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Physicians see unpaid work hours increase

Consultant physicians are increasingly working above and beyond their contracted hours, a census reveals.

The study, by the Royal College of Physicians, suggests that the NHS is increasingly relying on consultants’ goodwill to deliver the service that patients need. It also shows that the amount of time consultant physicians have available to spend with trainees is decreasing.

Each week, consultants are working an extra 11.5% of their contracted hours for free. This figure jumps to 14% for doctors who work part-time. This ‘goodwill’ work accounts for the equivalent of 1,450 fulltime consultants, up by 205 compared to 2009.

The census also shows that some specialties are experiencing low levels of growth in consultant numbers.

Dr Andrew Goddard, director of the RCP’s medical workforce unit, said: “Consultants contracted hours have fallen significantly as hospitals strive to save £20 billion over the next three years. Despite this, consultants continue to work the hours they have done in previous years and so the amount of goodwill work is increasing year-on-year.”

Despite working longer hours, 52% of consultants say that time available to spend with trainees has reduced during the past three years. This change is due to consultants spending more time doing jobs that would previously have been done by a junior doctor, the study claims.

“This is really worrying as the training of future senior doctors is vital to high quality patient care in the NHS,” Goddard commented.

The Working Time Regulations continue to be seen as responsible for the disintegration of the clinical team and training. The 2010 census, in addition to showing that the majority of consultants work more than 48 hours a week, also shows that 30% of departments do not work EWTD compliant rotas in practice – despite 95% being compliant on paper. Significant concerns are expressed in the census about the impact of the regulations on training and patient care.

Three quarters of physicians report that their work pressure had increased. Two thirds of consultants reported their job always, often or sometimes “got them down”.

The RCP is concerned that this is affecting consultants’ career planning. Just over half of consultants currently intend to retire at 60 years of age or younger and the main reason given was pressure of work.

Overall, consultant expansion slowed in 2010 to 6.7% from 10.2% in 2009. Much of this was due to a large increase in numbers in cardiology and respiratory medicine, with little expansion across other medical specialties.

There was no growth in geriatric medicine, which is of particular concern considering the ageing population of the UK. Although, the RCP explained that it may due to a re-classification of geriatricians as stroke physicians.

Read the full study.

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One Response to “Physicians see unpaid work hours increase”

  1. Supersub says:

    For me, this highlights 2 current concerns:

    1. The final paragraph about missing geriatricians: Come on, when did you last hear one of them actually use the “G” word? It doesn’t surprise me that they’re now reclassifying themselves as “stroke physicians”, “movement disorder specialists” or “falls experts” – God forbid they’d actually want to look after old people.

    2. The creeping weekly hours of consultant physicians highlights the folly of Richard Thompson’s current RCP crusade to have 7-day a week consultant working on all medical wards. In college bulletins he frequently cites the “evidence” for this, which is usually based on surgical complications and peri-operative issues. Curiously, the RCP don’t shout about the numerous studies carried out in medical specialities that haven’t shown any impact.
    I’d suggest working patterns in busy acute hospitals across the UK are vastly different to the central London ivory towers.

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