One factor that may not have been considered in the NHS new Long Term Plan is that hundreds of top doctors are thinking of leaving before retirement age, according to the British Medical Association, threatening a skills vacuum at the top of clinical care.
A new analysis by the BMA suggests hundreds of skilled hospital consultants intend to leave the NHS early, with 60% indicating they plan to retire before the age of 60, with the need for a better work-life balance cited as the main reason for the decision, followed by the impact of current pension legislation. Just 7% plan to stay after the age of 65.
It’s a sobering thought in light of the staffing uncertainties posed by Brexit – particularly plans for a minimum salary threshold for skilled migrants – as well as the stark reality that the NHS is already facing a crisis in its workforce. On average one in 11 NHS posts in England vacant in the last 12 months, equivalent to more than 100,000 staff in a workforce of 1.2 million.
Even before they leave, more than a third of consultants say they intend to reduce the number of days working for the NHS by 50%, and 18% are already planning to cut their commitment even further – some suggesting they will completely withdraw from NHS work.
The BMA notes that such a significant loss of specialist clinicians is “potentially disastrous” for both the junior staff they teach and the patients they care for, and will make some of the targets of the Long Term Plan almost impossible to achieve.
Proposals to improve access to personalised care for early stage cancer sufferers, prevent 150,000 heart attacks, stroke and dementia cases, and provide a 24/7 community-based mental health crisis response could all be in jeopardy, it says.
The survey also found that more than 40% of consultants were less likely or have already given up taking part in work initiatives to reduce waiting lists, which could impact other initiatives including the introduction of waiting time targets for emergency mental health services.
BMA consultants committee chair Dr Rob Harwood describes the situation as “clearly untenable”, saying it comes against a backdrop of a “derisory” new pay settlement that raises the average consultant’s wage by just £6.10 after tax “at a time when they have lost over 24 per cent of take-home pay in the last decade”.
“During a deepening workforce crisis, the NHS needs its most experienced and expert doctors now more than ever,” asserts Harwood.
“I struggle to understand how the Health Secretary can talk about increasing productivity in hospital care, while allowing the NHS to be a system which perversely encourages its most experienced doctors to do less work and, in some cases, to leave when they do not want to.”
Other recent surveys have found that the risk of an exodus is also looming, including a General Medical Council (GMC) poll published last month that found around a third of doctors are considering reducing their hours in the next three years, a fifth are planning go part time and another fifth plan to leave the UK to work abroad.
That research also revealed an emerging crisis in the top ranks of the medical profession, with 21% of 45–54 year old doctors and two-thirds of 55–64 year olds intending to take early retirement by 2021.
The figures come against a backdrop of uncertainty with a possible Brexit ‘no deal’ around how European Economic Area (EEA) qualified doctors, who make up 9% of licensed doctors in the UK, will be able to join the UK medical register after Brexit.