A shortage of children’s doctors in Scotland is putting young people’s health at ‘significant risk’, according to a report from the Royal College of Paediatrics & Child Health (RCPCH).

‘Unless urgent action is taken’, staffing shortages could ‘damage the health of future generations’, the report claims.

The RCPCH has called for an expansion of the current workforce, including the appointment of at least 82 consultant paediatricians, an increase of 25%, to bring the paediatric workforce back from ‘the brink of a recruitment crisis’.

The report states the number of paediatric consultants in Scotland has increased by just 5% between 2015 and 2017, lower than an 8.2% increase in England over the same time.

There were 323.5 whole time equivalent (WTE) consultants in 2017 in Scotland but the RCPCH estimates between 393 and 419 WTE are needed to meet demand.

Among the report’s recommendations, the RCPCH calls for NHS Education for Scotland to develop a bespoke child health workforce strategy, which would include ‘a wide range of professionals such as doctors, midwives, nurses, pharmacists, health visitors and school nurses’.

The largest shortfall in staff has occurred within general paediatrics – those who look after children from birth to late adolescence – and are trained to manage multiple health problems from life-threatening illnesses to chronic diseases.

The report also recommends the Scottish Government maintain the 2019 uplift in the number of paediatric trainee places in Scotland, and that incentives, such as pay bonuses, be introduced to attract and retain paediatricians, particularly in remote or rural areas.

Officer for Scotland at the RCPCH, Professor Steve Turner, said the report clearly highlighted the impending seriousness of the paediatric workforce situation:

“Tackling the shortage of paediatric doctors needs to be a priority. We know that unless more doctors are trained to be paediatricians today, the situation where paediatric wards are being closed will only get worse. 

“The good news is that we know that Scottish doctors want to train in paediatrics in Scotland, and there are three young doctors applying for each job.

“We also know that doctors who train in Scotland become consultants in Scotland. However, the reality is that we are seeing vacancies and gaps in rotas across Scotland, especially in centres outside of the central belt. Our calculations suggest that at least 82 more consultant paediatricians need to be trained to meet demand.

“The need to increase trainee numbers in paediatrics has been recognised and we are grateful that eight additional posts will be available for 2019 – but this is a one-off “sticking plaster” which does not address the underlying problem.

“I urge the Scottish Government, NHS Education Scotland, and the Scottish health boards to reflect on our findings and seriously consider how best to implement our recommendations as a matter of urgency.

“Failing to take the necessary steps now will be to the detriment of our children both today and in the future.”

A Scottish Government spokesperson responded by stating:

“The health of our children is paramount, that is why we have more than doubled the number of paediatric consultants under this government to 355, and increased the number of paediatric nurses by more than 40% in the last eight years.
“We have worked closely with the Royal College of Paediatrics and Child Health to agree the appropriate and sustainable paediatric trainee supply. As the report highlights, we have acknowledged the need to increase the number of paediatric trainees and have provided 18 additional posts approved since 2014, achieving a 100% fill rate in recent recruitment rounds.”

“The report also points out that trainees want to train in Scotland where there are twice the UK average applicants for each available post”, they added.
“Work is underway to develop a comprehensive plan to help address some of the recruitment and retention challenges faced by our health and care sector.

“We have already published workforce plans covering the NHS, Primary Care and Social Care, and an integrated health and social care workforce plan will be published shortly. Of course the uncertainty around Brexit continues to pose a significant recruitment in the NHS.”