Letter to Amanda Pritchard regarding anaesthetic recruitment

This letter was sent to Amanda Pritchard, Chief Executive Officer of NHS England on 12 February 2024.

Dear Amanda, 

I am writing to request your intervention in ensuring that the Anaesthetic National Recruitment Office (ANRO) be given the necessary resources to provide a service that is fit for purpose in recruiting doctors into Core and Higher anaesthetic training.

Doctors trying to forge a career in anaesthesia are dependent on the performance of ANRO, which in recent years has fallen below an acceptable standard. As you know, errors made in anaesthetic recruitment in autumn 2021 led to a Significant Incident Review, with further errors in February 2023 resulting in a second review.

While some of the recommendations arising from these reviews have been implemented, resource and staffing levels within ANRO remain inadequate. These need to be urgently addressed to provide an acceptable level of service and prevent further errors. To provide some specific examples:

• There have been repeated delays to the recruitment of additional staff members to the ANRO team, and I understand that your permission is required to allow this during the recruitment freeze.  
• We now understand that the commitment to provide additional capacity has been further undermined by the removal of a key member of staff from the team. 
• Just last week, applicants for Core training in anaesthesia were expecting the results of the multispecialty recruitment assessment (MSRA) which is used for shortlisting in the week beginning 5 February. They were only informed about a delay in releasing the results on the afternoon of Friday 9 February even though ANRO must have known about the delay much earlier. This lack of basic consideration for applicants and the fact that the College was not directly informed at all is further evidence of the unacceptable level of service described. We understand the need for quality assurance and the pressure caused by the number of applications but feel strongly that this delay must be related to the lack of resources outlined above. This is particularly dismaying as we had only recently met with the leadership of MDRS to voice our concerns and had been reassured that contingencies were in place.

Adequate staffing levels are fundamental to the operation of the recruitment process, which has a significant impact on our members, and ultimately on the provision of anaesthetic services and patient care. The College’s confidence in the leadership and management of ANRO has been fatally undermined but we are constrained by a lack of a viable alternative to run recruitment.

The College has consistently sought to work constructively with ANRO – on behalf of our members and the specialty – to help them improve the recruitment process. There is no lack of will within the ANRO team to make the necessary changes. But they cannot do so without urgent intervention from NHS England to provide adequate resourcing and support. 

I therefore seek your assurance that the issues highlighted here will be resolved with immediate and sustainable effect, or that we will be able to work with you to identify a viable alternative to the current provision of service.   

Yours sincerely

Dr Fiona Donald
President, Royal College of Anaesthetists

Copied to: 

Professor Sir Stephen Powis, National Medical Director, NHS England
Dr Navina Evans, Chief Workforce, Training and Education Officer, NHS England
Professor Sheona MacLeod, Director of Education and Training, NHS England