A&E recruitment crisis could be resolved through financial incentives

The Public Accounts Committee (PAC) have recently released a report stating that attempts to improve NHS emergency admissions were being ‘completely stymied’ by a serious shortage of A&E consultants.

In 2012, nearly one fifth of A&E consultant posts were either vacant or filled by locums. It also shed light on the problem of training not enough doctors to work in A&E. The committee suggested this staff shortage could be improved by offering financial incentives to work in understaffed accident and emergency departments.

The PAC’s chair, Margaret Hodge, observed that currently there aren’t any incentive payments to make working in struggling hospitals a more appealing prospect. It was also noted that, while hospitals, GPs and community health services all had a role to play in helping reduce emergency admissions, there were no financial incentives in place to encourage this either.

“You could also make greater use in A&E of consultants from other departments, or mandate that all trainee consultants spend time in A&E, or make A&E positions more attractive through improved terms and conditions” Hodge also suggested.

If these changes were implemented, it would require the British Medical Association and NHS Employers to negotiate a more flexible consultant contract.

The PAC urged the Department of Health, Monitor and NHS England to review the system for funding urgent and emergency care to ensure incentives for all hospital and community services were coherent and aligned.

Dr Paul Flynn, chair of the BMA’s consultants’ committee responded to the PAC’s report, saying the high pressure and stress of working in A&E had contributed to a recruitment and retention crisis.

“Consultants already work around the clock to provide emergency care for patients but, as the report makes clear, there simply aren’t enough to meet rising demand,” Flynn said.

“The government needs to urgently address issues such as workload pressures, resourcing and work-life balance if the NHS is to attract doctors in training and the consultant numbers that are needed, not least because spending large amounts on locum doctors is not financially sustainable in the long run.”

Health minister Dr Dan Poulter defended the government, saying that we did have a clear strategy to tackle the shortage of A&E consultants. He supported this statement by pointing out that there were 414 more doctors working in A&E departments than there were in 2009.

“It takes six years to train an A&E consultant, and there is no easy fix, but our long-term plans are robust, increasing the number of training places by 75 next year, and planning for all trainee doctors to spend time in A&E,” he said.

“We are also looking at making an A&E career more attractive as part of our negotiations on the consultant contract.”

Rig Healthcare specialises in medical recruitment, for more information please visit www.righealthcare.co.uk

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