Review of non-training NCHD grade ‘nearing completion’

Prof Frank Murray stated that the review “has comprised updated data analysis, primary research with international comparison, and extensive stakeholder consultation”.

The review follows a recommendation in a 2014 Department of Health-commissioned report (the MacCraith Review), which said processes should be put in place “as a matter of priority” to consider how to address the “limited” career structures for these doctors.

In a June 2014 report, the MacCraith Working Group stated that there were approximately 900 doctors in service posts in the acute hospital sector and around 260 public and community health doctors. It described career structures and pathways for these doctors as “limited”.

The Group recommended that processes be put in place by the HSE, as a matter of priority, to consider how best to address this issue, having due regard to the needs and requirements of the public health system, including service reconfiguration and integrated models of care; patient safety and quality of the patient experience; registration, qualifications and training; clinical governance; CPD; and supervisory arrangements.

According to the Eighth Annual Assessment of NCHD Posts 2017-2018, there has been an increase in trainees occupying clinical posts in the Irish healthcare system since 2011 (3,412 to 3,947; 15 per cent). This corresponds with the NDTP policy of growing training capacity to accommodate the increasing number of exchequer-funded CAO graduates from Irish medical schools, combined with the introduction of the International Medical Graduate Training Initiative (IMGTI).

“However, there has been a disproportionate increase in non-trainee numbers over the same time period (1,524 to 2,286; 50 per cent). Even this latter figure is likely to be an underestimate, as it does not take account of NCHDs employed through recruitment agencies,” according to the report.

Meanwhile, Prof Murray confirmed that the HSE is undertaking a review of the intern year, in collaboration with stakeholders. This process is at “preliminary planning stage” and is being led by NDTP, he outlined.