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Key messages

The welfare of the O&G workforce is at the centre of delivering the best care for our patients. The RCOG acknowledges that, like many other specialties, we are experiencing workforce shortages in response to the increasing demands on the service.

The RCOG believes that one of the most effective ways to address shortages and improve the quality of care for patients, is to improve the welfare of the workforce. This means addressing bullying and undermining in the workplace, but it also means celebrating talent and success and providing our doctors with rewarding career opportunities, as well as addressing the low morale of many of our workforce particularly the trainees.

The RCOG calls on policymakers, regulators and NHS leaders to develop a long-term plan to address workforce welfare. The College invites leaders to come together to agree how this can be achieved.

Key workforce stats

  • 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 wellbeing1
  • A 30% attrition rate2 from the O&G training programme is typical, further compounded by a loss at transition from training to consultant grade posts
  • 54% of those on the O&G Specialist Register are international medical graduates with 14% from the EEA3. The impact on this group of doctors of the UK’s exit from the EU together with the availability of visas for medics is unknown
  • O&G services rely on the significant contribution of SAS (Specialty and Associate Specialist) doctors and Trust grade doctors, however there is a significant turnover among this group with around 12% leaving the NHS workforce in England each year4
  • Although the majority (63%) of doctors provide both O&G services, 20% provide services in gynaecology only5, which must be factored into workforce planning
  • O&G trainees report more undermining behaviour than any other medical specialty6 and 64% of consultants say they have experienced or witnessed consultants being bullied7
  • Clinical negligence claims in obstetrics account for 10% of the volume but 48% of the total value of payouts8

Key workforce messages

  1. Workforce planners predict an increased number of consultants will be required on top of projected supply by 20219
  2. Developing and retaining talent is vital for the safe delivery of O&G services. This will also have a huge positive economic impact for the NHS
  3. Within the profession there are many examples of successful teams and working practices. We must celebrate their success and learn from them
  4. There is a human cost associated with the culture of blame within the NHS, which is not fully understood (both the cost to doctors and to women and their families)

  1. The National Maternal and Perinatal Audit 2017 ↩︎
  2. NHS Electronic Staff Records and General Medical Council data ↩︎
  3. General Medical Council 2018 ↩︎
  4. NHS Electronic Staff Records ↩︎
  5. RCOG O&G Workforce Survey 2018 ↩︎
  6. GMC National Training Survey ↩︎
  7. Shabazz T, Parry-Smith W, Oates S, et al. Consultants as victims of bullying and undermining: a survey of Royal College of Obstetricians and Gynaecologists consultant experiences. BMJ Open 2016 ↩︎
  8. NHS Resolution Annual Report and Accounts 2017/18 ↩︎
  9. Maternity Workforce Strategy -Transforming the Maternity Workforce 2018. Health Education England ↩︎