The proportion of unfilled medical consultant posts across the UK is at its highest level in almost a decade, according to a census conducted by the Royal College of Physicians, the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow.
Nearly half (48%) of advertised consultant posts across the UK were unfilled last year – up from 36% in 2013.
Most posts were not filled because there were no applicants. Of the 48% of posts that went unfilled in the UK, 49% were unfilled due to a lack of any applicants at all and 34% due to a lack of suitable candidates.
There were higher rates of unsuccessful appointments in Wales (59%) and Northern Ireland (57%), than in England (46%). In England, the East Midlands region had the highest proportion of unsuccessful appointments (63%), followed by the West Midlands (61%). In London, only 38% of appointments were unsuccessful.
Many higher student trainees were unable to complete their training during the pandemic, meaning there will potentially be fewer newly qualified consultants to apply for posts. COVID-19 has also affected the NHS financially and this too will have had an impact on appointing consultants.
However, the three Royal Colleges of Physicians believe a lack of long-term workforce planning is the primary factor behind the 33 per cent increase in unfilled consultant posts across the UK since 2013.
The three Royal Colleges of Physicians are among several organisations supporting an amendment tabled by former Health Secretary Jeremy Hunt to the Health and Care Bill in England to ensure that every 2 years the secretary of state publishes independently verified assessments of the workforce numbers needed in future to meet patient demand.
Currently there is no public data on whether England is training enough healthcare workers now to meet expected future demand. This amendment would help provide that data, enabling proper workforce planning that takes account of changes in the NHS workforce and rising demand for health services from an ageing population where multiple conditions are increasingly common.
Dr Andrew Goddard, president of the Royal College of Physicians, said: “We’re being hit by a perfect storm of high demand for services and not enough staff. This can’t go on. The fact that so many posts were unfilled because there were no applicants shows the supply of doctors falls woefully short of demand. We need a clear commitment from government to publish regular workforce projections so that we know how many staff to train to meet future demand.
“We know that medical school places need to be rapidly expanded, and our census results today show precisely why – vacancies among consultant physicians are at their highest level in 7 years. It takes 10-14 years to train as a doctor. We need long-term projections on the workforce we will need in future so that our health service is fully equipped to deal with future patient demand.”
Dr Marion Slater, elected member of council for recently appointed consultants at the Royal College of Physicians of Edinburgh, said: “The 2020 Consultant Census report provides clear evidence that we continue to have too few doctors to provide high quality, equitable and accessible patient care to our population.
“We must ensure that our chronic workforce shortages are now addressed as part of a sustainable and deliverable plan for our NHS, as we redesign our services in response not only to the COVID-19 pandemic but to achieve the NHS’ goal of a becoming a net-zero greenhouse gas emissions organisation.
“More must be done to support the wellbeing of our medical workforce, with over a third of consultants reporting having been undermined at work or having witnessed a colleague being undermined. We must ensure that we truly support our diverse workforce as figures show that experience of being undermined is more reported in women and consultants from an ethnic minority.
“The Royal College of Physicians of Edinburgh is committed to promoting equality, diversity and inclusivity in the medical workforce. We will continue to work hard to ensure that we are reflecting the diversity of our Fellows and Members both in the UK and internationally - and that we are raising awareness and progressing solutions.”
Professor Jackie Taylor, president of the Royal College of Physicians and Surgeons of Glasgow, said: “The results of the census do not come as a surprise to anyone working in our NHS. We are acutely aware of unfilled posts and vacancies in our health service. Doctors and other healthcare staff are forced to compensate for staff shortages by taking on excessive workloads. For too many, this is leading to burnout and has an impact on patient care.
“We simply don’t have enough doctors to meet the current and future demands on our health service. Current workforce planning is inadequate and does not ensure a sustainable medical workforce in the UK. In England, our proposed amendment to the Health and Care Bill will establish transparency and accountability in workforce planning and is an important step towards ensuring we can meet the healthcare needs of the population now and in the future. We are calling for a similar comprehensive approach to workforce planning in Scotland.”
About the census
The Medical Workforce Unit (MWU) of the Royal College of Physicians (RCP) conducts an annual consultant census on behalf of the RCP, the Royal College of Physicians of Edinburgh (RCPE) and the Royal College of Physicians and Surgeons of Glasgow (RCPSG). The 2020 UK consultant census was sent electronically to 15,383 consultants and 3,736 (24%) responded.