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Tomorrow’s Specialist

Published: 20/09/2012

In addition to the full report (above), you can download:

Nicholas Timmins, King’s Fund Health Policy Senior Fellow, has also written a synopisis of the key messages from High Quality Women’s Health Care and Tomorrow's Specialist: Tomorrow’s Specialist: The future of obstetrics, gynaecology and women’s health care (PDF, 664 kb).


The Tomorrow’s Specialist Working Party developed the discussion around, and produced a series of recommendations about, future services for women’s health care and the doctors necessary to provide high quality care. The need for these changes was clearly articulated in the evidence given by women, the profession and the NHS. There is a need for rapid change within the health service if women and their families are to have good, affordable health care now as well as in the future; the present structure and system of delivering care is unsustainable, as services remain disjointed and the focus of the specialty is on hospital-delivered procedures.

Women need a specialist workforce that is able to work in integrated clinical teams, providing care locally where possible. Tomorrow’s specialists will work differently: in teams with peers, providing on-site care 24 hours a day, 7 days a week, in non-hospital settings, as ‘localised where possible, centralised where necessary’ becomes the norm. Within such teams, the roles and responsibilities will differ and change over an individual’s career and may involve periods working in hospital, in the community or both as a member of the wider multidisciplinary team. Working closely with colleagues from other specialties and other healthcare professions is already an important component of a specialist’s work but will be even more vital as boundaries dissolve and professional and physical silos are eroded.

Doctors of tomorrow cannot look at present practice and assume their own working lives will be similar, not least because the impact of new scientific developments and technology will be translated into clinical practice with increasing rapidity. Women and their families will access health care in a multitude of ways and have higher expectations of all their healthcare providers. Other healthcare professionals will have expanded roles and other providers will have an impact on traditional working practices.

Developing flexibility within the training programme and beyond will ensure that senior doctors continue to develop their skills, learn new ones and contribute to all aspects of professional life. Support about career development and options should not be limited to younger doctors deciding on which specialty to enter but should be a thread running throughout a doctor’s career.

The focus for the specialty will always be on improving the quality of women’s health. To do this effectively within a rapidly changing health system requires highly skilled, flexible, adaptable doctors. These professionals must be able to work in teams, providing leadership in situations ranging from clinical decision making to developing policies that will influence politicians locally and nationally. Respect for other healthcare professionals from those within obstetrics and gynaecology is such that closer multidisciplinary team working, across different working environments, based on the principles explored in this report and ensuring meaningful engagement with women as partners in health care, is felt to be the most effective way to make High Quality Women’s Health Care a reality.

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We are keen to hear from doctors, specialist registrars, women and the public about what you think of Tomorrow’s Specialist. Please email