Hospital Dr News

Double pressure of winter and workforce shortages highlighted in new report

Patient demand is strongly outstripping the supply of paediatric doctors as seasonal pressures increase in tandem with a rise in children’s emergency admissions.

That’s the key finding of a report by the Royal College of Paediatrics and Child Health (RCPCH), which reveals chronic understaffing in paediatric units across the UK.

The Workforce Briefing Winter 2018 report says the demand for paediatric consultants is 21% higher than 2017 levels, with clinics falling 850 consultants short of being able to provide a safe and sustainable service.

Meanwhile, with winter pressures hitting the service, paediatricians across the country are reporting that staff are being pulled from treating children to deliver care to adults.

The report also reveals:

  • Approximately 600 additional training posts each year for the next 5 years are needed to account for the growth in less than full time working, doctors taking on different roles and the high level of doctors dropping out of training altogether
  • The number of consultants working less than full time working (LTFT) in the UK has increased to 24.2% in 2017, up from 21.5% in 2015
  • The number of applicants to paediatric training from the European Economic Area (EEA) fell from 97 in 2015 to 41 in 2017; a 58% fall in two years
  • The consultant paediatric workforce in the UK grew from 3,996 in 2015 to 4,306 in 2017, representing a 7.8% rise in headcount but only 6.4% in terms of Whole Time Equivalents (WTE) since 2015. Meaning for every additional consultant the increase in whole time equivalent is only 0.77 WTE
  • Vacancy rates are increasing – 11.1% on tier 1 (junior) rotas and 14.6% on tier 2 (middle grade) rotas; in 2015, these were 6.3% and 13.7% respectively
  • Employment levels for Advanced Nurse Practitioners, Physician Associates and of trainee GPs working on junior paediatric rotas remain unchanged since 2015

Between 2013/14 and 2016/17 there was a 13% rise in children’s emergency admissions in both England and Scotland. In Wales, this number increased to 17%, which doctors say is placing unprecedented demand on services.

Professor Russell Viner, President of the Royal College of Paediatrics and Child Health, said: “Paediatrics is a family friendly specialty and we pride ourselves in having a work ethos that reflects that. This is one of the many reasons why so many of our doctors choose to work less than full time. Therefore, we must take this into account when we calculate the number of doctors needed to train and work in paediatrics.

“In reality, due to the modern style of working our doctors quite rightly favour, we have the equivalent of ¾ of each doctor employed, available to actually deliver care. That’s why we urgently need hundreds more, allowing paediatrics to be a modern career choice and one that fosters the health and wellbeing of our members and our patients.”

The college is calling on the Government to recruit and train an additional 600 paediatricians in the UK in each training year for the next five years.

It also wants an expansion in the Medical Training Initiative scheme, which allows doctors from outside the UK to train and develop their skills in the NHS.

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