The growing shortage of cancer doctors

The Royal College of Radiologists has recently conducted a survey across hospitals treating cancer patients and the results show there is still a shortfall in the numbers of oncologists or doctors specialising in treating cancer.

Key findings:

  1. Workforce shortages have increased and are expected to increase furtherThere are currently 70 consultant oncologist posts sitting vacant, of which over half have been vacant for over 12 months or more. The cancer centres polled in this report responded that two thirds of advertised posts in 2018 were not filled. Where centres look to fill the recruitment gaps by looking overseas, there is proving to be a barrier due to significant differences in overseas specialist training. It is currently forecast that there will be continued growth of the gap between demand and supply, with a current 18% shortfall in consultant clinical oncologists rising to 22% in 2023.
  2. Clinical oncology trainee numbers need to double to close the growing gap between supply and demandIt is estimated that 53 trainees will enter the UK consultant workforce in 2019 but this falls short of the 70 vacancies reported in 2018. To address the growing shortfall of consultant clinical oncologists, expected to reach 272 in 2023, UK specialist training numbers need to double from the current average of 64 per year, to 138 per year. Even if these numbers are achieved, the gap between demand and supply will not close until 2029.
  3. Consultant clinical oncologists are showing signs of stress and burnout with early retirement resulting in the loss of valuable expertiseThe report has found that on average, consultant clinical oncologists are working an hour a week more than five years ago. This equates to 48 hours per week. 22% were contracted to work over 12 programmed activities in 2018. These are blocks of 4 hours dedicated to direct clinical care. This means nearly a quarter of consultant clinical oncologists are working more than 48 hours per week. If the number of programmed activities were reduced to ten per week, this could reduce stress and burnout. However, to cover the workload, an additional 116 consultant clinical oncologists would be required.
    In 2013, the percentage of consultants leaving the profession was 1.1% and just 5 years later in 2018 that has risen to 3.8%. In addition to this, over half of consultant clinical oncologists retire before the age of 60. The consequence of this is the loss of experience and knowledge. If they were incentivised to continue to work until the age of 65, there would be an estimated additional 93 experienced consultant clinical oncologists working within the sector.
  4. Consultants have less time for supporting professional activities which are vital for quality improvementSupporting professional activities allow time for consultants to implement new techniques and improve services for the benefit of the patient. In the last 5 years, time devoted to this practice has decreased by an hour and a quarter per consultant, per week. The recommendation is for each consultant to have 1.5 supporting professional activities per week, and in 2018, 1 in 5 were not achieving this benchmark. This figure has almost doubled since 2013.

With the NHS resources being stretched in this way in addition to other factors, it is entirely possible that the care being received is not as expected. With so many vacant posts, there may be delays in diagnosing cancer or potentially, it may not even be picked up on. There may be delays in receiving treatment which may cause a patient to undergo treatment that would not have been needed had the disease been diagnosed earlier.

“We urgently need to increase the number of clinical oncologists and to improve their working practices. Not doing so will have a serious impact on the treatment of our cancer patients.”

Royal College of Radiologists

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