Urgent need for increase in anaesthetic specialty training places

Published: 01/11/2024

The announcements in the Budget of a £22.6bn uplift in day-to-day spending on the NHS in England, and a £3.1bn boost to capital investment, are very welcome. A key task now is to ensure that an appropriate portion of that money is allocated to addressing anaesthetic workforce shortages. Without this, the ability of the NHS to deliver a significant reduction in patient waiting lists will be severely limited.  

Securing an increase in anaesthetic specialty training places, alongside measures to improve retention and recognition of consultant, SAS and resident anaesthetic doctors, remains an absolute priority for the College. We have repeatedly made the case for why this is essential to successive governments and to NHS leaders and will continue to do so.  

In recent months, our advocacy work has focused on opportunities to influence the new Government, building on our sustained action over the last few years and based on evidence provided by our members.

The need is clear 

  • Data collected for our forthcoming State of the Nation report and trailed in our manifesto shows that despite an increase in the number of anaesthetists, the shortage is worsening. Across the UK we now have a shortage of 1,900 anaesthetists, preventing around 1.4 million operations and procedures from taking place each year.  

  • Our advocacy work has secured an additional 70 higher anaesthetic training places in the last three years, helping to reduce the ST4 bottleneck. However, these increases remain significantly short of the expansion needed to meet the needs of patients. Our census data over many years demonstrates the demand for anaesthetic services significantly exceeds supply.  

  • In addition, we are now seeing an extremely concerning escalation in the bottleneck between foundation and core training. This year, there were 3,520 applications for 540 core anaesthetic training places. While the expansion of medical school places is welcome, there is an urgent need for a corresponding increase in specialty training. A detailed, long term and fully funded plan for specialty training is essential. 

What action are we taking? 

  • As the Government develops its promised 10-Year Health Plan for the NHS, we are seeking to influence at every opportunity. Recent examples include making our case in our manifesto, participating in Lord Darzi’s review as a member of the Expert Reference Group and meeting with senior NHS decision makers and government ministers – both in Westminster and across the devolved nations. We are preparing a response to the Change NHS consultation, which will feed into the 10-Year Plan, and seeking to influence the next iteration of the NHS Long Term Workforce Plan.  

  • We are making representations to NHS England based on our detailed workforce and training capacity data to demonstrate why expansion is warranted, provide detail on existing capacity to train additional anaesthetists and identify which Schools of Anaesthesia can take on additional training post at stage 1 and 2 of training.  

  • In response to questions our members have raised about the validity of using the MSRA in anaesthetic recruitment, we have initiated a detailed analysis of its use as a selection tool. Following a significant amount of work by our Recruitment Committee, a formal proposal for analysis has been submitted to the UK Medical Education Database (UKMED) to conduct the research. This will enable our Recruitment Committee to better understand and analyse the career progression and performance of anaesthetists in training recruited while the MSRA has been in use.  

  • As part of our work aligned with the EGM resolutions, we are developing a report of our work to improve recruitment, which will set out recommendations. This work has included focus groups with anaesthetists in training, discussions with other Colleges and faculties within the Academy of Medical Royal Colleges (AoMRC) and reviews of recruitment practices over the past few years. Thank you to everyone who has participated. 

I hope this is a useful update on the work we are undertaking on behalf of our members, the specialty and patients to advocate for an urgent increase in anaesthetic training places at every opportunity. Expansion of the anaesthetic workforce remains essential to meet the ever-increasing demands placed upon the NHS. Later this month we will publish our new State of the Nation report, which will provide us with further evidence for our campaign.  

Dr Claire Shannon
President