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‘It is time for flexible working in the NHS to be embraced’

Survey finds that medical staff shortages are likely to increase over the coming years as RCP launches report with initial pandemic lessons learned 

 

As the Royal College of Physicians (RCP Cymru Wales) publishes the follow up report to a virtual workshop with physicians across south west Wales (attached), doctors are calling on the Welsh NHS to focus on the positive changes that have come from the pandemic, and avoid returning to old ways of working.

 

Most doctors want flexible working to continue after the pandemic, but NHS workforce shortages present a key barrier.

 

Flexible working, remote clinics and working from home are all becoming more important to doctors in the NHS as wider expectations around work/life balance change. This has enormous implications for the medical workforce, and the Welsh Government should expand training and medical school places as soon as possible to avoid staff shortages in the NHS in the coming years.  

 

Expanding medical school places will be the best long-term solution to addressing shortages in the clinician workforce.

 

With more than a fifth (22%) of consultant physicians planning to retire in the next 3 years, NHS organisations across Wales need to develop workforce strategies that prioritise staff wellbeing and a high quality work/life balance. Where staff want to work flexibly, or from home, this should be encouraged wherever possible. During the pandemic, 37% of respondents in Wales started working from home.

 

Doctors in Wales want more flexible working opportunities.  

 

  • 59% said they want to work more flexibly
  • 73% said they want to work more from home
  • 70% said working from home has improved their work/life balance
  • 80% want to work fewer hours onsite

 

A lack of workforce is the key challenge.

 

  • 37% of respondents in Wales said it would be difficult or impossible to work more flexibly, due to staff shortages.  
  • 92% said there simply weren’t enough medical staff to allow flexible working.
  • 49% said they didn’t think their department would support a request to work more flexibly, due to staff shortages.  

 

Yet it’s clear that doctors in Wales would like this shift to more remote working during the pandemic to become the norm. 68% want more opportunities for remote IT access, online meetings and remote working to be available in the future.

 

The NHS workforce is exhausted.

 

At the end of the most challenging year in NHS history, almost three quarters of respondents in Wales (72%) said their working pattern changed in response to the pandemic, with 37% saying they began working additional hours on top of their contract. Almost half (48%) of respondents say they have little or no control of their professional life, and 65% said this got worse during the pandemic. Half of respondents had seen their protected time for non-clinical activities cancelled. Of these, 80% said this was done without consultation.

 

During our virtual visit to Hywel Dda and Swansea Bay health boards, consultant and trainee physicians told us:

 

  • Virtual working should ensure medical education becomes more flexible and accessible, especially in remote and rural hospitals. Doctors must be given every opportunity to learn.
  • Staff wellbeing, compassionate leadership and mental health must become a priority for the NHS. We need to raise awareness and remove the barriers to seeking help.
  • NHS health boards must share learning and experiences more effectively and work in a more united way to improve patient care across Wales.
  • COVID-19 has allowed a lot of clinicians to become more involved with research and innovation. Dedicated time, regional working, formal teaching and mentoring would ensure these changes work for everyone.
  • Every clinician has a role to play in reducing health inequalities. The NHS should target interventions for struggling communities and improve access to healthcare for everyone.

 

Dr Olwen Williams, RCP vice president for Wales said:

 

‘There is so much we can learn from the past 18 months. The NHS workforce has given everything, and in return, we’re calling for more flexible working, better clinical engagement, more remote access and more support for overworked and exhausted staff. More and more doctors want to work less than full time, but we simply do not have enough medical staff on the ground to enable part-time working. We’re hearing the worrying news that NHS organisations in Wales are starting to end flexible working practices – which began during the pandemic – because of staff shortages. This is such short-term thinking, and will do nothing to encourage doctors to stay in the Welsh NHS.

 

‘Health board executives and senior management must listen to their clinicians. If we can make the Welsh NHS a better place to work, we will persuade more doctors to stay and work in Wales. There is a wider cultural shift happening: trainee doctors want to work part-time and we need to find a way to make that happen to attract people into the profession and retain them. It’s vital that we urgently expand medical school places to train more doctors.’

 

A consultant physician working in the Welsh NHS said:

 

‘Our health board has undergone massive transformation [and] senior clinical engagement has been lacking at times. Working flexibly can be so much more productive due to the lack of interruptions. The impact of home schooling and the burden of care on working parents is not well recognised. It is time for flexible working to be embraced by the NHS.’