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Key messages

  • UK O&G services are being delivered safely but the pressure is rising on all staff involved
  • To manage obstetric and gynaecology care, units must address workforce issues in a safe and sustainable way
  • 9 out of 10 obstetric units report a gap in their middle-grade rota, which can affect job satisfaction, postgraduate training, quality of care and staff wellbeing (NMPA 2017)
  • A 30% attrition rate from the O&G training programme is typical, varying from 29% to 37% (HEE/GMC)
  • 15.4% of trainees think about leaving O&G once a month or more (Trainee Attrition Survey 2017)
  • Consultant presence in a unit should be based not only on the numbers of births, but also on the complexity of the O&G workload and the case mix of a department
  • Providers should explore alternatives to 24/7 consultant presence if they are as effective and more financially sustainable
  • Resident consultant working may be needed in many units so there are suitable numbers of doctors with the appropriate competencies
  • Consultants who work resident shifts out-of-hours should get parity of responsibility and professional development opportunities
  • All on call consultants in a unit should work towards providing a similar on call work pattern taking into account local job plans