Focus on physicians – Census of consultant physicians and higher specialty trainees 2018

14 Oct 2019

Each year the Royal College of Physicians and Surgeons of Glasgow partners with the Royal College of Physicians of London (RCPL) and the Royal College of Physicians of Edinburgh (RCPE) to conduct a census of the UK’s physician workforce. The aim of the census, which is carried out by the RCP London’s Medical Workforce Unit, is to provide the three colleges, our partners and others with robust data on the state of the consultant and higher specialty trainee (HST) physician workforce in the UK.

This year’s census reveals the increasing challenges that many of our members are facing in the course of their work. This workforce crisis isn’t just a problem for NHS boards and trusts, it’s a serious issue for everyone who relies on or works in the health service. Staff shortages and welfare issues have a direct impact on the quality of care that we are able to provide to patients within the health service. This pressure is demonstrated by ongoing problems with gaps in team rotas, unfilled posts and high levels of reported sickness absence. These issues are present in every part of the UK, and impact on every grade of doctor. Fundamentally the census shows that, across the UK, the number of posts needed across the system significantly outnumbers the supply of physicians.

The key results from this year’s census include the finding that 40% of consultants and 63% of HSTs said that rota gaps occurred in their workplace on a daily or weekly basis. Only 7% and 12% respectively said such gaps did not lead to significant patient safety issues.

At the same time 26% of HSTs said they frequently had to take on the work of more than one doctor when covering a gap, while over half (52%) of trainees with partners and/or children reported that work had affected their relationship with them during the past year.

69% of respondents reported that poor working conditions affected their morale. It will be of no surprise that just under a third of HSTs (32%) reported that their morale was worse compared with a year ago, while only 20% reported that it was better. We are now reaching a critical stage where the additional pressure created by the shortage of doctors in the NHS is placing intolerable strain on the remaining workforce. More doctors are dropping out of our profession, reducing their hours or considering early retirement, which is in itself exacerbating the problem. This is simply unsustainable.

We need action now from government and NHS employers if we’re to improve the working lives of physicians in the UK and allow us to continue to provide the world-class care that our patients need and deserve.

While there is clearly a need for a significant expansion of medical school places across the UK, this will provide no short-term respite to those of us who have who have had to take on the responsibilities of more than one doctor within our ward or clinic this week. With the UK seemingly set to leave the EU in the very near future, we urgently need to see new initiatives from governments to ensure that we remain an attractive prospect for doctors who are considering on coming to work in the UK. Action is also required to address the NHS pensions crisis, which is driving more and more of our most experienced consultants out of the NHS due to punitive and disproportionate tax charges.

Our members joined the medical profession to make a positive difference to the health of others. We are standing up for our profession today because unless governments and NHS employers address the fundamental challenges highlighted by this survey, we fear that the declining wellbeing of our membership will have far-reaching consequences for them and for the whole NHS.

Download the full Physicians’ Census report.

Category: Workforce