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‘Trainees are under pressure to fill rota gaps, which leads to patient safety concerns on a regular basis’

Welsh hospitals are understaffed and overstretched. Over two-thirds of trainees report regular and frequent rota gaps, almost one-third of advertised consultant posts go unfilled, and absence due to sickness is rising. As 120 doctors and health professionals gather today (9 May) in Deeside for the Royal College of Physician’s (RCP) second north Wales conference, the college has published a new report which showcases several innovative case studies and suggests how things could be improved in the future.

If we want to make sure that Wales has a sustainable medical workforce that meets the needs of patients, we need to move away from a piecemeal approach to workforce planning. We need an ambitious national health and care workforce strategy for Wales that is patient centred, clinically led and supported by new funding.

The reality is that in 2018, almost one-third of advertised consultant physician posts were unfilled across Wales. In north Wales, only 43% of these jobs were filled.

Other findings include:

  • 37% of consultant physicians in Wales are likely to retire within the next decade.
  • 20% of consultant physicians say that rota gaps are causing significant problems with patient safety.
  • 70% of medical registrars encounter frequent rota gaps.
  • 74% of medical registrars say that their work–life balance is the first thing to suffer.

Written in collaboration with trainees and specialty doctors, this report looks at how we could persuade doctors to come to Wales, and how we could keep them working here. With 16 overarching recommendations, medical leaders are calling on the Welsh Government and NHS Wales to:

  • make staff health and wellbeing a national priority
  • guarantee protected time for research, education, quality improvement and leadership schemes
  • build strong medical teams and encourage a sense of belonging and identity in hospitals
  • develop rural and remote medicine as a training pathway in which Wales is a world leader.

Dr Gareth Llewelyn, RCP vice president for Wales said:

We know that rota gaps are created by shortages of doctors. These shortages result in an increased workload, which consequently impacts on motivation, education and wellbeing, and on the quality of care offered to patients. This problem needs to be solved.

Today’s report highlights the challenges ahead in relation to hospital medicine, and the opportunities that will arise from collaboration between HEIW, RCP Wales and other stakeholders to develop new models of working. This is going to be crucial if we want to achieve our goal of ensuring that working in Wales as a trainee physician, specialty and associate specialist doctor or consultant physician, is supported, fulfilling and long term.

We need to create and develop an NHS that encourages school pupils to have the ambition to study medicine in Wales, and supports doctors who want to advance their career living and working in Wales.

We have an opportunity to do things differently in Wales. This requires strong and ambitious leadership to create the right environment, so that doctors can drive forward the changes needed.’

A trainee physician working in NHS Wales added:

When we start a new job, half the time we don’t get a signed contract… I know people who have threatened to leave jobs because they couldn’t get time off for their wedding. They were more stressed about swapping an on-call than their wedding. That is wrong.

Just because we are doctors, we shouldn’t have to accept that as normal, it shouldn’t be acceptable.


Doing things differently 546.67 KB Uploaded: 9 May 2019
Gwneud pethau’n wahanol 562.08 KB Uploaded: 9 May 2019