Further supplementary evidence from the
British Medical Association (WP 59C)
On 13 December, the Department of Health announced
the number of places for doctors entering specialist training
in England in 2007. Following this announcement, the BMA would
like to take the opportunity to contribute supplemental written
evidence to the Health Committee's current inquiry on NHS workforce
planning.
The BMA has taken an active interest in the
implementation of Modernising Medical Careers (MMC). In particular,
the BMA's Junior Doctors Committee and the Central Consultants
and Specialists Committee (CCSC) have been concerned about the
progress of implementation of the Run Through Grade of Specialty
Registrar (StR).
The BMA welcomed the announcement from the Department
of Health that there will be at least 18,000 places for doctors
entering specialist training in England in 2007. This is a major
improvement on the figure of 9,500 posts previously announced
by the Department of Health.
However, whilst the BMA welcomes this announcement,
there are still a number of crucial issues remaining unaddressed
and causing anxiety among doctors. In particular, the JDC is concerned
that:
— It is not yet known how many of these
posts will be entry points to long term training, and how many
will be short-term appointments—nor do we know at what level
they are.
— Junior doctors have not had enough
careers guidance, even though many will be forced to change speciality
as a result of the reform. Although money has been made available
for doctors currently in Foundation programme year two to receive
careers advice, there have been no extra resources for the approximately
16,000 doctors working at SHO level, many of whom are facing difficult
decisions about their future career.
— Competition is still likely to be
intense and, as the government acknowledges, no-one knows how
many applications there will be from overseas, or from UK doctors
in non-training posts.
— NHS Trusts have had insufficient
time to prepare, and there could still be a significant service
impact, particularly during the interview period.
The BMA's CCSC is fully supportive of junior
doctors' own concerns about their training and the potential effects
of MMC on their career progression. Moreover, the CCSC has a particular
focus on how the recruitment to Specialty Registrar in the Spring
might impact on consultant workload and, potentially, patient
care through absence of doctors on the wards. A letter dated 10
November to trusts by Steve Barnet, Director of NHS Employers,
states:
The absence of 21,500 junior doctors attending
up to four interviews [between 28 February and 13 April] could
have a major impact... on service delivery and/or the cost of
locum cover.[22]
This is a major worry for consultants whose
responsibility it is to deliver the service. The need to publicise
the precise timetable, stating the daily level of absence across
all deaneries for each speciality in each day during the whole
recruitment process is becoming increasingly urgent. It is, therefore,
an issue which is growing in its prominence for the CCSC. It is
essential that the timetable is published as early as possible.
Together with junior doctors, the CCSC also
fears that because the curricula will not be published until the
New Year, junior doctors will be forced to apply for posts without
a full understanding of the training which is to be provided.
Furthermore, there are concerns about the potentially detrimental
effect of cuts to MPET,[23]
especially on the availability of posts.
MMC should bring major benefits to both doctors
and patients; however, the BMA is extremely concerned about the
lack of planning of implementation and the speed with which the
service and training is being re-organised. We particularly worry
about its effect on the existing workforce making a transition
to the new system.
Dr Jo Hilborne
Chairman, Junior Doctors Committee, and
Dr Jonathan Fielden
Chairman, Central Consultants and Specialists Committee
British Medical Association
18 December 2006
22 http://www.nhsemployers.org/workforce/workforce-1944.cfm Back
23
MPET stands for Multi Professional Education and Training levy
(MPET). It is a funding stream from the Department of Health that
funds the additional costs to the NHS of supporting the practice
experience of medical and dental students. Back
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