The NHS could end up with more fully trained hospital doctors than it needs - and potentially an increased wage bill - unless it makes changes to the way they are trained and used, the Centre for Workforce Intelligence has said.

A ‘business as usual’ approach with current trainees all getting consultant jobs would lead to more than 60 per cent extra consultants by 2020 at a total annual cost of £6bn - £2.2bn more than 2010.

”In the current climate this puts an added burden on the productivity savings required and also assumes that doctors will continue to work in the same way,” the report on the future shape of the medical workforce adds.

Potentially, this would give the NHS 2,800 more consultants than the royal colleges predict it will need if services continue to be provided in the current way.

These extra consultants would allow the NHS to develop a ‘consultant-present’ service where senior doctors took a larger role in delivering care to patients across the week and out-of-hours. However, there might be a mismatch between the numbers needed and trained in different specialities, according to the modelling carried out by the CFWI.

But the NHS could seek to reduce the wage bill by looking at other ways of delivering services - such as having different levels of consultant or introducing a ‘consolidation’ year at some point in training.

There would also be scope to train more junior doctors for general practice - which could meet increased demand.

The CFWI is inviting responses on the way ahead. ”We need to make decisions now to avoid a situation in the future of unplanned oversupply,” it says.  It has already talked to many NHS employers and says most would like to see a consolidation period in training and some want to see a graded career structure for the consultant workforce which could offer benefits such as aligning skills and experience.

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