A second medical royal college has told HSJ it is concerned over the extent of gaps in rotas for junior doctors, with some maternity wards having a vacancy rate of 15-20 per cent.

  • Junior obstetricians and gynaecologists say they are missing training opportunities
  • RCOG says reconfiguration of maternity services is necessary
  • Larger numbers of trainees not working full time

The Royal College of Obstetricians and Gynaecologists said the shortages were increasing pressure on maternity services and warned that the current configuration of units needed to be reviewed.

The college said the preliminary data from its latest census of maternity units, shared exclusively with HSJ, showed that up to one in five rotas in the UK had gaps for the middle grade of junior doctors of ST1 and above.

Last month the Royal College of Paediatrics and Child Health told HSJ more than one in 10 hospital rotas for paediatricians in the UK had vacancies, with some hospitals seeing vacancies of almost a quarter in specialist units.

RCOG vice president for education Clare McKenzie and vice president for UK affairs Ian Currie told HSJ staffing levels in obstetrics and gynaecology were “increasingly under intense pressure”.

They said in a statement the gaps in rotas were being caused by doctors taking time out of training for research as well as those taking maternity leave and working less than full time. They said 80 per cent of the specialty’s trainee intake in the past five years was female.

Ms McKenzie and Mr Currie added: “The difficulty of ensuring a full service provision is compounded at registrar grade, as there is no alternative modelling staffing structure, due in part to changes in immigration regulations.”

The college is now working on new recommendations to try and ensure a sustainable staffing model but said the use of consultants to fill gaps was increasing year on year.

The statement continued: “The UK is a safe place for women to give birth but pressure on maternity services is growing, placing stress on clinicians, managers and patients. Pregnancies are increasingly complicated due to the rising levels of obesity among the population, along with increasing numbers of first time older mothers and multiple pregnancies.

“Not only do we need more consultants to manage the gaps in rotas secondary to reduced middle grade availability, but also to provide experienced care for women. The consequence of reduced middle grade staff and the effect of new job plan arrangements for consultants means we are likely to need a review of the current configuration of obstetrics and gynaecology services, especially maternity care.”

Matt Prior, chair of the RCOG trainees’ committee, told HSJ the rota gaps were a major concern among junior doctors, who he said were under pressure to work harder to fill the holes.

He said: “This reduces our training opportunities and means there is pressure to cover service provision rather than meet our curriculum objectives. Getting more consultants to cover the rotas is the only option as there isn’t the manpower available.

“I think trainees would support reconfiguration and having bigger units as it means more supervision and better training opportunities and ultimately better care for women and better trained doctors. But this isn’t something that can happen overnight”.