The latest census of consultant physicians and higher specialty trainees in the UK (2014/15) produced by the Royal College of Physicians, Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow, highlights significant concerns around filling gaps in trainee rotas.
Published in full today, the annual census measures the number of UK consultants and higher specialty trainees in all medical specialties, as well as capturing the views of those in the profession.
As part of the census, consultant physicians were asked about the gaps they face in their trainees’ rotas and their concerns. The findings from the consultant census show that trainee rota gaps were reported by 21% of respondents as, ‘frequent, such that they cause significant problems for patient safety’. This problem is reported more among consultants who have an acute or general medical commitment (28%). A further 48% stated rota gaps happened ‘often, but usually with a workaround solution such that patient safety is not compromised’.
The consultant census also notes, along with previous years, the growing need for consultants who can meet the needs of frail older patients. Following trends noted in last year’s census, the greatest increase in consultant jobs advertised have been in acute medicine and geriatric medicine, suggesting a move away from specialist working to more generalist roles treating acutely ill patients.
The nature of patients coming to hospital is changing. Sixty-five per cent of people admitted to hospital are over 65 years old and many have multiple complex conditions – often such patients require increased generalist input, as highlighted by the RCP’s Future Hospital Commission report.
Commenting on the data Dr Harriet Gordon, director of the RCP’s Medical Workforce Unit, said:
Consultants are at present seeing consistent and repeated gaps in their trainee rotas - with over a fifth stating that they are concerned that it could be having an impact on patient safety. We have been monitoring rota gaps for the last three years, and they have remained stable at 20–21%; therefore, the problem is neither new nor resolving. We know that consultants do ‘act down’ to fill such gaps but as there is a consultant shortage - this is not a sustainable solution. Such a situation is clearly unhelpful for staff, for our hospitals and most importantly the patients.
Other key findings from the census include:
- There has been a 3.2% expansion in consultant physician numbers – however the rate of expansion has continued to gradually slow over the past few years.
- Part-time working – the proportion of consultants working less than full-time stands at nearly one fifth (18%).
- Across the UK 40% of advertised consultant appointments could not be filled. Almost all were due to there being a lack of trained applicants. This was especially acute in the North West and the West Midlands with only 55% and 60% appointments filled.
- Satisfaction rates remain high, with 78% of consultants and higher specialty trainees reporting to enjoy their jobs ‘always or ‘often’.
At the time the data were collected, there were 13,003 consultant physicians working in the UK.
Also published today is the seventh annual survey reporting the outcomes for those holding a Certificate of Completion of Training (CCT) in the UK medical specialties.
The main findings from the survey notes:
- There has been a gradual fall over the past 5 years in perceptions of how well CCT holders feel trained in their specialty and more recently in general medicine.
- In total, 62% of CCT holders held a substantive consultant post, consistent with the early years of the survey and an improvement on the past 2 years.
- If they had their training period again, 94% of CCT holders reported that they would train again in their specialty, but only 65% reported that they would train again in general medicine.