Three quarters of young anaesthetists might leave NHS if subconsultant grade were introduced

More than three quarters of trainees and new consultants in anaesthetics would consider leaving the NHS if a subconsultant grade were introduced to manage the expected oversupply of consultants in the UK, a survey shows.12

Nearly 2000 anaesthetists were surveyed by the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland. A total of 79% of respondents said that they would emigrate or move to the private sector if a graded career structure was introduced for consultants.

Richard Paul, chairman of the Group of Anaesthetists in Training arm of the Association of Anaesthetists of Great Britain and Ireland, said that junior doctors work long, hard, anti-social hours and complete extra activities on top, such as studying for exams, “on the proviso that we would progress to a role with pay and respect commensurate to the seniority achieved.”

The NHS risks a “brain drain” should junior doctors no longer have the promise of becoming a consultant at the end of their training, he said. “High quality doctors, trained at the tax-payers expense, will practise their expertise abroad, to the detriment of UK patient care,” he said.

A 2012 report by the Centre of Workforce Intelligence estimated that the NHS would have 60% too many consultants by 2020 if hospital doctors continued to be recruited and trained at the current rate.3 The centre suggested seven possible responses to this predicted oversupply of consultants. These included shifting hospital training posts to general practice, fixing the retirement age of NHS consultants, and introducing a multilevel graded career structure.

The Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland conducted an online survey of trainees and consultants who had held a CCT for less than five years, asking them how the health service should deal with the expected oversupply of senior doctors. There were 1796 complete responses: 1741 from trainees (response rate 35%), 325 from new consultants (15%), and 94 locum consultants, specialty doctors, and fellows (response rate not given).

Anaesthetists who responded to the survey said that maintaining the workforce status quo was the best of the seven scenarios put forward by the Centre for Workforce Intelligence. Introducing a graded career structure for consultants was the least popular option among anaesthetists. Reducing the intake of students to medical school was also strongly supported as a solution.

When asked what other ways of working they would consider, respondents ranked most highly the possibility of introducing consultant resident on-call sessions to create a consultant delivered service. The potential to have consultant posts with no career progression or no pay progression was ranked lowest.