Sunday, December 3, 2023

One-in-four Model 3 hospital consultants in locum posts

Hospitals will need to recruit 1,000 consultants over next decade to meet demand, report predicts

Almost one-in-four consultants in Model 3 hospitals was in a locum post at the start of last year and one-in-three was aged over 55, a newly published report has revealed.

Of the 17 hospitals reviewed, Tipperary University Hospital in Clonmel had the highest proportion of non-permanent consultants, at 35 per cent. Mercy University Hospital in Cork had the lowest, at 12 per cent.

The Model 3 Hospital Report analysed the challenges in the recruitment and retention of consultants and was published by the HSE’s National Doctors Training and Planning (NDTP) group.

Figures were taken from January 2022 records and show the staffing issues facing general hospitals in Ireland. Across the Model 3 network, 24 per cent of consultants were in locum posts, compared to 12 per cent of consultants in Model 4 hospitals where tertiary care is provided.

“It is clear to me that, unless we actively encourage recruitment, the Model 3 network will be challenged in service delivery in the near future,” said NDTP Medical Director Prof Brian Kinirons.

“A service delivery crisis is inevitable unless Model 3 hospital posts are made more attractive. The Model 3 consultant workforce is senior, with one third of the workforce over 55 years of age. This has obvious implications for future recruitment.”

The report found that 807 consultants were employed in Model 3 hospitals, with seven per cent not approved by the Consultant Applications Advisory Committee (CAAC), which provides independent advice to the HSE on applications and qualifications for consultant posts.

The same proportion of consultants were not on the specialist register of the Medical Council of Ireland, despite the HSE making it an essential requirement for such appointments in 2008.

In general hospitals in Cavan and Kerry, the proportion of consultants aged over 55 was 49 per cent, but in Connolly Hospital in Dublin this figure was just 18 per cent. Across all 17 hospitals, five per cent of consultants were aged 66 or over, while 32 per cent were female.

Further emphasising the challenges in recruitment, the report projected that 1,005 consultants will need to be recruited by Model 3 hospitals between now and 2032 to meet growing healthcare demand.

“This will result in a projected 1,512 consultants employed, equating to a net increase of 87 per cent on the current Model 3 consultant workforce of 809,” the report said. “To put this in context, data shows that the average increase in consultants employed by Model 3 hospitals over the past four years was 37 per annum.”

The specialities which hospitals found most difficult to recruit for were radiology, obstetrics and gynaecology, and emergency medicine.

Figures from DIME (Doctors Integrated Management E-System) found that, in March 2023, 36 per cent of emergency medicine consultant posts were vacant, while 13 per cent of posts in obstetrics and gynaecology, and 11 per cent of positions in radiology, were unfilled.

Model 3 hospitals also appear to rely more on NCHDs than Model 4 sites. December 2022 figures show that 60 per cent of junior doctors at Model 3 hospitals are not on recognised specialist training schemes, compared to just 36 per cent at Model 4 hospitals.

Several hospitals raised concerns around the retention of NCHDs, with many emigrating to the UK where they can access higher specialist training.

The report was launched at the NDTP National Medical Workforce Conference on November 9. Leaders from across the health service presented on the future work of our health service in relation to HSE health regions.

Launching the report, Health Minister Stephen Donnelly said: “By planning, co-ordinating and reforming how we work to deliver our health and social care services along regional lines, informed by a population health approach, the HSE health regions will better enable our workforce to provide the high-quality integrated care our patients need.”

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