Shortage of oncologists is hampering cancer care

Author: Ingrid Torjesen
Shortage of oncologists is hampering cancer care

A staffing crisis in oncology threatens to hamper the roll out of cutting-edge life-saving interventions – such as immunotherapy drugs and high energy proton beam radiotherapy –The Royal College of Radiologists (RCR) says.

Its Clinical Oncology UK Workforce Census Report 2018 reveals that the UK’s clinical oncology workforce is currently 18% understaffed and that this shortfall is predicted to grow to at least 22% by 2023.

The report shows there were 922 clinical oncology consultants working across the UK’s 62 cancer centres in 2018. This equates to 863 doctors working full-time – an increase of 46 full-time consultants compared to 2017. 

However, although the number of consultant clinical oncologists is growing, it is not keeping pace with needs of hospitals and patients as demand for radiotherapy and chemotherapy services are rising by 2% and 4% per year respectively.

As a result, the UK is now short of at least 184 clinical oncologists – the minimum number needed to fill vacancies and cover the extra hours doctors are working to treat patients. This compares to shortfalls of 144 doctors in 2017 and 78 in 2016. 

While 53 new UK-qualified consultants are set to enter the workforce in 2019, these new recruits will not be enough to fill the 70 posts left empty in 2018.

With not enough consultant clinical oncologists being trained, cancer centres are reporting increasing difficulties with recruitment.

Last year, there were 70 funded vacancies for clinical oncology consultants – more than double the 33 empty posts in 2013.

One cancer centre admitted to having no new job applicants since 2015, stating “the situation is dire”, and others stated they could not fund, let alone recruit, much-needed extra posts.

Meanwhile, attempts to recruit from abroad have been patchy, with only five centres successfully hiring overseas doctors last year. Reported issues included not having the resources to support consultants trained overseas, as well as practical problems with remote job interviews and needing more hospital HR expertise to deal with complex overseas recruitment issues.   

The RCR’s workforce report estimates that by 2023, the NHS will need a bare minimum of 1,214 full-time clinical oncology consultants to look after cancer patients. However, based on current trends, there will only be 942, meaning the UK will be 22% short.

The report forecasts that we can close the gap between supply and demand if the number of trainee placements is doubled – from 64 placements a year to around 138 – and it would then still take another decade before consultant numbers catch up.

Dr Tom Roques, the RCR’s medical director of professional practice for clinical oncology and lead author of the report, said: “Today’s RCR workforce figures and forecasts show our cancer hospitals under immense strain – some centres have seen a reduction or stall in consultant numbers and many are desperate but failing to recruit, predominantly because we do not have enough consultants in training.

“We predict that by 2023 the workforce will be more than 20% short-staffed, and we are really concerned that it is people with cancer who will suffer, with less clinical oncologists’ expert time to go around.

“Central and devolved governments and their related health workforce agencies must face up to these findings and act on them now to boost clinical oncologist numbers, as well as improving working practices to help keep them in the NHS, for the sake of all current and future cancer patients.”