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Doing things differently: Supporting junior doctors in Wales

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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. There are a number of reasons for this: an ageing population, an increase in patients with complex health problems, a large number of doctors nearing retirement, and a more flexible approach to work among younger doctors. Overall, we simply haven’t looked far enough ahead and planned accordingly.

Key recommendations

The Welsh Government and NHS Wales should:

  • take a nationally coordinated and strategic approach to workforce planning and data collection
  • increase the number of undergraduate and postgraduate training posts in Wales
  • plan fair and flexible rotas and take the pressure off trainee doctors to organise their own cover
  • guarantee protected time for research, education, quality improvement and leadership schemes
  • fill permanent rota gaps by investing unspent trainee money in clinical fellowships and SAS doctors
  • establish a junior doctor forum in every hospital with access to staff support
  • increase the number of medical school places offered to Welsh-domiciled students
  • develop rural and remote medicine as a training pathway in which Wales is a world leader

Time for action

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 health and care workforce strategy for Wales, led nationally by Health Education and Improvement Wales (HEIW), that is patient centred, clinically led and supported by new funding from the Welsh Government. 

At a glance

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.