By Dr Marion Slater

THE Royal College of Physicians of Edinburgh recently published our manifesto for the Scottish Parliament election in May. It calls for action on health service recovery and redesign after Covid-19, workforce planning and training, public health and wellbeing, and health and social care integration.

Our manifesto also calls on political parties to support the creation of an independent working group to assess the impacts of Covid-19 on the medical workforce. This is vital as healthcare staff continue to experience severe pressure due to increased demand on the NHS.

The college fears that this additional pressure will result in doctors leaving medical training and retiring early. This would be deeply damaging for the post-Covid recovery of the NHS in Scotland and to the future of patient care.

Our concerns were recently highlighted by the BMA Report: Consultant retention in Scotland 2021. The report highlighted that the consultant vacancy rate in Scotland could be more than double the official government figures, and has increased over the past two years.

According to the report, the consultant vacancy rate now sits at over 15 per cent, with many long-term vacancies. The scale of the problem was highlighted before the pandemic, when the annual Consultants’ Census revealed that 43% of Scottish consultants will reach 60 in the next 10 years, worryingly close to the average intended retirement age of 61.7. Furthermore, more than a third of consultant appointment panels were cancelled in 2019; 85% were cancelled due to there being no applicant, no suitable applicant or the applicant withdrawing altogether. We are concerned too, that disproportionate tax levies on pensions are pushing consultants towards early retirement.

Workforce shortages undermine patient safety and staff wellbeing. Current consultant numbers cannot meet healthcare demand in the context of increasing population age, frailty, complexity and, now, Covid-19. Increasing consultant numbers alone does not offer the full solution. We must ensure that workforce planning is based on robust data that reflect real-time vacancies and anticipate future patient demand. We must invest in our doctors in training, building on the prescient investments in medical school places and Internal Medicine Training posts in Scotland. We must increase the number of higher specialty training posts in Scotland to ensure that we can train sufficient consultants to meet patient need.

Medical training must be more flexible, with consideration given to recruitment and retention and the different needs across Scotland’s complex geography. Consultants must be given time to train, teach and to innovate. Finally, we must do more to retain our senior doctors, revisiting punitive pension policies and enabling career development opportunities.

Scotland has a long history of excellence in medical training and patient care. We must continue to invest in doctors at every stage of their career, to ensure that medicine in Scotland offers an attractive and sustainable career. Never has it been more important to care for our doctors to enable them to deliver the best possible care for our patients. The future of the profession, and patient care, depends on it.

Dr Marion Slater FRCP Edin is Chair of the Recently Appointed Consultants’ Committee, Royal College of Physicians of Edinburgh.