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Update on O&G Workforce Report 2017 Recommendations

Maintain and increase the flexibility of the O&G training programme

In the O&G Workforce Report 2017 we recommended a hybrid model of recruitment into the O&G training programme to replace the increasing number of doctors working less than full time (LTFT) or out of programme. This approach also recognises the significant attrition that occurs in the first two years of the programme.

Health Education England (HEE) recognised the need to address these challenges and agreed to implement recruitment at ST3 (previously recruitment was only possible at ST1) in England. This was introduced in 2018 with 219 individuals applying, of whom 87% were offered a post.

Increased support for SAS and Trust doctors21

Specialty and Associate Specialist (SAS) and Trust doctors provide an invaluable service to O&G departments, with many performing highly specialist roles such as running clinics and theatre lists, but with a narrower remit compared with consultants. However, the turnover of doctors in these posts is approximately 12%22, resulting in the loss of valuable and much needed skills from the O&G workforce. Anecdotal evidence suggests that many leave the workforce due to a lack of career development, professional support and recognition of skills.

The Workforce Task Group has recognised the need to engage with and understand the needs of the SAS/Trust doctor workforce better. In January 2018 the College’s workforce survey was also sent to SAS and Trust doctors in membership to gain a better understanding of their working patterns, areas of interest and career aspirations as well as the workplace challenges they face. This information is being used to inform our future working.

In addition the College has begun advocating for interventions to retain, reskill and upskill SAS doctors. In March 2018 the RCOG appointed a new SAS/Trust Doctor lead, Dr Laura Hipple, who for the first time is a full voting member of Council. The lead represents SAS and Trust doctors on a number of RCOG committees as well as at external groups, including the Academy of Medical Royal Colleges’ SAS group and a new SAS development and retention group that has been set up by HEE. The Lead also chairs a new RCOG SAS Advisory Group, which was established to provide further advice on issues affecting SAS/Trust doctors.

Find out more about the work of the SAS/Trust Advisory Group

Increased resident consultant working

The increasing pressure brought about by middle grade rota gaps is leading to more units introducing resident consultant working out of hours. This is successful in many units and for some consultants. However others, especially newly appointed consultants, are expressing frustration citing unpredictable work patterns, lost professional development opportunities and a lack of management support from consultant colleagues. Each individual unit needs to decide the best way to provide safe care for women based on their knowledge of their work load and case mix, which in many cases will require some resident consultant working as one of the possible options. RCOG’s 2016 report Providing Quality Care for Women: The Obstetrics & Gynaecology Workforce contains standards for resident consultant job descriptions and plans to ensure post holders can take advantage of professional development and leadership opportunities.

The RCOG has also produced job planning principles that encourage a transparent, departmental approach to job planning linked to the developmental objectives of the new appointee as well as to the wider department. This includes a provision that time off before and after night shifts is clear in the job plan and do not impinge on clinical care, nor on professional development.

You can read more about the principles of good job planning and download a Template person specification for an O&G consultant at Job plan approval process.

Redeployment of retiring consultants

There is concern among job planners that, due to workplace pressures, consultants in the future may start to retire earlier than is currently the case. This would lead to the loss of much needed specialist skills and leadership support and have a detrimental impact on more junior colleagues. To explore ways to retain these consultants and their skills in a way that is professionally satisfying and supports a positive work-life balance, the Workforce Task Group has established a working party to make recommendations on and take account of the needs of consultants considering retirement. This working party will report back on activities early in 2019.

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  1. Specialty and Associate Specialist (SAS) doctors have at least four years of postgraduate training, with at least two of these in a relevant specialty. These doctors are not on a training scheme or in consultant positions but they are employed on a nationally agreed contract and have exactly the same appraisal and revalidation requirements as consultants. Trust Grade Doctors have a variety of titles and are employed on local contracts often on a short term basis. Some of these doctors will have stepped out of the O&G training programme for a period of time to pursue a special interest.
  2. NHS Electronic Staff Records ↩︎