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NHS is set to train 60% more consultants than needed by 2020

Authors: Ingrid Torjesen 

Publication date:  10 Feb 2012


The NHS will have 60% more consultants by 2020 if it continues to recruit and train hospital doctors at the rate it is doing now, a report from the Centre for Workforce Intelligence has estimated.

This scenario would provide the NHS with more fully trained hospital doctors than the current projected demand indicates, leaving many jobless and the money spent on their training wasted. Alternatively if all eligible doctors were given consultant posts, consultants’ salaries would cost the NHS £6bn a year in 2020—£2.2bn more than they cost in 2010.

The report, published this week, sets out the possible shape of the consultant workforce in 2020 and the opportunities and challenges that it presents to the medical profession, employers, and workforce planners.

It sets out seven possible scenarios and what they will mean, including no change to the current patterns of recruitment and deployment of trainees and doctors; a shift to general practice training to achieve a 50:50 ratio with hospital specialist training posts; and setting the consultant retirement age at 60 years. The report also models the implications of a consolidation period during which half of trainees work for a year at ST4 before completing their certificate of completion of training (CCT). Finally, it considers the effect of employers moving to a service where a consultant is in the vicinity at all times (or able to return to the hospital within a short timescale) and of introducing a multilevel career structure that recognises different levels of expertise, competence, and intensity of work.

The report says, “It is vital that an urgent debate now takes place, to reach agreement on what the system should do next. This should include discussion on the interplay between the current trainee workforce and future service requirements, in the context of what is needed to secure high-quality and highly productive care for patients.”

It adds: “We recognise that discussion of a potential oversupply may raise concerns for hospital-based specialty trainees, many with expectations of employment as a consultant as part of their career progression. It is essential that trainees have access to better information to enable them to make individual career choices. This will help secure future supply and a good return on investment, as well as help to maintain morale and motivation for current trainees who need to understand what their future is likely to hold.”

A report from the Centre for Workforce Intelligence last year, The Shape of the Medical Workforce: Informing Medical Specialty Training Numbers, concluded that the current growth in general practice was not strong enough to meet the predicted need and recommended that the system should reduce supply in a range of hospital based specialties (BMJ Careers, 1 Sep 2011, http://careers.bmj.com/careers/advice/view-article.html?id=20004422). It called for more evidence from commissioners and employers on service demand to help inform changes to specialty specific training.

Ingrid Torjesen news reporter BMJ Careers

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