More Consultants Urgently Needed To Deliver Quality Care To Patients, Says BMA, UK

Main Category: Public Health
Article Date: 09 Apr 2008 - 2:00 PDT

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Many more hospital consultants are needed across the UK to maintain and improve the quality of care in the NHS, the BMA says in a new report1 "Enhancing quality: promoting consultant expansion across the NHS", published today (Wednesday 9 April). The BMA has called2 on the Health Secretary, Alan Johnson, to support its campaign for more consultants.

The BMA's consultants' committee has collected data from medical royal colleges and specialist societies showing a shortfall in the number of consultants required in many specialties including surgery, paediatrics, obstetrics and gynaecology, and cardiology. There is also mounting clinical evidence that in many areas of medical practice, there is a need to increase the number of consultants over and above the expansion that has already taken place in recent years, in order to ensure that patients receive the highest possible level of care, and that the NHS delivers its services in the most cost-effective way.

Based on the current figures, consultant expansion is most needed in the following specialties:

- Emergency medicine
- Trauma
- Intensive care
- Acute medicine
- Paediatrics
- Obstetrics

The BMA report cites a number of recent influential publications3 that show a clear link between consultant care and quality, and which demonstrate a need for more consultants in order to ensure patients receive the best possible care. Recent financial pressures and short-term planning have forced many NHS trusts to artificially freeze consultant recruitment and this is now beginning to impede improvements in the quality of care, the report says.

Dr Jonathan Fielden, chairman of the BMA's consultants' committee says: "Mounting evidence confirms that consultants bring the highest quality care to hospital patients. Consultants are the most senior and highly skilled doctors working in the hospital who provide leadership and innovation to pioneer and drive forward new treatments and models of care for patients. Fewer complications, better cancer detection rates and lower mortality rates are linked to consultant based services.

"The recent freeze on consultant recruitment has left the UK short of its most highly skilled doctors. Now that the NHS is in better financial health we would urge NHS trusts to expand the number of consultant posts, where they are needed in their hospitals, to give patients the highest quality care possible. Many fully trained doctors, who are ready to take up a consultant position, are waiting to compete for posts when they become available.

"The government has ambitious plans for the NHS, including shorter waits for treatment and more focus on prevention. Increasing the numbers of consultants available will enhance care and allow the NHS to flourish beyond its 60th birthday."

This BMA report will be continually updated as further evidence on workforce planning data and projections is published. The BMA has criticised the lack of clear workforce planning and the paucity of evidence-based planning in the NHS for many years.

Notes

1 The full report can be accessed on the BMA website here.

2 Copy of the BMA's letter to Alan Johnson is below:

The Rt Hon Alan Johnson MP
Secretary of State for Health
Richmond House
79 Whitehall
London
SW1A 2NS
7 April 2008

Dear Alan,

Enhancing Quality -The need for consultant expansion

It has become clear that many Trusts/NHS employers in the recent past have frozen or radically reduced consultant expansion in many specialities. Driven by financial pressures, which have now been largely resolved, this freeze has had clear implications for the quality of the service in some areas. The CCSC promotes excellence in clinical care, so this matter is an urgent concern for us.

There is increasing evidence to suggest that expansion of consultant numbers is required now in order to maintain and improve the quality of patient care. Research has shown that consultants provide the highest standards of care and value to the NHS and patients. For these reasons, we will be launching a campaign tomorrow to highlight the need for an immediate, focussed and planned expansion of consultant numbers in the UK where there is evidence for doing so. With the NHS, overall, enjoying a welcome financial surplus, we will be urging the Government and Trusts to seize this opportunity to solve the problem with a short-term programme of planned expansion. Clearly, longer term workforce needs will be further informed by whatever mechanisms are put in place by the Next Stage Review.

The accompanying document outlines the evidence that we have collated and I hope you find it interesting and helpful. I would like to stress that this campaign is not about increasing the numbers of doctors being trained and is not part of any wider campaign for increased supply of doctors. It is purely about pursuing a quality and safety agenda that consultant expansion will address.

I very much hope that the Government will be able to lend support to our campaign and I would be happy to discuss it further with you and your officials.

I have contacted NHS Employers and the Foundation Trust Network about progressing this issue at a local level.

Best wishes,

Dr Jonathan Fielden
Chairman, CCSC

3 Sources of evidence include:

- Academy of Royal Medical Colleges report on Acute Services

- NCEPOD publication: "Trauma: who cares?"
Other NCEPOD publications from the same site includes "Who Operates When"

- Wanless

- DH Workforce figures

http://www.bma.org.uk