Changes required in delivery of surgical services – RCSI President

Changing the delivery of surgical services in Ireland and a review of non-medical grade roles within the medical workforce would address many of the current recruitment and retention issues faced by the Irish health service, according to RCSI President Mr Kenneth Mealy.

Commenting on a recent HSE National Doctors Training and Planning (NDTP) working group report, which identifies specific medical workforce issues related to NCHDs, Mr Mealy called for the expansion and upskilling of non-medical grade staff and the separation of acute and scheduled surgery to address the complex issues faced in medical workforce planning and better serve the clinical needs of patients.

The NDTP working group report acknowledges the risk to the safety and viability of smaller hospitals with a disproportionate number of NCHDs in non-training roles.

Mr Mealy said: “The NDTP report indicates that the safety and viability of smaller hospitals are at greater risk when they a disproportionate number of NCHDs in non-training posts. RCSI’s National Clinical Programme for Surgery has consistently made this point over many years.

“Non-training roles offer limited training opportunities to staff. Where these are not available, the challenge of attracting both consultants and non-consultant surgical staff is apparent. We have repeatedly said that these complex issues can only be addressed by reconfiguring our surgical services, separating acute from elective or scheduled surgeries.

 “In addition, we need to look at the expansion of non-medical grade roles such as advanced nurse practitioners and physician associates, as well as the upskilling of pharmacists and physiotherapists. In many cases, the care delivered by healthcare professionals in these roles are more appropriate to serve the clinical needs of patients.”

Mr Mealy continued: “Medical workforce planning is challenged worldwide with the increasing complexity of care required by many patients and changes in societal expectation. If we fail to grasp the logistic impossibility of staffing small hospitals which can neither offer high quality care for complex patient needs or satisfy reasonable career satisfaction and advancement for our medical workforce, we will continue to repeat the failed workforce planning models of the past and perpetuate the compromised delivery of acute surgical services seen in this country”.

The RCSI President welcomed the endorsement of the NDTP report by the HSE Board. “We look forward to supporting the recommendations of the report in order to create a sustainable health service workforce,” he added.