The higher specialist training (HST) intake for obstetrics and gynaecology (O&G) needs to increase from 18 to 24 annually by 2030, a new report has found.
The latest specialty-specific review from HSE National Doctors Training and Planning (NDTP) also stated the total O&G consultant demand across public and private healthcare settings is projected to reach 346 whole-time equivalents (WTEs) by 2040.
This is described as a “substantial increase” on the current public and private workforce of 223.8 WTE.
The key recommendations of the report are to increase the HST annual intake from 18 to 24 by 2030 and “address the causes of attrition and improve retention of trainees at mid-programme and post-BST [basic specialty training] stages”.
In the “medium-term” it will be necessary to recruit approximately 16 consultants from outside of the current domestic training pipeline to address anticipated retirements and facilitate workforce expansion while the training pipeline output is increased.
A “key strategy” to support increased training numbers is the conversion of non-training NCHD posts into structured training posts. The report noted there are currently over 200 non-training NCHDs (non-training scheme doctors (NTSDs)) working in O&G nationally.
“A large cohort of NTSDs is typically indicative of service gaps and unmet demand, which will be addressed through expanding the consultant and trainee workforces,” according to the report.
“Furthermore, O&G suffers from attrition among trainees, particularly at mid-programme and post-BST stages. This is driven by many factors such as poor work-life balance and litigation fears and remains a key challenge for O&G in the coming years.”
In the report’s foreword, NDTP Medical Director Prof Anthony O’Regan highlighted that the medical workforce in O&G is “currently under pressure to meet demand for services” and this demand is projected to increase in the coming years.
“Demand in obstetrics services will primarily be driven by safe staffing needs in maternity units, while demand in gynaecology will be driven by an ageing population and increased service utilisation. The estimates in this review suggest that by 2040 gynaecology will account for approximately two-thirds of the total workload in the specialty.”
Prof O’Regan outlined that the scale of expansion in both the consultant and trainee workforces outlined in the report was ambitious and will need to be implemented carefully. The implementation will need to acknowledge ongoing factors such as high workload intensity, litigation concerns, long duration of the training scheme, and ensuring sufficient clinical exposure to develop comprehensive clinical competence.
Also writing in the report, Dr Cliona Murphy, Clinical Director of the National Women and Infants Health Programme, said that workforce planning needs to take account of increased life expectancy and increased expectation of living well for longer.
“Our maternity workforce will need to deal with increasing complexity and more operative deliveries,” according to Dr Murphy.
“We have moved away from a narrow physician/patient model to an agile and responsive multidisciplinary team model that emphasises right care at the right time.”
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