Staff crisis as trainee doctors shun huge workload

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Pressure on A&E units is being exacerbated by staffing problems which mean half of key roles for doctors undergoing training in emergency medicine in the region lie vacant.

Yorkshire Post analysis suggests as many as three-quarters of specialist trainee roles are empty at A&E units in Leeds and Sheffield.

The problem is costing hospitals huge sums in locum staff to cover rotas as well as putting pressure on existing staff to fill gaps at night-times and weekends.

But it will lead to further problems in coming years as fewer doctors come forward to take up consultant posts in A&E medicine.

The trainees play a key role in A&E units overnight when they are often the most senior medical staff available.

Latest figures show around half of trainee posts are vacant across the region, with about one in six consultant posts lying empty.

Among the worst problems are at the Northern Lincolnshire and Goole NHS trust which runs casualty services in Grimsby and Scunthorpe. Of 10 consultant posts, six are vacant, with half of 10 specialist registrar roles also unfilled.

In Leeds, only five out of 21 registrar posts are filled, with hospital bosses among those in the region to have recruited overseas.

At Sheffield’s Northern General Hospital, seven out of 10 registrar posts are vacant. It is one of many units developing new roles for specialist emergency nurse practitioners to take over some duties performed by junior doctors.

Harrogate’s casualty unit has recruited two new specialists bringing the total to six but in Rotherham efforts to recruit an additional two have so far failed.

A&E consultant Alastair Wass, regional chairman of the College of Emergency Medicine, said problems recruiting to trainee posts were a national problem.

“Junior doctors do not see emergency as an attractive career, not from a satisfaction point of view, but for a work-life balance. Although your shift may be due to finish often it continues into the early hours and through the night, not to deal with emergency work, but from pure volume of work through a department.

“It’s quite physically and mentally exhausting. Patients have increasingly complex problems, numbers are increasing, the population is older and we live in a 24-hour society nowadays.

“Junior doctors are voting with their feet out of our speciality.

“It’s become very difficult to try to maintain rotas with sufficient senior staff. You can only go back and fill gaps with existing consultants and middle-grade staff so many times. Locum doctors are being used to pick up the slack in rotas – the problem is that it’s an expensive way of doing things.”

He said work was needed across the NHS to ease pressures on A&E.

“I get the impression people seem to have lost confidence in out-of-hours services a little bit and what they do is use a brand they are familiar with. They go to A&E because they know what they are going to get and of course we are open 24 hours a day,” he added.

Health Education England, which is in charge of training, has set up a taskforce to investigate how it can incentivise doctors to work in A&E due to report this summer.