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Paediatric workforce operating at a 20% deficit

Royal College of Paediatrics and Child Health (RCPCH) has published their ‘Rota gaps survey findings’ report. 
An empty hospital corridor

Earlier this year, RCPCH surveyed members to assess the extent and impact of rota gaps among a crucial subset of specialty doctors in paediatrics. The findings published today show that paediatric units are reporting an average 20% shortfall of Resident Doctors and Trainees on shifts. These gaps in rota can remain unfilled or be filled by a locum, or by other staff, taking them away from their main area of work. 

Operating with 20% deficit within the acute on-call workforce places immense strain on the existing workforce. Low morale and burnout are increasing within the paediatric profession. The GMC found that 15% of joiners to the paediatric specialist register left within 5 years between 2016-18. The College’s member survey also outlined that 48% of paediatricians surveyed report having an issue with balancing work and personal life, and 43% have a lack of time for activities such as research and teaching.  

Pressures on acute on-call services mean less staff are available for planned elective services, and the number of children waiting for elective treatment remains stubbornly high.  Children are often waiting longer than adults to access healthcare, paediatric services have not recovered at the same rate as adult health services, and there is a growing gap between demand and capacity across child health services.

In today’s report, RCPCH outlines a number of recommendations to alleviate pressure on the already stretched paediatric workforce, such as implementing workforce plans in every unit which will then be reviewed on an annual basis alongside predicted service demands. 

You can read the full survey findings and recommendations in detail in the report
 
RCPCH President, Professor Steve Turner, said:

Rota gaps have a detrimental impact on the wellbeing, morale and training of resident doctors, adversely affect the whole clinical team and ultimately affect the delivery of patient care. We recognise the incredible hard work from all our members to maintain high quality and safe care for our children and young people, but this report highlights how paediatricians are being stretched far too thin every day. 

It is completely unacceptable that our current paediatric services are only operating at 80% capacity when the level of demand on these services is now higher than ever. The Darzi Review rightly pointed the worsening state of children’s health and the immense pressure their health services are under. The Government is right to focus on reducing waiting times and implementing performance targets, but fundamentally we need a fully staffed workforce to meet these goals. 

We cannot allow 80% to become the new normal. Our children and the clinicians who serve them deserve more. Investing in and reforming paediatric services is not only valuable but is fundamental to the future health and economic wellbeing of our country.  

RCPCH Officer for Health Services, Dr Ronny Cheung, said: 

A rota gap rate of 20% is hugely significant when it comes to trying to tackle the exceedingly long waits that children and young people face in the UK. Currently 41% of children are not being seen by the NHS’s 18-week target and number of children waiting over year for treatment remains far too high. 

We welcome the Government’s focus on the current NHS waiting lists, but any plans to tackle this will be doomed to fail if we do not have the full quota of paediatricians to implement them. Child health services have their own set of challenges and unique needs, and child health professionals the unique skills to manage them – something the NHS Long Term Workforce fell far short of addressing. We need to see allocated funding and child focused policy plans, including plans to bolster the child health workforce, so that we can deliver the healthcare our children deserve.


Notes to Editors
  1. Overall rota gaps across England, Scotland and Northern Ireland were consistent at 20-23.5%; Wales experienced considerably lower gaps at 11.3% (this latter finding should be treated with caution due to the low response rate). 
  2. Across all nations, Tier 2 gaps were higher compared to Tier 1 except Northern Ireland where Tier 1 gaps exceeded those of Tier 2. 
  3. There was regional variation in rota gap frequency with the lowest in Wales, London and East of England and the highest in the Midlands, South East, North East & Yorkshire comparable with that of Scotland and Northern Ireland.