Shortage of surgeons might threaten NHS targets

BMJ 2005; 330 doi: (Published 17 February 2005) Cite this as: BMJ 2005;330:379
  1. Zosia Kmietowicz
  1. London

    An additional 3000 surgeons are needed for England and Wales over the next five years if the government's targets for the NHS are to be fulfilled by 2010, says a new report by the Royal College of Surgeons of England.

    Increasing subspecialisation among surgeons, the requirement for trainees to spend more time in training rather than providing a service, and shorter working hours means that more consultants are required to provide training and ensure that service needs are met.

    In 2001 the college estimated that an extra 1454 surgeons would be needed to meet waiting times targets set out in the 2000 NHS Plan.

    Now, however, the college has revised this figure upwards. Because of changes in working patterns, more surgeons taking early retirement, and a desire by the government to create a consultant led service, an additional 2760 surgeons will be required by 2010, says the college in its new report.

    A shortage of surgeons could prevent the NHS in England and Wales from meeting its targets for 2010


    The college says that so far the only target outlined in the NHS Plan that has been met is to increase the number of medical students across the United Kingdom by 1000 by 2002. Promises to appoint an extra 7500 consultants in England and 1000 specialist registrars by 2004 have been broken.

    Figures set by specialist associations in 2004 show that a total of 7974 consultant surgeons are required for England and Wales if they are to deliver the service that the NHS is demanding of them. However, currently there are only 5214 consultant surgeons, leaving a shortfall of 2760, says the report.

    Hugh Phillips, president of the Royal College of Surgeons of England, said: “The college's prime responsibility is the improvement of surgical standards for patient care. Our survey shows that because of the numerous changes in the NHS—new technologies, new treatment opportunities, and the increased demands of training and education—more surgeons are required if they are to deliver patient safety: this is the price of improved surgical opportunities.

    “The NHS improvements are welcome, but the government has failed in its calculations as to who is actually going to do the work. The target driven environment of the NHS is not conducive to the provision of quality training for junior surgeons, nor to the prioritising of patients in order of clinical need.”

    The report shows that, despite increased turnover in all surgical specialties, patients are waiting an average of 3% longer for most operations. The college calls for extra central resources to fund new training posts and to deliver training of the required standard.

    Developing a Modern Surgical Workforce is available at

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