Response to the Welsh Government National Workforce Implementation Plan

On Wednesday 1 February the Welsh Government published its National Workforce Implementation Plan: Addressing NHS Wales Workforce Challenges.  

Workforce shortages are a critical issue for anaesthesia and we have engaged with the Government and Health Education and Improvement Wales (HEIW) productively in the past to secure a number of new anaesthetic training posts. In order to build on this progress, the Royal College of Anaesthetists (RCoA) worked alongside other medical royal colleges and allied health professional bodies in calling for a more comprehensive workforce plan and fed into conversations with the Welsh Government in its development. 

While the publication of the plan shows welcome attention to the workforce – we also believe it is, at best, only a first step towards addressing the challenges anaesthesia, and the wider health workforce face. Our most recent census found there is a shortage of 150 anaesthetists in Wales, which we estimate is preventing 112,500 operations and procedures from taking place per year. Unless urgent action is taken, the shortfall has been projected by the York Health Economic Consortium (YHEC) to grow dramatically by 2040. 

Unfortunately, the Welsh Government’s plan as published does not refer to the numbers of doctors needed now or in the future, nor set out any plan or targets to increase trainee numbers. Given that waiting lists are large and growing and given that most operations cannot take place without an anaesthetist, this is an omission that needs to be addressed.  

We hope that the published document is built upon with more specific plans and targets. These should look at the numbers of doctors and healthcare workers needed specialty by specialty, now and in the future, as well as considering new ways of working and the integration of emerging professions such as Anaesthesia Associates. While the document does refer to retention of staff, which we welcome, we believe this needs to be bolstered with more robust action to stem the tide of early retirement. 

Building a more detailed plan along these lines will require substantial investment that goes beyond the current proposal of a voluntary committee sitting between Government and HEIW. There will be a need for sufficient staffing and clear structures to do the necessary analysis and modelling work, and this will need to be resourced – as will the delivery of the plan’s final recommendations. While this may be difficult, it is also imperative if the long-term health of people in Wales is to be protected and improved. 

Dr Abrie Theron
Chair, Royal College of Anaesthetists Welsh Board

Dr Simon Ford
Vice Chair, Royal College of Anaesthetists Welsh Board

Dr Fiona Donald
President, Royal College of Anaesthetists