Members Only

Numbers of acute and stroke consultants rise while other specialties suffer

The number of consultants working in acute medicine in the United Kingdom has risen by almost a quarter in a year, but numbers in other specialties have fallen, new figures show.

The latest census of consultant physicians in the UK, published on 25 November, shows that the number in the specialty of acute and general medicine rose to 259, a 23% increase on the previous year’s figure, at a time when the availability of junior doctors has dropped.

The rise reflects the increasing importance of the role of consultant physicians in medical admissions, says the report, published by the Federation of the Royal Colleges of Physicians of the UK, a joint body of the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow, and the Royal College of Physicians, in London.

The survey resulted in 5018 completed questionnaire forms, a 55% response rate. It also found that the number of consultants practising stroke medicine doubled: from 27 in 2007 to 50 in 2008.

The federation said that NHS trusts were recognising the benefits of consultants delivering care in the relatively new specialty of acute and general medicine to cope with increasing numbers of acute medical admissions.

The authors said it was unclear at this stage whether these posts were all entirely new or had been transferred from another specialty. The census would try to find this out next year.

The figures show a 4.5% rise in consultant numbers across all specialties; growth in Scotland and Wales was higher than in England and Northern Ireland.

However, some specialties experienced a fall in numbers. Geriatric medicine had 1.6% fewer consultants (giving a new total of 1111consultants), and dermatology and allergy also saw falls, although these specialties have smaller numbers. Overall 27% of consultants are women—a small rise from 25% in 2007. But the survey found a small fall (from 57% to 48%) in the proportion of female consultants younger than 34 years of age.

The report says that this is against the trend of a rise in the number of female consultants seen over the past five years, but it is expected to be a temporary blip. Nearly three quarters (73%) of consultants said they had experienced an increase in work pressure in comparison with three years ago. The data were collected 10 months ago, and at that time less than a third (31%) of consultants reported that they believed the European Working Time Directive could be implemented without compromising the care of patients. Andrew Goddard, director of workforce at the Royal College of Physicians, said, “The European Working Time Directive has reduced the number of junior doctors available to see patients admitted to hospital. Expansion of consultants is vital to ensure that patients get high quality care early.

‘The census shows that this appears to be happening at the moment, but as public finances face a big squeeze over the next few years further expansion may be limited. Unless we can maintain that expansion, patient care and safety will be compromised.’

Adrian O’Dowd, London

Cite this as: BMJ 2009;339:b5046

Census of Consultant Physicians in the UK, 2008 is at workforce/census/Pages/Overview.aspx.

Philip Dyer
President for The Society for Acute Medicine

Administration Office Society for Acute Medicine
9 Queen Street

Phone: 0131 247 3634

Share this article: