As Northern Ireland waits to find out whether a new Stormont election will be called, the Royal College of Physicians (RCP) has published findings and recommendations following its recent president’s roundtable in Belfast.
The RCP is calling on assembly members to form an executive, pass a multi-year budget, and take urgent action across the health and care system to support the HSCNI workforce, improve patient care and tackle inequalities.
Earlier this year, we published The time is now with our colleagues in the royal colleges of physicians of Edinburgh and Glasgow, and after the election we called on assembly members to secure a multi-year budget for HSCNI. This latest briefing, with 24 recommendations from the RCP, looks at the situation today, in which we report findings from the 2021 census of consultant physicians and higher specialty trainees in the UK:
- 53% of NI consultant physicians report daily or weekly trainee rota gaps
- 40% of NI consultant physicians say they have substantive consultant vacancies in their department.
- 28% of NI higher specialty trainees (HSTs) say they almost never feel in control of their workload
- 41% of NI HSTs say they feel emotionally drained at work almost all or most of the time
- 58% of NI HSTs say they work excessive hours and 55% have an excessive workload
- 75% of NI HSTs report daily or weekly rota gaps.
Almost six months after the assembly election, there is still no functioning executive at Stormont, and doctors in Northern Ireland are warning that the HSCNI workforce is exhausted and reaching burnout.
Physicians here feel very undervalued. We’re trying our best, but it’s extremely challenging. It’s taking a huge effort on our part to keep everything going.
Patient demand is rising and healthcare reform is slow. Without a multi-year budget, HSCNI cannot expand the medical workforce, invest in new models of integrated care or tackle growing poverty and inequality (which itself puts huge pressure on the health service).
A NICVA survey in May 2022 found that 52% of respondents said the top issues facing Northern Ireland were the need to transform the health service and reduce HSC waiting lists, followed by 34% who cited the rising cost of living which is likely to put even more pressure on HSCNI. We need politicians to take action now.
One consultant physician in Northern Ireland said:
"The health service is under severe pressure with long waiting times because there are not enough people to do the work. There is definitely an impact on patient care; we are stumbling towards disaster."
RCP president Dr Sarah Clarke said:
"In September 2022, RCP registrar Professor Cathryn Edwards and I met with senior stakeholders in Belfast to discuss the challenges and solutions facing the Northern Ireland health and care system. We heard so many stories of frustration and exhaustion during our visit – but there’s ambition too, and a genuine belief that things could improve if HSCNI staff were given the chance to lead change.
"The medical workforce crisis in Northern Ireland is getting worse. In 2021, only 27% of advertised consultant physician posts in Northern Ireland were filled, with 33% of unsuccessful appointments caused by a total lack of applicants. This is a frightening drop from 2008, when 83% of advertised posts were filled, or even just a few years ago in 2018, when the figure for Northern Ireland was 73%. Doctors, nurses and allied health professionals need political stability, strategic direction and recurrent funding so they can start to tackle waiting lists, rota gaps and growing inequalities. Patients can’t wait any longer."