News

27.09.17

All is not lost

Source: NHE Sep/Oct 2017

During these turbulent times of Brexit, Professor Jane Dacre, president of the Royal College of Physicians (RCP), explains what government and trust managers can do to support international staff members.

As the NHS battens down the hatches for the winter, it is time to take stock of where we are with workforce issues. From the RCP’s point of view, not much has changed in the past year – we are still suffering from rota gaps. We are covering for colleagues, including acting down and finding workarounds for missing staff. For the last couple of years, two in five newly advertised consultant posts were unfilled, with little prospect of this situation improving. In our last survey of consultant physicians, nearly three-quarters were worried about the ability of their service to deliver safe patient care in the next 12 months. 

Over the past year, we have made our views clear with our report ‘Underdoctored, Underfunded and Overstretched’, and a letter to the prime minister pointing out the need for funding increases for both the NHS and social care. Regardless of the wave of like-minded organisations pointing out the same needs, the government does not appear to have heard, and we head into winter with the same concerns about insufficient staff and beds to provide high-quality, safe care. 

Brexit is the current preoccupation of the political class, and with it comes yet another threat to the NHS and patient care. Around 9% of doctors working in the NHS are from EU member states, and 21% of doctors who qualified overseas told the RCP recently that they plan to leave the UK in the next five years or are unsure of their plans. We may struggle to keep those people, and it will also be harder for the NHS to recruit new doctors from outside of the country with all the current uncertainty.  We will not have the necessary numbers of homegrown doctors to replace them for a long time, despite the welcome increase in medical student numbers. 

So, given this scenario, how are we going to cope? 

The RCP believes the government must provide strong and clear reassurance for doctors from EU member states that they will be able to remain in the UK when it leaves the EU. Effective systems also need to be in place to allow the NHS to continue to recruit doctors from overseas to meet rising demand. 

Recruiting international doctors to limited term training posts would be a win/win. We can provide high-quality medical training, and the international doctors contribute to the NHS during that training. 

Physicians are a pragmatic lot, and we will make the best of what we’ve got. This includes recognising and minimising burnout, increasing retention rates and trying to make existing posts more attractive. Health service managers can help by engaging with physicians at their trusts and involving them in health service planning, particularly for winter pressures and sustainability and transformation partnerships. 

Improving and maintaining morale will be vital; our trainees have come through one of the most bruising years ever, and any hospital manager should be making sure that there is a focus on supporting and valuing them. They are the frontline in patient care – evidence has shown, unsurprisingly, that a fulfilled workforce makes for better patient outcomes. 

Managers should establish robust induction programmes for trainees, monitoring workloads, supporting flexible working, and ensuring they have access to healthy food and drink outside catering hours. Managers could also support time for research, training and education. Asking a hard-pressed trust to do this may be tricky, but we now have very good evidence that departments that take part in research have better patient outcomes – a welcome and measurable benefit in this world of league tables. 

So all is not lost: there are many things we can do when we work together.

FOR MORE INFORMATION

W: www.rcplondon.ac.uk

Top Image: © LanceB

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