Posts Tagged ‘Academic posts’

Rise in clinical lecturers but fears over teaching

By Mike Broad - 31st May 2011 10:49 am

Clinical lecturer numbers continues to increase, new figures suggest.

Data published by the Medical Schools Council (MSC) shows a 2% increase in the number of clinical professors, senior lecturers and lecturers during 2009-10.

Medical schools are encouraged by the increase - to a total of 3175 full time equivalents - for the fourth consecutive year. However, the numbers are still 10% lower than in 2000.

Clinical lecturer numbers have risen by 12% since 2009, and a 36% increase since 2006, suggesting that sustained investment into early career grades is enabling more to enter clinical academia - largely funded by the National Institute of Health Research.

Women continue to be under-represented in senior clinical academic grades, making up only 14% of all clinical professors.

The workforce is also getting older with 63% of clinical academics aged over 46, compared with 53% in 2004.

Prof Tony Weetman, chair of MSC, said: “The increase in the number of clinical academics is encouraging, but the challenges in delivering high quality research and teaching, alongside clinical service to the NHS, will inevitably be compounded by budget cuts to both health and higher education. Furthermore, unless the level of recruitment of new clinical academics is sustained or increased, expertise and leadership in clinical academia will be lost through retirement.

“By continuing to work with the NHS, funding councils, and medical charities, we can protect the education of future generations of doctors and improve patient care through innovative discoveries in health and healthcare.”

The report expresses concerns over the low clinical academic staffing levels in some specialties, including anaesthetics, pathology, psychiatry and public health.

Professor Michael Rees, co-chair of the BMA’s medical academic staff committee, recently warned the Conference of Medical Academic Representatives that while the number of medical academics has declined in the past 10 years, medical student numbers have doubled.

He said a shortage of medical academics is threatening to undermine the UK’s vital clinical research base and leave some medical schools struggling to teach their students.

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Let’s reverse the decline of academic medicine

By Professor Michael Rees, co-chair of the BMA’s medical academic staff committee - 20th May 2011 3:13 pm

Professor Michael Rees, co-chair of the BMA’s medical academic staff committee, addressed the Conference of Medical Academic Representatives earlier today. Here’s his full speech:

In dealing with a new government in a time of austerity we should have expected a large number of changes and new directions for medical academia. And this has certainly proved to be the case.

Our first priority over the last year has been to remind the government of the importance of medical academics in the viability of our science research and teaching base in the UK. I believe this message has been heard. What clearly has not been heard is the ability to make this funding effective in the light of changes proposed in the new Health and Social Care Bill.

Changes to the funding of our universities, modifications to the funding of clinical teaching via SIFT, and the new Health and Social Care Bill in England all threaten to destabilise further medical academia in this country and with it the valuable contribution medical academics make to UK plc via the NHS, our universities and via industry.

We need to remind government that under the last administration there was a dramatic erosion of the medical academic base in this country and that this should not be repeated. Indeed, it should be reversed.

Universities across the UK are undergoing profound change. In the future all, but especially those in England, will depend increasingly on the income from student fees. The rise in fees could make it more difficult to achieve a medical student population which better reflects society. It will also bring into sharp focus the quality of education provided by our medical schools.

If the government continues to press ahead with its plans it must, as well as addressing the issues around widening access, seek to redress the balance within universities between the value placed on research and the value placed on teaching, and consequently the value placed on those undertaking each of these tasks.

The GMC is beginning to take on board the need to ensure resources for education follow the student. In the past 15 years, the number of medical academics has halved while the number of students entering medical school each year has almost doubled. Our Medical academic base is now barely able to sustain the increased number of medical students.

The temptation in this time of financial crisis might be for universities to shed further medical academic staff. This would be a grave mistake. It would result in a worse student experience at a time of rising fees and further undermine our research base. Taking the temperature of current university intentions, however, we may find ourselves fighting possible significant redundancies over the next years. We need to ensure this is not the case. Not just for the medical academics we represent, but for the current and future generations of medical students, and the patients they will serve.

During the last 15 years, because of the reductions in the medical academic base, medical schools have looked increasingly to the NHS to provide clinical teaching. This option is now under threat in part through changes to the way such work is funded, but also through increased pressure from NHS employers on consultants supporting professional activities.

The proposed changes in the way funding for clinical teaching is allocated will add to the mix of adverse effects I have already noted. These changes will impact most significantly on the traditional urban medical schools. These are schools with the proven research track records. If money follows the student out of the institutions jobs will be lost - academic jobs that are unlikely to be replaced in hard-pressed district general hospitals.

MASC has taken a great deal of time to examine the effects on teaching and research of the Health and Social Care Bill. Along with the rest of the BMA, and indeed the whole profession, we have concerns about the make-up of commissioning bodies and their oversight and the national level regulation of many of the proposed provisions. We also have major concerns about the impact of the ‘any willing provider policy’ on the provision of research and education facilities locally.

In some ways, what was of greatest concern for MASC was that the Bill made little mention of research and no mention of medical education. It betrays a fundamental misunderstanding of how education and training, research and the provision of healthcare services are inextricably linked in the UK and how all three strands can work together co-operatively to their mutual benefit and to the benefit of patients and the public.

We, along with many others, lobbied strongly to preserve and enhance the funding for medical research. This is a message that we had believed has been listened to in England and in the devolved nations. Given the preservation of much of the funding for scientific research in the Comprehensive Spending Review and the priority given to medical research by BIS and in the Health White Paper it is surprising that there is such lack of attention in the Health and Social Care bill to ensure that research and innovation is a cornerstone of the NHS.

We believe that commissioning consortia should look to have clinical academic input when dealing with issues of quality innovation and development, where they arise.

The research and development functions of PCTs must be preserved and have a home, as must the staff that support such functions. It is therefore essential that consortia take into account the place of these functions when they are making their decisions. We do not want to see medical education reduced to issues of price and we do not want to see research falter and fail because no one on these consortia has the knowledge to deal with these issues.

The government has issued policy on training in its white paper Developing the Healthcare Workforce. Like many parts of the profession, MASC had grave concerns about the effects of the policies in this paper, and the damage that could be done to hard-won structures designed to support our trainees following the MTAS debacle. Our starting principle is that, with the current level of spending, the current system of medical education and training broadly works. This does not mean that we think it is perfect or lacking the possibility of improvement, but it delivers the education and training medical students and doctors need as well as the doctors required to support the UK’s healthcare systems. Hence, any changes proposed need to demonstrably improve on the current system.

We are therefore concerned that the provisions in this white paper will sweep away structures that work. That does not mean we are against change but as local employers unavoidably lack a broad overview of workforce requirements, we believe that the management and planning of the medical workforce can only be done at minimum at a national level.

Hence, we cannot support the implications in the education white paper that funding for workforce development and training for medicine will be devolved to local level.

We had heard, for example, that universities were to be excluded from local skills networks, this is an extremely bad idea as universities are central to the provision of innovation and educational excellence and the development of medical research, changing this is a measure which we hope is part of the pause and listening exercise.

MASC has also been very busy in negotiation and I am very pleased to announce that this year we have been able to agree new guidance on pay scales for clinical academics below the grade of consultant. This means that many doctors in training and SAS grade academics should have an improvement in their pay this year. It was vital that this happened because we have to maintain the attractiveness of clinical academic training.

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Academic shortages risk education and research

By Mike Broad - 11:31 am

A shortage of medical academics is threatening to undermine the UK’s vital clinical research base and leave some medical schools struggling to teach their students, a leading medical academic says.

Professor Michael Rees, co-chair of the BMA’s medical academic staff committee, warned delegates at the Conference of Medical Academic Representatives that while the number of medical academics has declined in the past 10 years, medical student numbers have doubled.

Prof Rees said: “Our medical academic base is now barely able to sustain the increased number of medical students. The temptation in this time of financial crisis might be for universities to shed further medical academic staff. This would be a grave mistake. It would result in a worse student experience at a time of rising fees, and further undermine our research base.”

He said the likelihood of further redundancies in academic staff over the next few years could make the situation worse “not just for the medical academics we represent, but for the current and future generations of medical students and the patients they will serve”.

The number of medical academics has fallen to around 3,100 according to the latest figures from the Medical Schools Council. This is down from the estimated 4,963 in 2000. The number of medical students entering medical school has increased by 43% since 2000, up from 5,610 to 8,009 in 2010.

Rees also warned the conference that changes to funding threaten to further undermine education and research.

“Changes to the funding of our universities, modifications to the funding of clinical teaching and the new Health and Social Care Bill in England all threaten to destabilise further medical academia in this country and with it the valuable contribution medical academics make to UK, through the NHS, our universities and industry,” he said.

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Academics must protect their jobs from cuts

By Francesca Robinson - 28th January 2010 9:22 am

Medical academics are being advised to have proper job plans and regular appraisal in order to protect their jobs from funding cuts.  

“We are anticipating a very tough time ahead for many medical schools and academics because of the current economic crisis,” warned the BMA’s medical academic staff committee co-chair Professor Michael Rees.

At the beginning of January Imperial College London made 21 medical academics redundant as part of a restructuring to tackle a £28m deficit. 

Another 14 academics are currently facing redundancy at the Institute of Psychiatry at King’s College London, which has a £5m hole in its budget.

“There is certainly an increase in the generalised threat to academic employment. I can’t quantify the level of that threat but there certainly is a threat,” said Rees.

A three-pronged funding squeeze is putting a strain on medical school budgets. All university budgets will be affected by a £400m funding cut in 2010-11, announced by business, innovation and skills secretary Lord Mandelson in December. Some medical schools will also lose money because of a redistribution of funds following the Research Assessment Exercise (RAE) and a review of the Multi Professional Education and Training (MPET) levy currently being conducted by the Department of Health.

The MPET review is looking to more fairly distribute funds for clinical training. The MPET levy is likely to be replaced with a tariff-based system where the funding follows the student or the trainee.

The BMA fears that this will not equate to posts following the students and could result in academic jobs being axed. Traditional medical schools, particularly those in London, which employ more staff than the newer medical schools, are likely to suffer most from any reallocation of funds.

“The threatened redundancies at the Institute of Psychiatry at King’s are particularly unfortunate because it’s a high flying department, was shown to be a very productive department in the RAE and is an important site for academic training,” said Rees.

He added that the chances of academics finding work by either moving to other universities or NHS jobs were very slim in the current economic climate.

The BMA is publishing new job planning guidance for academics, which will advise them to ensure they have a job plan which clarifies the work they do. They should undergo regular appraisals and ensure they know exactly where the funding for their joint contracts between universities and the NHS is coming from. They are also being advised to avoid any dubious fixed term contracts and to carefully check terms and conditions before accepting any job.

A spokeswoman for Imperial College said they had now agreed a new structure for their Faculty of Medicine that would safeguard their internationally leading research and education activities, and address a significant projected deficit of 28.7m by 2013/14. The deficit was caused by rising salary costs, a cut in central funding and “the difficult economic climate that universities are now operating in”.

“Staff identified as holding posts that were at risk were fully consulted during the process, and every effort was made to avoid compulsory redundancies. In total, 21 academic members of staff and 27 support staff have regretfully been made redundant,” she said.

Read a blog on the future of medical research sector.

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A plan for rescuing the UK’s medical research sector

By Mike Broad - 17th January 2010 11:26 am

Academy of Medical Sciences (AMS) has contacted the major political parties ahead of the general election to outline its vision for UK medical science.

It claims that groundbreaking advances in medical science offer the next government an unprecedented opportunity to reinvigorate the economy, to enhance the productivity of the NHS and to make public services more cost-effective.

Professor Sir John Bell, president of the AMS, said: “We believe that making medical science a central pillar of government policy will produce a flourishing UK economy and alleviate the burden of ill health on patients and public services.”

The UK has historically supported vibrant research-intensive medical science industries and internationally renowned academic medical research centres as part of its knowledge economy. It generates over 10% of the world’s clinical science and health research outputs and has created nearly a quarter of the world’s top 100 medicines.

Historically, both larger pharmaceutical and smaller biotechnology companies have flourished in the UK, where the availability of skilled researchers and a unified health system present a significant advantage for both basic and clinical research.

However, the report warns that the future of commercial medical research in the UK is under serious threat and much activity has already moved abroad. It says that between 2000 and 2006, the proportion of the world’s clinical trials conducted in the UK fell from 6% to 2%, in part because of more attractive regulation and incentives elsewhere.

“The UK’s competitors, including the USA, China, Canada and Singapore, have begun to realise the huge potential of medical research to both their economies and public services, and are implementing robust policies to grow this crucial sector. Decisive action is needed now to attract and anchor increasingly mobile medical researchers and life science industries in the UK,” it urges.  

The report sets out seven important challenges that must be tackled to reap the rewards from recent investment in medical science:

1. To benefit patients the NHS must become a willing participant in health research

A unified health system offers a unique advantage as a resource for medical research and innovation. High-quality research should be an integral component of the next NHS Operating

Framework; it should be an outcome on which the performance of NHS trusts is measured; and should be a central goal of any system for electronic health records.

2. The regulatory environment is driving medical science abroad

The combined regulatory requirements of the EU Clinical Trials Directive, European Medicines Agency, Medicine and Healthcare products Regulatory Agency, NHS ethics committees, R&D offices in NHS trusts, the National Information Governance Board and other agencies are stifling R&D in both the private and public sector.

Regulation must be proportionate to the risks involved. We should lead the world in creating a proportionate, risk-based regulatory framework for medical research involving patients, which is fit for purpose and informed by an independent review of existing regulations.

3. Innovative incentives must firmly root the medical science industries in the UK

Investment in novel therapeutics, diagnostics and devices, should be encouraged through flexible pricing, public procurement strategies, tax incentives and new pathways to support uptake and access to medicines. Alliances should also be encouraged between the NHS, universities and industry to share the risks and rewards of new products.

4. Publicly funded health research needs further coordination

Maintaining a ring fence around the budgets held by the Medical Research Council and the National Institute for Health Research would help, as would better coordination of their work.

5. Public health challenges must become cross-departmental priorities

Effective public health research and delivery can provide enormous economic and health benefits to the UK, but are hindered by under-investment and fragmented responsibility and oversight. The UK lacks the necessary co-ordination to tackle health inequalities and major public health challenges such as obesity, infectious pandemics, ageing, alcohol and climate change.

Budgets and strategies need to be established for specific public health priorities that fund research and service delivery across government departments.  

6.  Health research should be used as a driver of foreign policy and international development

Medical science can underpin cost effective international development measures that enable poorer countries to address their health needs and help to reduce health and security threats to the UK.

Greater efforts are made by the government to support indigenous research capacity in resource-poor countries.

7. We must grow and sustain its world-class biomedical workforce

There needs to be better coordination of efforts to build biomedical research capacity, focusing on developing interdisciplinary researchers and workers in key areas of current and future need. Biomedical research training for doctors needs to be supported and the mobility of researchers across academic, industry and healthcare sectors incentivised.

The report provides a much needed rallying cry for academic medicine during a challenging time. The big medical research centres are under pressure to make cuts, and both Kings College and Imperial have made researchers redundant recently.

Earlier this year a study revealed that, while overall staff numbers have stabilised, the workforce profile is ageing, top heavy and male dominated. Certain specialties that were previous academic strongholds have also been decimated.

Sir John said: “A government that unites researchers from across academia, the NHS, industry and the charitable sector, and engages with patients and the public, can make significant progress towards addressing these challenges within five years.

“Bold leadership is needed to ensure that the UK can continue to generate world class medical science that is translated into health and wealth benefits. Generous donations to medical research charities and enthusiastic backing of the NHS indicate strong UK public support for medical science. The next government must respond to this chorus of public approval by placing medical science at the heart of its agenda.” 

Read an article on how to get into medical research.

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Funding review threatens training posts

By Francesca Robinson - 18th November 2009 9:25 pm

A shake up in the way clinical training is funded by the NHS could result in trusts axing junior doctor and medical academic posts, the BMA fears.

The proposed changes could destabilise the NHS, claims junior doctors’ committee (JDC) vice chair Dr Tom Dolphin.

The Department of Health has been reviewing education funding in England because it is no longer considered to be fairly distributed between different organisations or professions. It believes the current system also fails to reward quality in education.

The current Multi-Professional Education and Training levy (MPET) is likely to be replaced with a tariff-based system where the funding follows the student or the trainee.

There are proposals to cut the money paid to trusts for the provision of undergraduate medical education. Current funding of between £10,000 and £100,000 a year for each student is to be replaced with a flat rate of £40,000.

Funding that trusts receive for the salaries of junior doctors is also likely to be re-allocated to fund only the education and training element of posts and not the service contribution.

Trusts currently receive 100% funding from the DH for the salaries of foundation doctors but this is to be cut to 80%. Funding for ST1, ST2 and ST3 doctors is to be cut to 40% and for ST4 doctors to 25%.

Savings from these changes are intended to free up money for training nurses, midwives and other healthcare professionals. Trusts will receive a placement allocation of £90 per student week for this group.

A decision by the DH on the proposed changes is imminent and the new system is likely to be run as a ‘shadow’ programme from April so that trusts can prepare for the shift in funding over a transition period of up to four years.

Dolphin said they were concerned about the speed of the review. He said: “We are deeply concerned that the massive shifts in funding that will occur could result in the loss of many medical academic posts. This means that there will be insufficient staff to train the next generation of doctors let alone carry out research.

“We’re talking about changing the flow of several billion pounds through the NHS, and we can’t be sure that at the end of it employers are still going to find it worth their while to have junior doctors.”

He said the JDC was not satisfied that the impact of the review has been thought through properly and they did not feel the DH had any clear idea how they will measure quality of training even though the changes are designed to shift money in order to incentivise and reward high quality training.

“Consultants and GPs don’t grow on trees and the Department of Health needs to be very careful that they don’t end up making the training of doctors so unattractive, or the funding system so unstable, that hospitals will no longer want to do it.”

NHS Employers head of programmes David Grantham admitted there would be “pain” for some trusts which had been receiving thousands of pounds more for training doctors than others.

But he said: “I don’t think there is anything here for junior doctors to worry about. This is about a redistribution of funding rather than an attempt to cut junior doctor training posts. Some trusts will lose money but others will gain. It might mean that some hospitals will be willing to lose a few training posts but others might be able to expand their training.”

A spokesman for Medical Education England, which has been providing independent expert advice on the review, said: “We are supportive of moves to tackle historical difficulties in this area and of work to ensure greater transparency about funding for clinical training.

“However, we have expressed concern during this ongoing debate about any potential impact, whether intended or unintended. We believe that any proposed changes should be piloted and introduced slowly, with the full engagement and support of appropriate stakeholders and backed by evidence where it exists.”

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