'Still too few doctors'

More doctors are needed, says the Royal College of Physicians

Doctors are warning there is still a major shortage of physicians - two years after they first warned there was a problem.

In one speciality, the Royal College of Physicians (RCP) estimates there needs to be more than an 800% increase in the consultant workforce to provide top quality care for patients.

A report from the RCP says there has been some expansion in numbers since its last report - but estimates there is a shortage of over 6,550 consultants and says workloads for consultants working in the NHS is still "unacceptable heavy".

The report 'Consultant Physicians Working for Patients' is intended to be a "manual" for providing high quality care.

Physicians want to deliver a high quality, patient centred, team based service

Professor Carol Black, RCP

It says there are vast variations between the number of doctors currently working in specialities, and the number the RCP estimates are needed to provide a top-class service.

In audiological medicine, the report estimates an incredible 863% increase is needed on top of the existing 31 doctors now working in that specialty in the UK.

In neurology, which now has 316, there needs to be an increase of 332%, and in rehabilitation medicine, which has 113 consultants, an increase of 280% is needed, says the college.

Specialities, such as kidney experts and respiratory specialists, need at least treble the current number of consultants, the report said.

Increasing demands

The RCP says more doctors are needed because of pressures such as ensuring patients brought into A&E see a senior doctor quickly, and coping with the reduction in junior doctors' hours.

Patients coming into hospital, particularly the elderly, often have very complex conditions, and the college says more physicians are needed who have generalist skills.

Professor Carol Black, clinical vice-president of the RCP, welcomed the fact the government had prioritised certain areas, including those which have been given National Service Frameworks setting out standards, which had then attracted staff.

She said she was "cautiously optimistic", but more doctors were needed to provide a top-quality service.

'Shoestring NHS'

"Physicians want to deliver a high quality, patient-centred, team-based service but in order for them to do this it is necessary for that extra resources allocated to the NHS be targeted to the front line where they can really make a difference," she said.

A Department of Health spokesman said: "It is well known the NHS has been provided on a shoestring in the past, that is why the NHS Plan promised as part of a package of investment and reform to bring in 10,000 more doctors by 2004.

"As the RCP points out there has been an expansion in the number of consultants - already there are 6,700 more doctors working in the NHS than in 1997."

He conceded more needed to be done to reduce workloads, but said thousands more hospital doctors and GPs were being trained, in addition to doctors being recruited from countries such as the USA, Spain, Germany and Israel to help plug the gap.