When a GP is unable to reach a diagnosis or treat a condition, patients may be referred to a specialist consultant. In recent years, hospitals have struggled to recruit staff in various specialities and locations. According to the Nuffield Trust and the NHS workforce census, regional variation between 2015 and 2017 meant 21% of postgraduate places in the North East went unfilled, compared to 1% in London. A 2017-2018 census by the Royal College of Physicians found:
- 45% of advertised consultant posts went unfilled due to a lack of suitable applicants
- rota gaps occurred frequently or often, with significant patient safety issues in 20% of cases
On top of this, over the last decade, researchers and MPs have identified and debated a “weekend effect”, whereby staffing shortages at weekends may cause variations in the quality of care received by patients. This policy is a promise to provide uniform consultant supervision over the whole week.
This pledge is linked to the seven-day NHS plan. Under that plan, “access to consultant-led care” and a “time to first consultant review” no longer than 14 hours are listed among the top priorities. In April 2018, a self-evaluation survey encompassing 146 NHS acute trusts revealed that around 75% of hospitals are meeting these priority standards. In addition, the NHS is currently trialling a new framework to measure the success of seven-day services.
The NHS Long Term Plan includes various measures aimed at tackling staff shortages and improving consistency of patient care. Published in January 2019, many of its proposed initiatives remain at the early stages of implementation.
With 75% of acute trusts reporting attainment of consultant care targets, a new evaluation framework being rolled out, and a “comprehensive new workforce implementation plan” in the Long Term Plan, this is ‘in progress’. We’ll be looking for improvements in staffing levels and further quantifiable evidence of more consistent consultant supervision before we can move this to ‘done’. Follow this policy for updates.
Properly consult the details
- Shortage Occupation List – NHS Employers
- Recording 7DS webinar Workforce and Delivering 7 Day Services – NHS England
- Focus on physicians: 2017–18 census (UK consultants and higher specialty trainees) – Royal College of Physicians
- The NHS workforce in numbers – Nuffield Trust
- Managing NHS hospital consultants – National Audit Office
- NHS Long Term Plan – NHS