Trainee shortage causes hospital cutbacks

15 February 2010

HOSPITAL services in some parts of the UK are under threat due to a shortage of junior doctors.

Tighter immigration laws and the impact of the European Working Time Directive are two factors being blamed by some for causing a recruitment crisis. The EWTD was introduced in August limiting the average working week for junior doctors to 48 hours.

Problems have been highlighted in the past few weeks in Fife, Northern Ireland and the Isle of Wight. This follows recent reports of trainee shortages in Wales – reported in last month’s eFYi newsletter – which forced Llandudno hospital to stop night-time emergency admissions.

In Scotland, new problems have been reported by NHS Fife. The area could be left with one overnight accident and emergency department if a shortage of junior doctors is not resolved. There were four unfilled posts in emergency medicine in January due to recruitment problems and staff taking sickness or maternity leave.

If the posts remain unfilled, health bosses admitted they may be forced to close emergency services at Victoria Hospital, Kirkcaldy, between midnight and 8am and concentrate them at Queen Margaret Hospital in Dunfermline. A minor injuries service would continue at the Victoria. In the past, NHS Fife has used locum appointments to fill posts but new, stricter immigration visa rules governing the recruitment of overseas doctors has made this more difficult.

In Northern Ireland, a shortage of junior doctors could lead to services being suspended with patients waiting longer and travelling further for treatments, the BMA has warned.

The obstetric and gynaecology service at Erne Hospital was suspended last summer for several weeks because of a juniors shortage. And the BMA in Northern Ireland predicts services will be hit again this year.

Dr David Farren, chair of the BMA (NI) Junior Doctors committee, said: “There are two main factors creating this problem — one is the immigration laws and the second is that the number of posts have been increased to ensure rotas are EWTD compliant.”

Northern Ireland’s health minister has set up a working group to look at ways of improving the recruitment and allocation process. But Dr Farren said: “I would predict gaps are going to be worse in the coming year as early indications suggest applications for junior doctor posts are down by 30 per cent.” He said the working group should lobby European government for a change in the immigration laws.

Trainee shortages are also causing problems at St Mary’s Hospital in the Isle of Wight. Staffing levels there have been described as “unsafe” in a new report, with only one junior doctor on duty in the emergency department overnight.

A senior consultant is always on call from midnight to 8am, but Isle of Wight Primary Care Trust plans to bring in an additional senior staff member to improve services and support junior doctors. The governance and assurance report, presented to a recent meeting of the Isle of Wight PCT service delivery board, warned staffing levels on the hospital’s Luccombe and St Helens wards were also unsafe.