Call for action to tackle the medical workforce crisis

  • 08 Dec 2021
  • RCOphth news

Pressure to tackle the workforce crisis is growing

 The Academy of Medical Royal Colleges (AOMRC) today published ‘A dozen things the NHS could do tomorrow to help the medical workforce crisis’, which was sent to Sajid Javid, the Secretary of State for Health and Social Care. The RCOphth contributed to this new statement which sets out practical solutions including more flexible job plans, better retirement and return arrangements, access to training in the independent sector and greater flexibility in training pathways.

Crisis is very much the right word. Latest NHS Digital data shows we have almost 100,000 vacancies in the NHS, at the same time as the elective care backlog reached 5.8 million. In ophthalmology, our 2018 census found that three quarters (77%) of units in the UK reported unfilled consultant posts, with two thirds reliant on locums.

The National Audit Office last week projected that the waiting list could double to 12 million by 2025. Ophthalmology is bearing a heavy toll, with almost 600,000 patients waiting for procedures and a third of these having waited over 18 weeks. Outpatient waiting lists for ophthalmology are also higher than most other specialties and continue to rise.

Innovations in ophthalmology need to be backed up by investment

Great innovation is being seen in ophthalmology to try to this backlog, with the implementation of high flow cataract lists and plans to incorporate ophthalmology services into community diagnostic centres – including in a shopping centre in North London.

But these innovations require funding, either from NHS trusts or health boards, or from central government or NHS bodies. In England, the government has just announced that 187 trusts have received funding to support the recovery of services over the next six months as part of the £700m Targeted Investment Fund. NHS England’s Eye Care Hub provides useful examples of business cases that have been used to secure investment in essential ophthalmology services.

The RCOphth will continue to make the case to policymakers – including through the National Eye Care Recovery and Transformation Programme – of the importance of prioritising ophthalmology as community diagnostic centre services are rolled out. As part of this, greater support for training technicians would also help to quickly expand outpatient capacity in ophthalmology and tackle the backlog.

Focus on the long-term challenge is needed

 This focus on urgent short-term measures reflects not just the scale of the current backlogs, but also the reluctance of government to face the reality of the need for long-term workforce planning. Like other health organisations the RCOphth was disappointed that a proposed amendment to the Health and Care Bill that would have required  the publishing of regular projections of the health and care workforce requirements in England was defeated. The RCOphth hopes this could still be changed as the Bill moves to the House of Lords.

Looking ahead, it is expected that Health Education England’s (HEE) strategic workforce framework will be published in Spring 2022. While it remains to be seen how HEE’s forthcoming merger into NHS England will affect how the workforce is trained, the College was clear in our response to the call for evidence on the strategic workforce framework that an expansion is needed in the number of training places available for ophthalmology to meet patient need. The College also stressed the need to support innovative training pathways to develop eye care professionals in multi-disciplinary teams and release the potential of upskilled nurses, optometrists, and imaging technicians.

Momentum is growing to tackle the workforce crisis. The day after the government defeated the amendment to strengthen workforce planning in the Health and Care Bill, a Parliamentary committee comprised of MPs from the three leading parties launched an inquiry into how to improve retention and recruitment in the NHS and social care workforce.

The College will be responding to this inquiry to outline the urgent need to invest in the eye care workforce, as part of the necessity of proper long-term planning of what is needed for the wider health and social care workforce. It appears the message is starting to get through, and it is essential that this pressure to tackle the workforce crisis now leads to firm action.