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Workforce challenges

 

Trainee attrition

GMC data show a significant number of trainees who start the O&G training programme but do not finish. An attrition rate of 30% in any region is not unusual, with rates ranging from 29% to 37% (HEE/GMC).

 

Recent RCOG trainee surveys show that:

  • 75% have considered leaving O&G since the start of specialty training.
  • 89% have at some point felt low in mood, depressed or anxious since starting specialty training
  • 19% report feeling this way at least monthly

(Trainee Attrition Survey 2017)

 

The factors behind this high trainee attrition rate include:

  • Rota gaps
  • More out-of-hours working
  • Poor work–life balance
  • Less supervision
  • Fewer training experiences

These are also challenges for the wider workforce that will result in changes to the O&G consultant role of the future. For some it is becoming a less attractive prospect, especially for more junior consultants.

 

Rota gaps

88% of obstetric units reported a gap in their middle-grade rota (NMPA 2017).

 

Locums

83% of units reported requiring locum cover to staff their middle-grade rotas in the previous three months (NMPA 2017).

Locums are an important and valued part of the workforce. However, at a time of NHS austerity, relying on locums to cover gaps is an expensive use of budgets. Reliance on locums to deliver services could also lead to inconsistency in service delivery as locums are often unfamiliar with local systems and need time to acclimatise. This impacts on team work and, potentially, patient safety.

A more sustainable and efficient option would be to address the reasons for the gaps being there in the first place.

 

 

Number of units in each response category

(excluding units which responded a proportion was unknown)

Proportion of the middle grade rota in the last 3 months which was:

Entirely unfilled

Filled by a locum

Filled by a consultant

0%

93
(57%)

28
(17%)

95
(58%)

Overall proportion reporting rota gaps either: entirely unfilled, filled by a locum, or filled by a consultant (excluding unknown)

70
(43%)

138
(83%)

69
(42%)

1-5%

25
(15%)

27
(16%)

44
(27%)

6-10%

24
(15%)

38
(23%)

10
(6%)

11-25%

12
(7%)

54
(33%)

12
(7%)

26-50%

5
(3%)

17
(10%)

1
(1%)

More than 50%

4
(2%)

2
(1%)

2
(1%)

Total
(excluding unknown)

163
(100%)

166
(100%)

164
(100%)

Unknown

22

19

21