There was an increase in the number of positions processed by the consultant applications advisory committee (CAAC) last year compared to 2024, according to the CAAC’s 2025 annual report.
The HSE National Doctors Training and Planning ‘consultants’ division’, which is the secretariat to the CAAC, processed a total of 400 applications in 2025.
These applications include new post applications, requests to restructure existing approved consultant posts, direct replacement applications, and change of contract type requests.
The volume of applications processed increased by 53 applications, or 15 per cent, compared to 2024.
Of the 400 applications, 275 were considered by the CAAC, which was an increase from 225 in 2024.
The remaining 125 applications were direct replacement requests and were processed directly by the consultants’ division.
Of the 275 applications considered by the CAAC, 272 applications were recommended for approval, while three were deferred for further consideration.
The posts recommended for approval by the CAAC included 92 in general medicine, 42 in surgery, 31 in psychiatry, 30 in radiology, 23 in emergency medicine, 21 in pathology, and 17 in anaesthesiology.
The 125 direct replacement post approvals processed directly by the consultants’ division included 33 in psychiatry, 28 in general medicine, 15 in surgery, 10 in pathology, and 10 in obstetrics and gynaecology.
This year’s report highlighted the “significant evolution” of the CAAC’s work since the introduction of the public-only consultant contract (POCC).
The report states that following the introduction of the POCC in 2023, applications in respect of replacement consultant posts are no longer required to be presented to CAAC.
However, posts requiring restructuring from original approval still require committee approval.
“This procedural change represents a significant evolution in the committee’s workload and oversight responsibilities,” according to the report.
As a result, the CAAC’s role regarding replacement posts has shifted from high-volume, administrative scrutiny toward a more “targeted and strategic oversight” function.
“The committee’s focus is now concentrated on posts that involve restructuring, service redesign, or material deviation from original approval – areas where its evaluative and governance expertise adds greatest value,” according to the report.
“This enables deeper consideration of workforce alignment, service reform objectives, and compliance with national policy, rather than routine confirmation of established approvals.”
See news feature in the 5 May edition of the Medical Independent
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