Worsening shortfall of anaesthetists predicted for UK's NHS
A shortage of anaesthetists could force operations to be delayed and threaten patient safety, according to research from the Royal College of Anaesthetists (RCoA). The research suggests that 74% of hospitals currently rely on locum anaesthetists from medical employment agencies or are forced to pay locum rates to staff to fill rotas and that by 2033 there may be 10-20 fewer consultant anaesthetists at every hospital trust. President of the RCoA, Dr Liam Brennan, said, “If consultant anaesthetists are continually having to ‘act down’ and fill gaps in rotas, then they are less available during the day, so there will inevitably be delays to people needing elective care, such as hip operations.” Brennan calls for more training places for anaesthetists in order to minimise the expected shortfall.

The NHS faces a critical shortage of anaesthetists that could force operations to be delayed and even threaten patient safety, doctors’ leaders have warned.

New research shows that by 2033 every hospital trust will have 10-20 fewer consultant anaesthetists than they will need to meet rising patient demand. It estimates that, while the NHS has agreed that its total of anaesthetists should expand to 11,800 by that date, on current trends it is likely to reach only 8,000 – a shortfall of 3,800, or about 33%.

Anaesthetists play a vital role in preparing patients for surgery and monitoring them, are key members of the medical teams in maternity units and intensive care, and deliver pain relief and resuscitation. They become involved in the treatment of two-thirds of hospital inpatients.

Like many other areas of medical care, anaesthesia already has too few practitioners. Rota gaps – where there are too few doctors to cover every shift in hospital units – are increasingly common.

The Royal College of Anaesthetists (RCoA), which carried out the research, warned that patients and the smooth running of hospitals would be hit if the existing shortfallin numbers was allowed to increase. Dr Liam Brennan, the college’s president, said: “Anaesthetists possess a unique and non-transferable skill set that is essential to maintaining core hospital services, so the potential impact of a reduced anaesthetic workforce would have serious implications for patient safety across the whole NHS. We already have fewer than we need and the shortages are worrying.”

The college’s latest census of the UK’s anaesthesia workforce, the first since 2010, also found that 74% of hospitals already rely on locum anaesthetists hired from medical employment agencies to ensure their rotas are full. The cost of that is part of the NHS’s huge annual bill – £3.7bn a year in England alone – for temporary staff.

Brennan said the outlay on locums showed that the shortfall in anaesthetists was a false economy. Even more anaesthetic departments – 98% – needed their own staff to do extra shifts as internal locums to avoid rota gaps. The report’s findings were “very worrying”, said Brennan.

“These shortages mean that doctors who are already overstretched are having to work even harder to maintain services, particularly for urgent and emergency care for patients. They are going the extra mile on a daily basis to fill these gaps.

“Part of the picture is that there are no other doctors that can do our jobs, therefore there’s no potential for cross-cover, because the skills we have aren’t part of the generic skill set of doctors.”

Tight NHS budgets and hospitals’ need to make efficiency savings meant there was not enough money to hire the number of anaesthetists needed, he added.

“If consultant anaesthetists are continually having to ‘act down’ and fill gaps in rotas, then they are less available during the day, so there will inevitably be delays to people needing elective care, such as hip operations and the like. Is this situation sustainable? I don’t think it is,” said Brennan.

A report last year by the Centre for Workforce Intelligence, which is part of the NHS staffing agency Health Education England, said that demand for anaesthetic services would grow by 25% by 2033 because of the ageing and growing population. That would require the number of anaesthetists to grow by 300 a year to keep up. But the royal college’s findings show that only 130 more a year were added between 2007 and 2015, leading to a significant gap that on current trends is set to continue widening.

Brennan urged NHS planners to create more training places for young doctors seeking to make a career in anaesthetics in order to minimise the expected shortfall.

The time-sensitive nature of what anaesthetists do made adequate numbers essential, added Brennan. “If we delay even for a few minutes intubating a patient who needs intubation, that patient might well die,” he said.

Labour’s Heidi Alexander, the shadow health secretary, warned patients could be hit by the shortages the college’s research uncovered. “Anaesthetists are absolutely essential to the delivery of many hospital services – and staff shortages of this kind present a serious risk to patient care. Ministers can’t keep turning a blind eye to this crisis. Unless urgent action is taken the people who will suffer most will be patients,” she said.

The Department of Health said: “We don’t recognise the RCoA figures. Anaesthetists play a vital role in the NHS, so it’s important we have an appropriate number available across the week. Since 2010 we have almost 900 additional anaesthetists in the NHS, an increase of more than 16%, with more than 3,000 in training posts every year.”