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Outmoded workforce planning poses risk to child health

More paediatric trainees needed, says Royal College

Jo Carlowe

Monday, 07 March 2016

Out-of-date workforce planning poses a risk to child health, lead paediatricians have warned. 

The Royal College of Paediatrics and Child Health (RCPCH) has today published its workforce survey, MMC Cohort Study, which reveals that just 38% of doctors who began training in paediatrics in 2007 and still in the scheme in 2014, had reached the final two years of training. 

With gaps on trainee rotas already hard to fill, the RCPCH warns that without an increase in the number of doctors coming into the specialty, there will not be enough to safely staff children’s hospital services.

The findings reveal that increasing numbers of trainee paediatricians opt to take time out of clinical training to engage in research, whilst others embrace opportunities to share parental leave. As a result, the RCPCH is calling on the government to adapt workforce planning to bring children’s services “in line with 21st century working realities”.

The fourth part of the MMC Cohort Study which is completed by paediatric trainees in their seventh year of the training programme, found that:

  • 38% of trainees had progressed through the training programme as far as expected if they were full time and had no time out of the programme i.e. reaching the final two years of the training programme or had finished the programme completely. The remainder were still working their way through the programme.
  • Overall 54% of respondents took a period of time out training in the previous two years (59% of women and 36% of men)
  • 26% of all trainees took time out for parental leave in the previous two years
  • 19% took time out for academic activities
  • The proportion of the cohort working less than full time increased to 31% from 22% and almost half would like to work less than full time on completion of training (48%)
  • An estimated 3.6% of trainees leave the training scheme each year

Commenting Dr Simon Clark, Workforce Officer for the RCPCH said: “We are seeing a clear shift in the way our doctors want to train with many spending time with a family of their own or undertaking research to improve the care delivered to children. This isn’t surprising given the family centred nature of paediatrics.

“Adaptations to workforce planning, such as an increase in the number of paediatric trainees coming into the training programme, are necessary to complement these changing behaviours and attitudes. Without them, there is a risk there won’t be enough paediatricians to staff children’s services and this could compromise patient care.”

To address some of the issues highlighted by the MMC Cohort Study, the Royal College of Paediatrics and Child Health has made a series of recommendations. These include:

  • Calling on Government to increase the number of paediatric trainees
  • Calling on paediatric tutors and programme directors to work closely with Trusts to ensure rotas are designed to allow trainees to attend teaching
  • Calling on Health Education England (HEE), which funds the paediatric training programme, and workforce planning bodies in Scotland, Wales and Northern Ireland to collaborate with the RCPCH to ensure that training places are mapped more closely to consultant opportunities and demand
  • A commitment by the RCPCH to ensure all data relating to less than full time working, out of funded programme activity and attrition, are highlighted to relevant training bodies (HEE in England, deaneries and national planning bodies in Scotland, Wales and Northern Ireland)
  • Drawing the attention of HEE and the National Institute for Health Research (NIHR) to the lack of confidence amongst academic trainees in obtaining posts

Dr Simon Clark concluded: “For paediatrics to thrive as a specialty, it is crucial that Government and HEE heed these findings and adapt to contemporaneous requirements. The RCPCH will play its part by conducting a follow-up survey two years from now – making it nine years after the cohort began training - to ensure as detailed a picture as possible is obtained in order to help attract, and retain doctors to the speciality.”

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