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Model 3 hospitals face ‘significant and serious’ challenges – NDTP report

By David Lynch - 19th Nov 2023

model 3

Model 3 hospitals face “significant and serious” challenges to service delivery due to recruitment difficulties, the Medical Director of HSE National Doctors Training and Planning (NDTP) has warned.

Speaking to the Medical Independent (MI) at the NDTP National Medical Workforce Conference in Dublin on 9 November, Prof Brian Kinirons said the new consultant contract may help future recruitment in model 3 hospitals.

However, he added that the issue is “bigger than the contract”.

Prof Kinirons was speaking as the NDTP launched its Model 3 Hospitals Report. The report found the future of these hospitals is “precariously balanced” due to challenges in the recruitment and retention of consultants.

“The challenges in model 3 [hospitals] are significant and serious and it’s about more than just the contract,” Prof Kinirons told MI.

“There are some specialties that are more challenged than others and I think there are certain sites more challenged than others.

“So, for example, we know if a model 3 hospital is in reasonable proximity to a model 4 [hospital], recruitment in that model 3 isn’t as difficult… but I think there are a whole series of challenges in relation to model 3 hospitals.”

The new NDTP report identified “marked differences” between model 3 and model 4 hospitals.

In model 3 hospitals, 24 per cent of consultants are in locum posts; 7 per cent are not on the specialist division of the Medical Council register; 7 per cent are in non-approved posts; and 33 per cent are over the age of 55 years. These numbers are significantly higher than in model 4 hospitals.

The report noted that while there had been “substantial growth” in the number of consultants employed over recent years, “recruitment and retention of consultants remain a national challenge”.

During his address to the conference, HSE CEO Mr Bernard Gloster described the model 3 hospitals as a “wonderful concept” and important to the planned regionalisation of healthcare.

“But if we don’t mind it [model 3 hospitals] and if we don’t think about it now… we will lose its benefit, because we will not be able to sustain the medical workforce in it.”

The NDTP report makes a number of recommendations, including the need for a “robust” recruitment drive.

“Analysis showed an estimated recruitment need for 1,005 model 3 hospital consultant posts in the next 10 years,” according to the report, which recognised that this target represented a “major challenge”.

The report also recommended addressing consultant workload in model 3 hospitals, investing in education and training, improving on-site infrastructure and reinforcing links with model 4 hospitals.

There are 17 model 3 hospitals in Ireland, which are divided across five Hospital Groups.

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