Expanding the Consultant Workforce
Consultant Staffing in Emergency Departments in the UK
Find below the Royal College of Emergency Medicine's RCEM Workforce Recommendations 2018: Consultant Staffing in Emergency Departments in the UK:
NEW: RCEM Workforce Recommendations 2018: Consultant Staffing in Emergency Departments in the UK (revised Feb 2019)
* Please note that the references to Consultant staffing in the remainder of the historic RCEM guidance has been superseded by the above publication. *
The Benefits of Consultant Delivered Care (Jan 2012)
The most comprehensive and focused review into the benefits to patients of consultant delivered medical care has been published by the Academy of Medical Royal Colleges (AoMRC). The review was commissioned by the Academy and carried out by a Steering Group led by Professor Terrence Stephenson (Academy Vice-Chair and President of the Royal College of Paediatrics and Child Health). The review’s Steering Group called for written and oral evidence from professional organisations and individuals. It also commissioned an independent and systematic review of existing literature on the subject which identified over 70 relevant studies published between 1992 and 2011 (although much was from the last 3 years).
On the basis of the best evidence available, the Academy concluded that medical care delivered by fully trained consultant doctors has demonstrable benefits in terms of:
- Rapid and appropriate decision making
- Improved outcomes for patients
- More efficient use of resources
- GP’s access to the opinion of a fully trained doctor
- Patient expectation of access to appropriate and skilled clinicians and information
- Benefits for the training of junior doctors.
The Academy recommends:
- That the identified benefits of consultant-delivered care need to be taken into account alongside cost implications when considering the future shape of the medical workforce at local or national level
- Current contractual arrangements for consultants need to be separated from the question of the benefits of consultant-delivered care
- The benefits of consultant-delivered care should be available to all patients throughout the whole day and the whole week
- Implementing a full system of consultant-delivered care will require different thinking about consultant working patterns
- Work should be undertaken between clinicians and employers to map out the staffing requirements and service implications of implementing a consultant-delivered service throughout the week.
This report is not suggesting that it should only be consultants who deliver medical or clinical care. The Academy and Medical Royal Colleges fully recognise and support the principle that successful care depends on a team based approach where a range of healthcare staff contribute to the delivery of a successful outcome.
College recommendations to expand the Emergency Medicine Consultant workforce
- Download the document here.
The principal focus is to inform Acute Trusts, SHAs, commissioners et al of the urgent need to expand Emergency Medicine (EM) Consultant numbers and highlight the wide-ranging benefits.
The evidence quoted provides compelling support for the investment required and the dividends resulting - including patient safety, quality of care, productivity and crucially in the present financial climate, the affordability agenda from bed days saved, focused use of diagnostics (particularly imaging) and the expensive legal consequences of unsafe discharges. The current number of EM Consultants is woefully inadequate and the comparison with other specialties is telling.
The principles and messages are applicable throughout the UK and ROI, although the data and evidence used in this initial version are mostly from England. This is an organic document and will continue to be refined. In this regard we would very much welcome your comments and any local evidence available describing the impact of increasing EM Consultant numbers, particularly cost benefits.