Trusts should cut workload of senior physicians to retain them
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《英国医生杂志》
More than three quarters of consultant physicians currently in post intend to retire early. This exodus could leave every large hospital in the United Kingdom short of two physicians and could mean a loss of over 6000 working years in total to the NHS, the Federation of Royal Colleges of Physicians has warned.
The findings, from the federation抯 2004 annual census of UK consultant physicians, indicate that the government needs to take more account of changing working patterns. Doctors are leaving the profession early, escaping long working hours and stressful conditions, says the federation, which comprises the Royal Colleges of Physicians in London, Edinburgh, and Glasgow.
The Royal College of Physicians in London, which commented separately on the findings, recommends that doctors approaching retirement age should be allowed to concentrate on less intense duties such as postgraduate education, management, and specialty work, to escape from "the heavy burden of emergency medical on-call."
"The time has come to take a long hard look at the way consultants work as they progress through their careers," said Alistair McIntyre, director of the Royal College of Physicians?Medical Workforce Unit. "We need to change the working environment and workload to encourage this experienced and committed workforce to stay in the NHS."
The recruitment of new consultants is already failing to keep up with NHS demand, the federation says. Nearly half of advisory appointment panels in England in 2004 failed to appoint anyone because of a lack of holders of the certificate of completion of specialist training applying for the post, meaning that the number of consultants in the UK increased by only 5.4%.
The problem is particularly severe in the acute medical specialties. Although the number of posts in these specialties increased markedly in the past year, when it came to filling them more than half of appointment panels were unable to appoint anyone because of a lack of suitable candidates, the royal college says. Women appear particularly reluctant to enter the field, and the royal college argues that greater provision for flexible working could reverse this trend.
With nearly a quarter of consultants due to reach retirement age in the next decade, the royal college warns that the issue is pressing. The findings echo BMA research from December last year which found that as many as 79% of all consultants aged 50 or more had seriously considered early retirement and that 57% had even made financial provision to do so. The main reason given was pressure of work, cited by 23% of respondents.
The federation梬hich surveyed 5000 physicians梤eports that a large proportion of consultants are still overworked, clocking up a 59.3 hour week on average, 11 hours more than the 48 hours permitted by the European Working Time Directive.
Factors other than workload related stress could also be playing a part in the trend. After the agreement of the new consultants?contract in 2004, the BMA warned that an improvement in doctors?working conditions could, paradoxically, tempt many into early retirement, as better salaries improved the pensions available to those who decided to give up work.(Madeleine Brettingham)
The findings, from the federation抯 2004 annual census of UK consultant physicians, indicate that the government needs to take more account of changing working patterns. Doctors are leaving the profession early, escaping long working hours and stressful conditions, says the federation, which comprises the Royal Colleges of Physicians in London, Edinburgh, and Glasgow.
The Royal College of Physicians in London, which commented separately on the findings, recommends that doctors approaching retirement age should be allowed to concentrate on less intense duties such as postgraduate education, management, and specialty work, to escape from "the heavy burden of emergency medical on-call."
"The time has come to take a long hard look at the way consultants work as they progress through their careers," said Alistair McIntyre, director of the Royal College of Physicians?Medical Workforce Unit. "We need to change the working environment and workload to encourage this experienced and committed workforce to stay in the NHS."
The recruitment of new consultants is already failing to keep up with NHS demand, the federation says. Nearly half of advisory appointment panels in England in 2004 failed to appoint anyone because of a lack of holders of the certificate of completion of specialist training applying for the post, meaning that the number of consultants in the UK increased by only 5.4%.
The problem is particularly severe in the acute medical specialties. Although the number of posts in these specialties increased markedly in the past year, when it came to filling them more than half of appointment panels were unable to appoint anyone because of a lack of suitable candidates, the royal college says. Women appear particularly reluctant to enter the field, and the royal college argues that greater provision for flexible working could reverse this trend.
With nearly a quarter of consultants due to reach retirement age in the next decade, the royal college warns that the issue is pressing. The findings echo BMA research from December last year which found that as many as 79% of all consultants aged 50 or more had seriously considered early retirement and that 57% had even made financial provision to do so. The main reason given was pressure of work, cited by 23% of respondents.
The federation梬hich surveyed 5000 physicians梤eports that a large proportion of consultants are still overworked, clocking up a 59.3 hour week on average, 11 hours more than the 48 hours permitted by the European Working Time Directive.
Factors other than workload related stress could also be playing a part in the trend. After the agreement of the new consultants?contract in 2004, the BMA warned that an improvement in doctors?working conditions could, paradoxically, tempt many into early retirement, as better salaries improved the pensions available to those who decided to give up work.(Madeleine Brettingham)