Doctors are struggling to gain permission from trusts to undertake nationally important policy and leadership work, according to senior medical figures.

A letter signed by figures including NHS medical director Sir Bruce Keogh, General Medical Council chair Sir Peter Rubin and chief medical officer Dame Sally Davies has been sent to every NHS organisation in the UK. It says the government and bodies such as the National Institute for Health and Clinical Excellence and medical royal colleges “all rely heavily” on the expertise of senior doctors “in a whole variety of roles”.

“The part time work they undertake alongside their clinical duties contributes a great deal to the quality of patient care, medical education and the effective running of the health service,” it says.

The letter recognises that “there is considerable pressure on local resources” but adds: “We hope you will regard such activity by your senior clinical staff as an investment in the system and a reflection of the high standards in your organisation.”

Many trusts did support this work it said, but “more encouragement… would bring significant benefit”.

GMC chief executive Niall Dickson told HSJ trusts were telling doctors: “We’re not sure we can release you because of the pressures on the organisation.”

This had left the GMC and other national bodies struggling to find experts from particular areas who were available to help with work such as performance assessments, clinical leadership and evaluations of new drugs.

The problem was also affecting the government, which “requires doctors to provide help and expertise as it develops policy areas and the implementation of policy,” he said.

HSJ has previously revealed the extent to which trusts are cutting the amount of time consultant doctors are paid for “supporting professional activities”.

Mr Dickson acknowledged the NHS’s tightening finances made this a growing issue. He said: “It must be recognised that being a consultant doesn’t simply mean treating patients, they have to do other things – one of them is bringing on the next generation [of doctors] – and that’s absolutely vital.”

But Cambridge University Health Partners director Robert Winter, formerly medical director of NHS East of England and Cambridge University Hospitals Foundation Trust, said: “I’ve never seen anyone who has been prevented from doing a worthwhile project.”

He said this was a “very strongly evidence-based way of improving quality” but clinicians had a responsibility to put forward a “convincing case” for their involvement in projects to their trust. He said specialists, particularly in smaller trusts, also needed to discuss with colleagues how the lost clinical time would be managed.

Related files/tables