we do not address this problem we will have much less to celebrate in future.

“Caring commitments and health reasons will be key drivers behind part-time working, but we have to view this as part of a wider cultural shift. If a majority of trainees coming into the system are keen to work part-time, we need to find a way to make that happen to keep attracting people into the profession and retaining them. The NHS has recognised that and wants to offer flexible working – but it is stuck in a true Catch-22 situation where it cannot do the very thing needed to attract more staff because it doesn’t have enough staff at the moment.

“Meeting the complex needs of an ageing population, let alone another pandemic, will be all but impossible if we do not expand medical school places now to train more doctors, invest in social care and address the inequalities that create and worsen ill-health.”

About the survey
The RCP surveyed approximately 25,500 RCP members and fellows in England, Wales, Scotland, and Northern Ireland Between 4-27 June. The survey received 1,523 responses. This is the eleventh survey the RCP has emailed to its members during the COVID-19 pandemic. Further information can be found here.