The Scottish Academy of Medical Royal College and Faculties has published a report, which sets out and explains the factors combining to create an imbalance of workforce and workload. They argue that the situation is unsustainable.
The report is intended as a working document to which additions and retractions can be made as the workforce climate changes in a politically unpredictable time. Some of the report's key findings are as follows:
- There is a shortage of doctors in the UK. The supply of undergraduates is insufficient to meet the demand of Foundation and subsequent training places and, as a result, there are vacancies at consultant and General Practitioner (GP) principal/salaried GP level.
- The overall pattern of medical workforce in Scotland continues to be one of growth. Over the past 5 years, consultant numbers have increased by about 15 per cent.
- Senior posts are advertised but filling these is inconsistent. In 2018 38 per cent of advisory appointments panels were cancelled, 88 per cent of these were applicant related (no suitable applicant).
- Information Services Division (ISD) figures show in June 2018 there were 428.6 Whole Time Equivalent (WTE) medical consultant vacancies and of these 62 per cent have been vacant for greater than 6 months. Since June 2017 there has been an 18.8 per cent increase in the number of consultant posts vacant for greater than 6 months.
- UK and Scottish governments have attempted to redress this imbalance by increasing the number of undergraduate places in medical schools. Between 2015-16 and 2020-21 the annual intake of medical places in Scottish Universities has increased from 848 to 1038 (22 per cent increase) including Scotland’s first Graduate Entry Medical Programme. This is a long-term fix, however, as it will take a minimum of 9 years for these expansion posts to achieve the shortest UK postgraduate medical training programme completion (General Practice) whilst most programmes anticipate 12-14 years from starting medical school until certification of completion of training.
- There is a recorded reluctance of doctors in the European Economic Area (EEA) to come to the UK or stay here related to Brexit.
- Visa restrictions and loss of permit free training have been associated with a massive decline in numbers of non-EU doctors who gain entry to the UK for training.
- 33 per cent of the Consultant Physician workforce will reach planned retiral age (mean 63 years) in the next decade.
Professor Derek Bell, President of the Royal College of Physicians of Edinburgh and Chair of the Scottish Academy said:
This is an important report which identifies some of the biggest challenges facing the NHS in Scotland. But it is essential that as clinicians we offer solutions to some of those challenges, and I am pleased that this report does that.
In Scotland, we must ensure that we get it right on workforce planning. Recent research by the Scottish Academy shows an increase in the number of cancelled interview panels due to there being no applicants, no suitable applicants or applicants having withdrawn for consultant posts.
Therefore, the Scottish Academy supports a greater number of medical school places, and the creation of a strategic planning group which would oversee workforce planning in Scotland over the course of a 5-10 year cycle. The Scottish Academy also backs the expansion of the Medical Training Initiative and improved matching of candidates to hospitals in Scotland.
But more must be done to make our medical workforce feel valued, too. Work should be undertaken to ensure a positive working culture and environment for all medical staff, and the findings from the GMC Wellbeing Advisory Group should be fully implemented.
