Key points

  • There are 1289 UK gastroenterologists, a 2.7% expansion from 30.09.13.  The average expansion for the last 10 years has been 5.0%/year (range: 2.3% - 7.1%).
  • The RCP document “Consultant physicians working for patients” in 2011 predicted that we need 6 whole-time equivalent (WTE) consultants in gastroenterology (with GIM) all working 11.5 PAs per week per 250,000 population. For the current UK population of 63,181,775 (2011 national census) this is a total of 1516 WTE, or an additional 227 WTE.  If we assume that the number of less than whole- time (LTWT) consultants (anyone working <10PAs) will stay at 11% and they will work 7 PAs on average this gives a total of 1584 consultants (295 more).  If the proportion of LTWT consultants rises to 30% (as it is predicted to do due to increased feminisation of the workforce) then 1718 consultants would be required (429 more).
  • Trainees have been enrolled to fill posts based on 6.5% expansion over the next 6 years, or 576 new posts, plus the predicted 170 retirement posts (746 posts in total).
  • In the last 4 years 4 NTNs have been lost in England, but 1 has been gained in Scotland & 2 in Northern Ireland, so overall there has been a loss of 1 NTN in the UK.
  • ~100 CCTs in excess of retirements are predicted each year for the next 5 years (mean training time 6 years).
  • 130 substantive posts were advertised in the last year, but 36% were not filled, especially in the north of the UK. The number of trainees >6 months post CCT (78) is 6% lower than the previous year.
  • There are several drivers for Gastroenterology expansion: flexible sigmoidoscopy screening, 7 day working, management of UGI bleeding, increasing hepatology burden and an aging population (who are high users of gastroenterology services) will increase the number of gastroenterologists needed. However in this austere financial climate Trusts may choose to meet this service demand by a reduction in GIM commitment of the specialty.
  • Changes to the NHS pension scheme in 2015 may link usual retirement age (currently 60 for most) to State Pension age (increasing to 66 in 2018-2020). If this occurs there will be a 6 year retirement vacuum leading to an excess of CCT holders over jobs in 13 years when protection arrangements cease.