Respiratory medicine could be heading for crisis

Respiratory medicine could be heading for crisis if doctors are not offered more opportunities for flexible training and working, according to a new survey launched by the British Thoracic Society (BTS).

The survey of specialist registrars and consultants, published in a letter to the Royal College of Physicians’ journal Clinical Medicine, shows that if there are to be enough respiratory physicians to provide a high quality service for patients in the future, there will need to be greater opportunities for staff to train and work flexibly.

The BTS Working Party on Flexible Training and Working asked consultants and specialist registrars about their current training and working arrangements and whether they intended to work flexibly in the future. Their research demonstrates an unmet demand for flexible consultant posts with more than half (51%) of specialist registrars questioned considering working flexibly as a consultant.

The research also highlights the impact of an increasing retirement rate. Half of respondents (50%) stated they wish to retire before or when they are 60 years old leading to both a loss of expertise and an increase in job vacancies in the next five years. Experts are worried that if trainees are not offered the opportunity to work flexibly as a consultant they may not come into specialty at all and there will not be enough respiratory specialists to make up the hours lost and provide the care needed to patients.

There is also concern about the lack of funding in this area, particularly as the demand for flexible working and training is increasing. Currently 20% of all female consultants and specialist registrars work flexibly but a rapid change of gender in respiratory medicine means that the proportion of female consultants working in respiratory medicine is likely to double from less than 15% to 30% in 2010.

Providing opportunities for trainees and consultants to work flexibly is essential for the recruitment and retention of doctors to respiratory medicine and other specialties. The new consultant contract provides opportunities for flexible job plans for respiratory and other consultants.

Dr Louise Restrick, member of the BTS Working Party on Flexible Training and Working said:

“Our research shows that already 20% of female lung specialists have found a way to work flexibly and provide quality care for their patients. But this is the tip of the iceberg when it comes to the number of lung specialists – both male and female - who say they want to work flexibly in the future. With more provision for flexible working and training, the NHS will be able to retain this changing workforce and attract new staff to deliver high quality services in the future.

“But a major issue, which must be addressed, is funding. There are trainees who despite meeting the criteria for flexible training or working – for example having young children or other caring responsibilities – are unable to train flexibly because of lack of funding for such posts. If the NHS is to become ‘an employer of choice’ it must face up to the fact that the workforce is changing and provide the resources that will improve opportunities for flexible working and training.”