Threat to quality of gynaecology care

Medical professionals want to improve the service

An overhaul of the provision of obstetric and gynaecology services is needed if the quality of patient care is to be maintained, according to medical experts.

Doctors in this field are facing a number of challenges that affect the way they can provide services, says a report by the Royal College of Obstetricians and Gynaecologists (RCOG).

The professional body welcomes a 6% increase in consultants over the past 12 months, but is concerned about a reduction in junior doctor numbers which is creating service problems.

Richard Warren, chairman of the RCOG Medical Workforce Committee, said: "We are facing a number of challenges that affect the way we can provide obstetric and gynaecological services.

"The reduction of the number of doctors in O & G is already causing difficulties, and changes in working hour regulations are forcing trainees to work in shift-systems.

"These affect the continuity of care and training can suffer as mentoring and education sessions are reduced."

New measures

In addition to staffing increases the RCOG has called for measures to be introduced to allow:

• an increase in the time consultants spend with patients during outpatient appointments

• the establishment of emergency gynaecological admission units, early pregnancy assessment units and day-assessment units for obstetric complications

• increased use of multi-disciplinary service delivery - including extending the roles of midwives and nurses to take over some duties held by senior house doctors

RCOG president Professor Robert Shaw said: "The report published today shows that as of 30 September 2000 there were 131 doctors holding their Certificate of Competence in Specialist Training (CCST) who were still in training posts.

"These doctors will become redundant if extra and new consultant posts are not available within 18 months.

"Their acquired skills will then be lost to women requiring obstetric and gynaecological services.

"The government, doctors and midwives are all in agreement that we should be moving toward a consultant-provided service wherever possible.

"We need Trusts to be prepared to invest in establishing the consultant posts that will allow health professionals to work together to deliver the quality service women want and deserve."