Extended working

The College supports increased availability of consultant-delivered care, including at evenings and weekends, where there is potential to improve quality of care for patients with the appropriate staff and services in place. It is essential that an evidence-based approach to extended working is taken, recognising the importance of a multi-professional approach and an appropriately phased implementation. Extended working cannot be delivered without additional resource and collaboration between Government and clinicians is vital to build on the emerging evidence in this area.

Safe and sustainable staffing

The medical workforce faces a number of challenges and the College recognises the need for safe and sustainable staffing levels throughout the NHS. We need to ensure that we continue to recruit and retain a world class workforce to deliver the best possible patient care. The College is committed to working with Government and other allied organisations to address issues around recruitment and retention such as consultant vacancies, rota gaps and trainee attrition rates, as a matter of priority. We are also committed to working with partner organisations to promote innovative ways of working in the NHS. The roles of Physician Associates, Advanced Nurse Practitioners and other examples of physician extenders should be further examined to create a workforce fit for the future.

Political parties must commit to developing and implementing safe staffing levels for all professions within hospital settings, based upon best evidence, along with improved workforce planning which reassesses the size and structure of the consultant workforce taking account of such changes as the rise of part-time working, extended working, and the needs of an ageing population. The College supports the introduction of the Health and Care (Staffing) (Scotland) Act which gained Royal Assent on 6 June 2019. The Act is the first in the UK to set out requirements for safe staffing across both health and care services and most clinical professions.


The College is committed to promoting the highest clinical standards and implementation of robust, evidence-based medical practice. Standards must be measurable and the associated scrutiny proportionate in order to be effective. Improving patient flow across health and social care remains vital in this regard, both in terms of patient safety and quality improvement. Patients must be treated in the right place, and as quickly as possible. This requires the right numbers of staff and mix of skills across health and social care.