MR 04
Ymchwiliad i recriwtio meddygol
Inquiry into medical recruitment
Ymateb gan: Andrew Davies
Response from: Andrew Davies

Medical recruitment is the biggest problem I face in my capacity as Orthopaedic consultant in Morriston. More than anything else it is limiting our ability to improve services. There simply aren't enough staff to provide any more than a basic safe level of cover and sometimes we struggle to provide even that.

The greatest problems are at consultant and core training level

We have failed to appoint to consultant posts in Orthopaedics in Morriston this year and last. We have adverts live continuously for junior doctors but we find it extremely hard to get appointable applicants.

Core trainees (SHOs) continue to have an important role in service provision in Orthopaedics. Deanery training numbers have been reduced however and it is extremely hard to recruit and retain non-training grade juniors to work in the department. Of four such posts we have three unfilled and are forced to run the department on agency locums for extended periods which is hugely expensive and does not provide and continuity of patient care. Doctors who do come are usually first job in the UK and use the post to get a reference and move on.

Nationally Orthopaedics is over-subscribed but in Wales we have unfilled posts.

The controls on recruiting overseas doctors also severely affected recruitment

Wales has a particular problem recruiting doctors at all levels. Trainees do not want rotations which mean they may have to rotate between distant hospitals. Rotations between North and South Wales are particularly unpopular.

Having a Welsh connection is the factor most likely to encourage doctors to work in Wales. Thus doctors who have lived or trained in Wales at any stage are much more likely to want to work here.

Graduates of the Welsh medical schools are much more likely to stay in Wales for their training if they were previously domiciled in Wales.

Doing core training in Wales greatly increases the likelihood of applying for specialist training in Wales

Doing specialist training in Wales greatly increases the likelihood of applying for consultant posts in Wales

Any initiative in England to increase training grade posts adversely affects recruitment in Wales.

We need to increase the numbers of medical school places in Wales and increase the percentage of Welsh-domiciled students.

We need to examine to structure of the hospital service in Wales. It is more difficult to recruit trainees to smaller rural hospitals. Training needs to concentrated in larger hospitals.

We need to introduce innovative training posts to attract trainees. eg academic-linked posts, rural medicine posts etc

The Welsh-language names of our Health Boards do not encourage applicants. They are seen as opaque 'foreign' and offer no clue as to geographical location or workload.

Andrew Davies

Consultant Orthopaedic Surgeon. Morriston Hospital