Letter to the health secretary - Northern Ireland
Mr Robin Swann MLA
8 June 2021
Re: Trainee Anaesthetists
We are writing to you on behalf the Association of Anaesthetists which represents more than 10,000
anaesthetists (including approximately 3,500 trainees). We are seeking urgent action to increase the
number of ST3 training posts in anaesthesia this summer. In light of the well-described workforce
shortage in anaesthesia, it seems that time is of the essence to grow the number of trained
anaesthetists in the UK.
This year, due to a combination of factors, there are many more applicants for specialist training in
anaesthesia than in previous years. A recent estimate found there are around 350 jobs for
approximately 1,050 candidates, leaving up to 700 trainee anaesthetists without a suitable training
post. The increase in applicants this year results from a number of factors: a new curriculum which
places an imperative to obtain a training post before the regulations change and the ‘goal posts’ move;
the impact of the Covid pandemic on the number of trainees who might otherwise have sought a year
abroad to consolidate their learning but who are now unable to travel and wish to remain in the UK;
the difficulty in achieving educational targets while re-deployed during surges; and, a desire to
complete training without any further interruptions after the unprecedented pressures and challenges
of the last 14 months.
These trainee doctors have already spent at least two years gaining experience in anaesthesia and
intensive care. During the pandemic surges most anaesthesia trainees were reallocated to intensive
care units to provide the medical workforce and enable the provision of this resource to be massively
increased. They have committed to a career in our speciality, and they are the workforce of the future.
Providing them with training posts now will ensure we have a supply of trained senior staff in five
years’ time, and during their five-year training they will provide significant service, staff many out-of-hours
rotas, and ensure the resilience we need for further surges.
We know you are working with colleagues on the huge backlog of investigations and therapeutic
surgical procedures that has grown over the last 14 months. The pressure on the NHS is extraordinary
and unprecedented. Surgery and anaesthesia are, of course, intimately linked and there can be no
increase in surgery without a concomitant increase in anaesthesia.
Last month, our journal – Anaesthesia – published the collated results of three surveys which highlight
the extraordinary pressures faced by anaesthetic departments throughout the country during the
surges. In addition, the most recent census published by the Royal College of Anaesthetists has
confirmed the findings of previous censuses that there is a very significant shortage of anaesthetists in
the UK (over 1,000, and almost certainly closer to 2,000). At a time of a very significant anaesthetic
workforce shortage, it is disappointing and surprising that, to date, there has been no increase in the
number of training posts. As a result, the workforce gap will continue to grow. The impact of fatigue
and stress, leading to more retirements or move to part-time working, will only further increase the
We urge the UK and devolved governments to tackle the workforce shortage by funding a very
significant increase in training posts. Not to do so will miss an opportunity to provide more anaesthetists right now, provide greater resilience immediately for further surges, and prevent these 700 doctors becoming the new ‘lost tribe’ in medicine. A recent
survey of our own trainee members has shown a very significant degree of disillusionment in our trainee anaesthetists. If you do not act, we believe there is a very real risk that many of these doctors in whom we have already invested time and money in training will be lost to the profession forever as they will seek alternative careers or move to work abroad once travel restrictions are lifted.
We suggest that the number of training posts (ST3) is doubled this year from approximately 350 to 700, and remains at that level for the subsequent two years. We know that Trusts (and Boards) have money set aside for creating non-training ‘locally employed doctor’ (LED) posts this year as they recognise the need for more anaesthetists. We understand that Health Education England already has money set aside to support of education of trainee anaesthetists. LED posts will not lead to training of qualified specialists, but if the funds we have identified and some additional new money was used to create training posts then there will be a long-lasting improvement in the anaesthetic workforce and the capability to provide more surgical services.
We would be happy to meet with you and discuss our proposal further.
With best wishes,
Dr Roopa McCrossan
Chair, Trainee Committee
Dr Mike Nathanson