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Three quarters of medical specialties in the NHS face shortages of doctors

The NHS is facing a staffing crisis with three quarters of medical specialities facing shortages of doctors going forward.

Figures obtained by the BMA show that training places across three in four medical specialties in England went unfilled last year, with many specialties experiencing recruitment shortfalls year on year.

The figures, obtained through FoI requests, show that at each stage of the training process, from applications to medical school, to training as a specialist, fewer people are choosing to enter medicine or remain in the NHS as doctors.

The new analysis of vacancy rates shows that:

  • The number of applications to UK medical schools has decreased for the third year in a row and by more than 13% since 2013;
  • Applications to the foundation programme (the first year of doctors’ training following medical school) are decreasing, with 2016 having the lowest number of applicants in recent years;
  • Applications to specialty training are in decline;
  • Fewer trainees are moving directly in specialty training and instead choosing to take a career break.

The areas of medicine with the lowest fill rates include Psychiatry, Genito-Urinary Medicine (GUM), and Emergency Medicine.

There are also significant geographical variations in vacancy rates, with northern regions bearing the brunt of the recruitment crisis.

The North of England (North East, North West, Yorkshire and the Humber) experienced the lowest fill rates in the country; and, the East of England and West Midlands have seen a steady decrease in fill rates since 2013 signalling a worsening problem with recruitment.

There are a number of reasons for this continuing decline, says the BMA. Although medicine remains competitive, rising tuition fees and higher student debt could be a major factor in the decline in applications.

For many, student debt can exceed £80,000 (including maintenance) and medical graduates on an average salary are unlikely to repay their SLC (Student Loans Company) debt in full.

Rising workloads, worsening morale, the NHS pay cap which has seen doctors’ pay fall by up to 17% in recent years, could also be factors.

The BMA is calling for rota gaps to be filled and greater career flexibility, including greater access to part time working, and more flexibility around shift patterns, out of hours working and locum working.

Improved health and wellbeing services are also needed, to help NHS staff when they are under pressure or struggling to cope with the demands of the service.

Dr Chaand Nagpaul, BMA council chair, said: “It is deeply concerning that we are seeing a drop off at each stage of doctors’ training, we have to ask why some, who have spent many years training to become a doctor, are deciding not to continue in the profession.

“With the NHS at breaking point, if the government doesn’t get to grips with this workforce crisis, the NHS will struggle to attract and retain highly trained staff, and patient care will suffer as a result. Ignoring this staffing crisis creates to a vicious circle, compound existing problems, adding to pressure on existing staff making them more likely to leave.”

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