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Life in the time of COVID-19: the 2020 UK consultant census

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The most recent census of the consultant physician workforce in the UK shows that the number of doctors needed to meet patient demand continues to significantly outnumber the supply.

Every year the Royal College of Physicians (RCP) conducts a consultant census on behalf of the Federation of the Royal Colleges of Physicians: the RCP, the Royal College of Physicians of Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow. Our aim is to provide robust data on the state of the physician workforce in the UK.

The 2020 census was conducted between 17 November 2020 September – 29 January 2021. We received 3,736 completed forms from consultants and confirmed data on an additional 13,483 consultants in the NHS.

Key findings

The COVID-19 pandemic has had a profound impact on the NHS, but the pressure on its systems and medical workforce are not new. The number of doctors and other clinicians needed to meet patient demand continues to significantly outnumber the supply. As the NHS moves from crisis management to recovery, we must take the opportunity to address this long-term issue.

  • Only 52% of posts advertised were filled. For the past 8 years, barely half of advertised consultant posts were filled, mostly due to a lack of suitable applicants.
  • 36% of consultants described being in control of their workload only ‘sometimes’ or ‘almost never’. 38% said that they worked excessive hours or had an excessive workload ‘almost always’ or ‘most of the time’.
  • 35% of consultants had experienced being undermined and 35% had witnessed a colleague being undermined, usually by managers or fellow consultants. This was more common among women and consultants from an ethnic minority.
  • Consultants estimate that they work 11% more than they are contracted to work, mainly due to their clinical workload.
  • 55% of consultants reported that their morale was worse during the pandemic and only 5% reported that it was better; 69% reported that morale was worse in their department and only 4% reported that it was better.
  • The ratio of population size to number of consultant physicians varies widely. Regions with comparatively fewer consultants have the highest rates of unfilled advertised posts and locum consultants.

The continuing pressures that physicians are under, exacerbated by the pandemic, appear to be the main factor behind the negative experiences documented by the consultants who contributed to the census. Filling vacant consultant posts, reducing experiences of undermining, addressing excessive workloads and improving consultant experiences of general internal medicine (GIM) are crucial if we are to improve the working lives of physicians in the UK.

Next steps

We will continue to:

Further information

To view the data and learn more you can download Life in the time of COVID-19: the 2020 UK consultant census and the tool below. If you would like to discuss a bespoke analysis of data by region or other factor, please contact us via policy@rcp.ac.uk.

Correction note – 6 December
These data have been updated to correct an error published in the original census report. A small number of doctors in the NHS Grampian region were erroneously included in data for South England. This has now been updated and the relevant figures corrected.

The RCP Medical Workforce Unit independently verified consultant headcount by nation, specialty and demographics by checking with specialty representatives, the GMC and with consultants’ work locations.

Read the latest 2020 census news items from the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow.