Hospital Dr News

Consultant-delivered paediatric care increasing

One in five paediatric general consultants are permanently working resident shifts – a 67% increase from two years ago, research finds.

The survey by the Royal College of Paediatrics and Child Health (RCPCH) also reveals that 72% of clinical directors are concerned about how their service will cope in the next six months. Consultants are still having to provide unplanned cover in some units.

The survey, conducted in winter 2012/2013, is the fourth consecutive survey by the college and asks clinical directors of paediatric and neonatal units across the UK about compliance with European Working Time Regulations (EWTR), the extent of rota vacancies and gaps in paediatrics and the extent to which consultants are working resident shifts.

It reveals that there isa 7% vacancy rate on tier 1 (junior) rotas and 15% on tier 2 (middle grade) rotas; 60% of vacancies are filled by a locum; and overall vacancy rates have increased slightly in the last year, from 8% in 2011 to 11% in 2012.

Despite 99% of paediatric units adhering to the European Working Time Directive on paper, in practice 7% are still struggling to comply with the regulations. Nearly a third (32%) of units have resident shift working consultants.

Consultants provided unplanned cover in 37 of the responding units on average 1.8 times in the 4 weeks before the survey – a slight increase from the year before (1.6 times in 2011).

Dr Carol Ewing, workforce officer at the Royal College of Paediatrics and Child Health, said: “This annual data allows us to monitor the potential impact of service changes – including how it plays out across the countries in the UK. It’s encouraging that we’re seeing more doctors working resident shifts and that consultant delivered care is increasing. More units are complying in practice to European Working regulations and the majority of those that aren’t have plans to do so.”

The survey also reveals difference between UK countries. For example middle grade vacancies in Scotland are 23% (compared to 13% in Wales) and the proportion of units employing consultants working resident shifts is highest in England (34% of units) and lowest in Northern Ireland (17%).

Respondents were also asked about how they felt their service would cope in the future.  72% said they were either ‘very’ or ‘moderately’ concerned about how the service will cope in 6 months – compared to 76% last year and 86% in 2010. However, concern about the future was particularly high in Scotland, with 77% saying they were very or moderately concerned.

Ewing added: “We can’t ignore the concerns of doctors about the future sustainability of services. We know demand on services is increasing and in order to deliver the safest possible care for children, they need to have a senior and timely opinion. In the short term we need to ensure that we fill rota vacancies with appropriately qualified staff and in the long term look seriously at how more care can be delivered outside the hospital setting, and that expertise isn’t spread too thinly.”

Read more on the research.

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2 Responses to “Consultant-delivered paediatric care increasing”

  1. cd says:

    de facto working like a registrar for the entire career – the nhs really knows how to make the job attractive!

  2. Paedssho says:

    What a disaster for paediatrics, within a few years there will be terrible burnout. Why would you choose this over GP or other specialities.

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