Over a million patients miss out as anaesthetist shortage grows
Our State of the Nation 2024 report, published today, shows the dire shortage of anaesthetists is limiting the ability of the NHS to reduce patient waiting lists, as the UK lags behind the rest of Europe in anaesthetic staffing levels.
With only 14 anaesthetists per 100,000 people, the UK ranks 26th in Europe, far below comparable countries like Germany, where the equivalent figure is 37, Italy (25) and even some lower income countries like Moldova (16).
The shortage of anaesthetists prevents around 1.4 million operations and procedures from taking place each year. The RCoA warns this figure could increase to 8.25 million unless the government invests in training more anaesthetists because most operations cannot take place without one.
On average across the UK, the number of anaesthetists is 15% lower than needed, although there is some national and regional variation. The shortage is slightly worse in Wales (17%) than the other UK nations and within England, the shortfall is greatest in the East of England and the North-West, at 18% lower than needed.
The RCoA report highlights there are currently thousands of doctors who want to train as anaesthetists but there are not enough training posts for them to do so. This year there were 3,520 applications for an available 540 core anaesthetic training places.
At the same time, NHS trusts and health boards are increasingly using expensive agency locum staff to plug gaps. In 2022, there were 399 locum consultants working in NHS trusts and health boards, a much costlier option than a permanent consultant anaesthetist.
The shortage also puts anaesthetists under increasing pressure as they struggle with additional workload, fuelling burnout and compounding the NHS retention crisis. Of anaesthetists who retired or left the profession early, 25% did so because of issues to do with mental wellbeing, burnout, or stress. And one in five anaesthetists surveyed in 2021 said they intended to leave the NHS within five years.
The report calls for urgent intervention to fund more anaesthetic training places, both in the immediate and long term and for urgent implementation of measures to improve retention of anaesthetists currently working in the NHS.
Dr Claire Shannon, President of the Royal College of Anaesthetists, said:
“The dire shortage of anaesthetists is preventing patients from getting the operations and procedures they need.
“We all want the Government to succeed in its pledge to reduce waiting lists, but that will only be possible if we train more anaesthetists and retain the limited numbers we already have.
“Right now, there is capacity within our training system for at least an additional 140 anaesthetic training places, so we need to see immediate action coupled with a longer-term commitment to address specialty training shortages in the forthcoming revision of the NHS Long Term Workforce Plan.”
Jenny Westaway, Chair of PatientsVoices@RCoA said:
"This report illuminates by putting cold hard figures on the scale of the problem that individual patients are suffering every day. For people waiting for operations, the shortage of anaesthetists is counted in painful delays and feeling like life is on hold.
“It’s not only the long waits and delays of operations. The lack of anaesthetists also means that clinicians are often stretched too thin. It is so important to address the shortage of anaesthetists so we can improve the quality of care and patient experience so that patients can be fitter, better, sooner."