The Royal College of Physicians and Surgeons of Glasgow has published its response to the draft health and care workforce strategy for England “Facing the Facts, Shaping the Future”.
Our main recommendations to this draft document are:
- Actions which would limit the connection of the international community to the UK workforce could have long lasting deleterious consequences
- The suggested move of the point of registration to remove the need for international students to undertake a post-graduation year is ill conceived. The assessment of doctor performance in real practice, under the challenging conditions of responsibility for patient care, is completely different to that of assessment while a student. Patient safety in the UK demands the level of scrutiny afforded by such real-work assessment prior to full registration
- Burnout is a serious problem that will be exacerbated by prolonged career duration and increasingly pressurised ‘front door’ specialty care. Measures to protect staff enthusiasm for their career and to support safe care delivery could include: sufficient staff to enable contracts for such doctors that routinely permit them to spend portions of their week away from the ‘front door’ e.g. in teaching roles; pairing of new junior and senior consultant posts, permitting a staged reduction in oncall activity for those over 55 linked to other roles such as managerial leadership roles and mentoring.
- It is important to recognise that many Trusts at present do not recognise the resource of people coming to the end of their career. Many give the ultimatum of full time work or none. Retired staff who wish to continue in some clinical activity are underutilised or worse still rejected and not used at all.
- There must be a seamless border between health and social care. At present the difference in funding agencies (in England) means there are barriers to care and employing staff of the right quality. Combined funding and training of care staff is essential to maintain a quality service. The present system is unsustainable in the long term.