Written evidence submitted by Association of Anaesthetists
The Association of Anaesthetists is made up of over 10,000 anaesthetists in the UK, Republic of Ireland and internationally. We seek to promote patient care and safety. Along with colleagues in intensive care, anaesthesia is the largest specialty in the NHS.
Anaesthetists have a crucial role to play in the national recovery plans and dealing with the surgical backlogs – indeed, the majority of surgery cannot take place without an anaesthetist. However, the anaesthetic workforce is currently facing unprecedented shortages – currently more than 1400 clinicians short – and this figure is set to continue to grow as more and more anaesthetists opt to retire early due to pension issues, fatigue and lack of work-life balance. The only surgical specialty which has been able to return to working at the same rate at pre-pandemic is ophthalmology and the fact that anaesthetists are not required for this type of surgery is part of the reason for this.
The Association of Anaesthetists is calling for urgent action to address the growing anaesthesia workforce shortages. In a five-year period, gaps in workforce numbers have doubled and the reliance on an older workforce has continued to grow. The impact of the COVID-19 pandemic on the anaesthesia workforce cannot be overstated, bringing to the fore issues surrounding recruitment and retention, early retirement and fatigue.
Royal College of Anaesthetists (RCoA) workforce census data from January 2020 states that there are 10,057 consultant and Trust grade anaesthetists and approximately 4,300 trainee anaesthetists working in the NHS. The survey also reports:
- Just over 90% of departments had at least one consultant vacancy. There were 680 vacant consultant posts and 243 vacant SAS doctor posts in the UK
- The funded workforce gap in the consultant workforce continues to rise from 4.4% in 2015, 5.4% in 2017, 6.9% in 2018 to 8% in 2020
- More consultants are now working beyond the age of 60 years, up from 5% in 2015 to 7% in 2020. The 50 plus age group is now 39% of the workforce, compared with 31% in 2007.
- Many of these doctors will soon be approaching possible retirement age and plan to retire. The Association has recently launched a new guideline including recommendations to help departments retain older doctors for longer. Implementation of these may help to reduce the numbers of those leaving.
While we are aware of innovative ideas being developed to help clear the backlog in some areas (a Hight Intensity Theatre list in London for example), there is neither the workforce nor the infrastructure in place throughout the country for this to be replicated at the scale needed. As the population is ageing and more people are living with multi co-morbidities, surgery is becoming more challenging and the time and input needed to prepare for this is increasing.
Without a significant increase in workforce, it simply will not be possible for the national recovery plans to have their intended impact. Additional funding is needed to make the workforce that is needed a reality but given the current economic situation, it seems unlikely that the government will make the money available.