Emergency medicine in 'crisis'

Just 46 per cent of the 180 posts on the emergency medicine training programme for junior doctors were filled in 2011, according to figures from the Modernising Medical Careers programme.

NHS Employers and the College of Emergency Medicine say there has been a similar pattern over the past few years. The General Medical Council meanwhile said its survey of trainees earlier this year highlighted concerns about junior doctors’ workloads in emergency departments.

The DH told HSJ it would collect information about emergency department staffing levels as part of its winter planning process. The college believes this will be the first time the DH has asked for such detailed information on medical staffing. DH will consider a more detailed piece of work if the initial survey reveals concerns.

The college, which held a “crisis summit” to discuss the issue last week, estimates there are 50 per cent too few emergency consultants to meet its ambition of 10 in every emergency department.

College registrar Clifford Mann told HSJ the number of trainees coming through was only sufficient to compensate for retirements and staff emigrating.

Dr Mann said: “Often posts are not filled or filled by poor quality locums which puts pressure on other staff in A&E and is unsafe.

“It’s a vicious circle: because workloads and work pressures have risen unrelentingly over last 10 years the attractiveness of the specialty has diminished.”

Many hospital trusts are reporting problems filling medical posts in accident and emergency departments. Recruitment problems were partly behind recent decisions to close A&E departments overnight at Mid Staffordshire Foundation Trust and Mid Yorkshire Hospitals Trust.

The summit heard many consultants were regularly working up to 14 hour days and then being called when they got home or ‘acting-down’ to cover for middle grade doctor shortages.

To become a consultant in emergency medicine doctor junior doctors have to undertake a six-year training course beginning with two years of the acute care common stream. This allows trainees who initially signed up to do emergency medicine are able to move to a range of other acute specialties after three years. Dr Mann said this saw a lot of trainees lost to specialties offering a better work life balance.