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The medical workforce BC (Before COVID-19): the 2019 UK consultant census

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Please scroll to the bottom of the page to download the census data toolkits.

This is the Royal College of Physicians, Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow’s most recent census on the consultant physician workforce in the UK. It was conducted between 30 September–31 December 2019.

Every year the Royal College of Physicians of London (RCP) conducts a consultant census on behalf of the Federation of the Royal Colleges of Physicians with the aim of providing robust data on the state of the physician workforce in the UK. These census data help us plan for the future and is more important than ever, considering the effects of COVID-19 on the NHS. The 2019 census received 4,668 completed forms from consultants. In addition, the RCP undertook an exercise to confirm data on an additional 12,078 consultants in the NHS.

Key findings

2020 has been dominated by the profound effects on the UK NHS of the COVID-19 pandemic. Although the census covers the pre-COVID period, as the NHS moves from crisis management to recovery, longer term issues will need to be addressed. The 2019 census reveals the continuing pressures on the medical workforce and the systems in which we work, prior to the pandemic. The number of consultant posts needed continues to significantly outnumber supply.

  • Close to half (43%) of advertised consultant posts in England and Wales were unfilled due to a lack of suitable applicants (data for Scotland and Northern Ireland were unavailable).
  • The ratio of consultant physicians to population served varies widely. Regions with fewer consultants have the highest rates of locum consultants, and, for England and Wales, unfilled advertised posts.
  • Consultants find their general internal medicine (GIM) work much less satisfying than specialty work.
  • Unselected medical take/receiving was undertaken by only 30% of consultants and care of GIM inpatients by 42% of consultants.
  • 20% of consultants experienced, and 25% witnessed, bullying or harassment. This was more common among female consultants.
  • Consultants of black, Asian and minority ethnic origin (BAME) were twice as likely to experience discrimination as white consultants. Female consultants were twice as likely to experience discrimination as male consultants.
  • Consultants estimate they work 10% more than they are contracted to do, mainly due to their clinical workload.
  • Consultants who have retired and returned now constitute 15% of the workforce.

The pressure that physicians are under appears to be the main factor behind the negative experiences documented by the census. Filling vacant consultant posts, reducing experiences of bullying, harassment and discrimination, addressing excessive workloads and improving consultant experiences of GIM are all crucial steps if we are to improve the working lives of physicians in the UK so that they can care for the population.

Next steps

We will continue to:

  • use the census data in our discussions with government and stakeholders about the long-term pressures on the NHS and their impact on staff wellbeing
  • work with the NHS in England to help develop the People Plan that supports its Long Term Plan, making the case for greater flexibility for staff of all ages and career stages
  • call for medical school places to be doubled to 15,000 per year, publishing a report on the feasibility of such an expansion and how it could help regions with lower numbers of doctors
  • identify and promote ways of encouraging trainees to work in specialties and locations with the largest recruitment gaps
  • make the case for the UK to be accessible and welcoming to trainees and doctors from countries outside the UK.

For more information, please visit the most recent RCP Commentary to read the report. 

We will be updating this page with more information from the census and our interactive data tools soon. If you would like to see the interactive data tools from the 2018/19 Census please click here.

Click here to see the latest 2019/20 census blog post from the Royal College of Physicians of Edinburgh.

Further information

To view the data and learn more please download Focus on physicians. If you require a bespoke analysis of data by region or other factor, please contact us via policy@rcplondon.ac.uk.

The RCP Medical Workforce Unit independently verified consultant headcount by nation, specialty and demographics by checking with specialty representatives, the GMC and with consultants’ work locations.

Please note that if you are planning to use the census data toolkits for further or secondary analysis, we request that you contact the Medical Workforce Unit team for support and further advice. Thank you.