Growing gaps in children’s doctor workforce revealed

New figures have been published by the Royal College of Paediatrics and Child Health (RCPCH) highlighting an urgent and growing problem in the paediatric workforce.

A study conducted by the RCPCH has found that almost one in five paediatric trainee positions are vacant although trainees themselves report high levels of enthusiasm for the speciality. This figure jumps to nearly one in four in more senior trainee positions, and almost 90 per cent of children’s units express concern over how they will cope over the next six months.

The annual survey involves a poll of clinical directors and workforce leads for paediatrics. This year the survey assessed units in England in relation to the impact of the 2016 Junior Doctors’ Contract. Of responders, 67 per cent said the contract is having a ‘negative impact’ on recruitment and retention.

One respondent said: “The impact of the contract is to make working hours and conditions less attractive and therefore likely to deter doctors from wanting to enter the speciality of paediatrics.”

The report also highlights the pressured workforce was stretched to breaking point through the winter of 2016, with Dr Simon Clark, RCPCH Officer for Workforce Planning, saying that ‘there is nothing so far to indicate 2017 will be any different’.

He said: “Large gaps in the paediatric workforce have a serious impact on doctors and vital hospital services. The shortages create very difficult working environments resulting in low morale amongst doctors and a lack of time for training and education. More senior doctors end up back-filling the gaps which, in turn also leads to cancelled services.”

Four out of every ten vacancies are being filled by locums, whose services are expensive in comparison to full time staff.

Clark said: “In an NHS, already stretched by budget cuts, the new figures shed further light on the pressures facing junior doctors. With more than 40 per cent of positions filled by expensive ‘locum’ temporary staff, this can only add more pressure to strained hospital budgets. Whilst recognising the need to curtail costs, the pay cap was a simplistic short-term approach to a complex problem; it does not go to the root of the problem and as such is working for nobody.

“These figures should act as a wakeup call for government to act now. Health Education England is responsible for training but has insufficient funding; NHS employers have insufficient funding; yet this problem is here and now. Efforts need to be coordinated across the now multiple components of a fragmented NHS. And with paediatric trainees excluded from the Home Office Shortage Occupation List in England, Wales and Northern Ireland, hospitals and doctors have been left in a difficult and unsustainable position.”

The RCPCH is calling for the government to take urgent action to fix the growing crisis through measures including: identifying a responsible body for workforce planning; centrally funding an increase in the number of paediatric trainee places to 465 in each training year for the next five years; committing to funding integrated primary/secondary care child health training; and immediately placing paediatrics on the shortage occupation list.

A Department of Health spokesperson said plans were in place to ensure there are enough doctors.

She said: “We are helping the NHS cope with rising patient demand — that's why there are 11,700 more doctors and 13,100 more nurses on our wards since 2010.”

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