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NHS will reach ‘breaking point’

Census reveals consultants are working harder than ever

Jo Carlowe

Friday, 10 December 2010

The NHS will reach ‘breaking point’ within the next few years – senior consultants have warned.

The results of the 2009 census of the Federation of the Royal Colleges of Physicians of the UK, published this week, reveals wide-spread concern among Britain’s specialists.

The census reveals that within their contracts, consultant physicians are working harder than ever, and 59.2% of consultants often or always have to work faster on ward rounds than recommended by the RCP.

The European Working Time Directive (EWTD) is also having a detrimental effect on the consultant workload, with 58.1% of consultants doing jobs that previously would have been done by junior doctors (up from 55.3% in 2008). Almost the same percentage report they have little or no time to support their trainees.

Some 93% of consultants say their Trusts are complying with the EWTD, but this does not necessarily mean they are compliant in practice, and other surveys from the College show that 40% of registrars reported working more than 50 hours a week.

Dr Andrew Goddard, RCP director of the medical workforce said that increasing hospital admissions, inflexibility of junior doctors’ hours due to the European Working Time Directive, and fewer new consultant posts being created all added ‘further stress to a system which may reach breaking point within the next few years’.

In 2009 the number of consultant posts created across the UK increased by 10.2%, which reflects the expansion in medical school places seen 15 years ago and the subsequent rise in numbers of physicians in training posts.

However, the RCP warns that the financial climate means that this is not likely to be continued, and there are growing fears that there will not be enough extra training posts in future for doctors who are currently in the last couple of years of training.

Dr Goddard explained: “We have already seen a drop in the number of new posts being advertised in 2010, and although we have enough doctors in training to develop a consultant delivered NHS, these doctors need to have jobs to go into if this service is to be realised.”

The RCP said it welcomed the fact that there had been increases since last year in acute medicine and geriatric medicine but warned that cardiology and gastroenterology had not increased at the same rate.

RCP president Sir Richard Thompson said: “Patients deserve better care at night and at weekends, delivered by consultant physicians, and this will only be achievable if we continue to increase the number of posts, particularly in acute medicine.”

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