Northern Ireland Assembly election asks published

Ahead of the Northern Ireland Assembly election on 5 May, the Royal College of Physicians of Edinburgh has joined with our sister Colleges in London and Glasgow to publish a new call to action. The full document can be read below. Together, we are calling for:

• an updated NHS workforce plan for Northern Ireland, focused on recruitment and retention;
• a cross-government plan to tackle ill health and inequalities;
• a pandemic recovery plan that tackles growing waiting lists and diagnostic delays.

Reflecting the urgency of these shared priorities, the three UK Royal Colleges of Physicians have taken a collaborative approach as we urge the next Northern Ireland executive to deliver a multi-year budget for the health and care service while prioritising the wellbeing of the health and social care workforce and taking a strategic approach to workforce planning and data collection. We are also calling on the next health minister to expand the number of medical students in Northern Ireland and recruit specialty and overseas doctors to reduce rota gaps. Other recommendations include:

• introduce integrated care systems as soon as possible;
• implement existing plans and strategies;
• prioritise digital technology and regional working;
• develop high quality patient-reported performance measures;
• invest in specialist, clinically led multidisciplinary weight management services.

Figures from June 2021 revealed that 184,000 people in Northern Ireland were waiting more than a year for a first hospital outpatient appointment. A further 66,000 patients were waiting more than a year for surgery or another form of treatment in hospital, while 48,000 were waiting more than six months for a hospital appointment after being referred by their doctor for further tests.

This collaborative action plan comes as the three colleges publish joint census data for Northern Ireland that shows 40% of consultant physicians in Northern Ireland will reach retirement age in the next decade, while more than half (57%) of advertised consultant physician posts in Northern Ireland were not filled this year. Senior trainee physicians are also stretched, with almost a third (32%) reporting they work excessive hours and almost a quarter (24%) saying they have an excessive workload. In addition, the census revealed that:

• Over a quarter (26%) of senior trainees have felt undermined at work in the past year;
• Only a third (34%) of senior trainees feel valued by their trust or hospital managers;
• Almost half (46%) of senior trainees regularly feel emotionally drained at work;
• Only one in five (21%) senior trainees have protected time for administrative tasks;
• Less than a quarter (23%) have access to catering facilities in hospital with hot food provided 7am–7pm.

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh said:

A&E care services are currently under extreme pressure, and have been for some time, particularly as a result of the COVID-19 pandemic. Regrettably, the current challenges in delivering A&E care services in Northern Ireland negatively impacts on the ability of many medical specialities to effectively and efficiently provide their usual level of elective care.

It is vital that these issues are addressed both for the good of patients in Northern Ireland, and for the physical and mental wellbeing of our healthcare workers. Efforts must continue to recruit and retain a world-class workforce to deliver the best possible patient care.

Dr Andrew Goddard, president of the Royal College of Physicians (London) said:

The past 2 years have been the most difficult in NHS history. We can expect to see the long-term effect of the COVID-19 pandemic on health, education, income and wellbeing outcomes in the coming years. The next Northern Ireland executive has a chance to make a real difference by prioritising a cross-government approach to tackling inequalities. Better health leads to a better quality of life.

It is no secret that there is an NHS workforce crisis across the UK. The next Northern Ireland executive should take swift and decisive action to recruit and retain more doctors, nurses and allied health professionals. Northern Ireland is a wonderful place to work, but too often rota gaps and an excessive workload are leading to staff burnout and low morale. A fresh approach is needed.

 Mr Michael McKirdy, president of the Royal College of Physicians and Surgeons of Glasgow said:

The future of healthcare is a very important matter in the 2022 Northern Ireland Assembly elections. The three UK Royal Colleges of Physicians’ action plan outlines key issues for voters and candidates to consider.

We urge all involved to acknowledge the importance of recruitment and retention for the healthcare workforce in Northern Ireland, particularly in the recovery of services from the COVID-19 pandemic. Improving access to care, and shorter waiting times, depends on staff being available and we know that good healthcare improves lives and reduces inequality across society.