Hundreds more emergency medicine (EM) doctors must be trained to avoid a staffing crisis in hospital A&E departments in England, according to the Royal College of Emergency Medicine (RCEM). Its analysis suggested that at least 700 new trainees were required over the next 6 years.
The RCEM said that many NHS trusts were compensating for a lack of staff by employing locums, leading to a significant drain on their wages budget.
College president, Dr Adrian Boyle, said: "The system is stretched beyond capacity now and is only functioning because of the safety net of locum staff. We are seeing increasingly this reliance becoming the norm rather than the extraordinary."
The analysis cited NHS benchmarking data for 2022 showing that in emergency medicine, 25% of reporting trusts spent more than a third of their consultant pay budget on locums, with five trusts spending more than half the budget on locums.
The RCEM's report, Emergency Medicine Workforce in England, published as part of it acute insight series, examined the current situation and made recommendations for issues that needed addressing.
Readying the Next Generation of EM Doctors
It found that emergency medicine trainee doctors currently made up 45% of the total emergency medicine workforce, which it said posed a "potential threat" to service provision, especially out of hours – overnight and weekends. It also established that the pool of consultants was ageing with 29% of RCEM’s consultant members now aged over 50.
"We know from our own members that the cohort of emergency medicine consultants is ageing, said Dr Boyle. "These are doctors looking to do fewer hours and wind down as they move towards the latter stages of their careers."
The analysis also found that EM consultants see almost double the number of annual attendances that was considered safe, whilst increasingly difficult working conditions and expectations placed on clinicians was resulting in burnout, low morale, and high attrition rates.
To ease pressure on existing staff, and to try to increase capacity and resilience the RCEM concluded that at least 120 additional EM training places must be created annually for at least 6 years from 2024. "You have to keep topping up the team," said Dr Boyle.
The RCEM expressed concern that the long-awaited NHS workforce plan might be delayed further.
Dr Boyle said that "it is becoming increasingly important that this is published as soon as possible to avoid the crisis in the NHS worsening – and that it contains specific numbers, details, and costings".
In a statement, a spokesperson for the Department of Health and Social Care said: "We are making progress to recruit more staff into the NHS, with more than 5400 more doctors and over 12,900 more nurses compared to a year ago, and we will soon publish a long-term workforce plan setting out plans to support and grow the workforce.
"There are almost 2400 consultants working in emergency medicine specialty across the NHS in England – over 500 more than in 2019.
"We have also set out a plan to recover urgent and emergency care services to deliver one of the fastest and longest sustained improvements in emergency waiting times in NHS history, while growing and supporting the workforce."