Released today, the RCR’s Clinical Oncology UK Workforce Census Report 2017 details the current staffing crisis among clinical oncologists1 – the doctors who treat cancer with radiotherapy, chemotherapy and immunotherapy.
Based on data from every UK cancer hospital2, the report reveals:
- Without investment, the clinical oncologist workforce will be short of 247 full-time consultants by 2022 – more than a fifth of the number needed to treat growing numbers of cancer patients
- In 2017, 7% of NHS clinical oncology posts sat empty (up from 5% in 2016) – a third of which were unfilled for at least a year
- Only two-thirds of the clinical oncologist trainees needed now joins the workforce each year;
- Meanwhile, experienced clinical oncologists are leaving the NHS earlier – with an average retirement age of 60 in 2017, compared to 64 in 2015 and 2016
- Along with not having enough clinical oncologists, patient safety could be being put at risk as one-in-six doctors are struggling to find time to keep up-to-date
The new figures show that last year there were 876 consultant clinical oncologists working in UK hospitals, the equivalent of 817 full-time doctors. While that represents a two per cent rise on 2016 (859), the growth in clinical oncologist numbers is slowing down, as from 2012-2016 the workforce was expanding at five per cent year-on-year.
Despite having an extra 17 clinical oncology consultants in practice in 2017 compared to 2016, individual doctors and the cancer centres they work for are getting busier.
Nearly 1,000 people are diagnosed with cancer every day3, with patients needing access to a wide variety of treatments. RCR data shows 99 per cent of cancer centres are now working their radiotherapy machines non-stop for eight or more hours a day to keep up with the demand for treatment.
Doctors’ hospital contracts split their working time into blocks of “programmed activities”, with 10 seen to be a standard workload. In 2016, clinical oncologists had an average of 11.4 programmed activities a week, which rose to 11.5 last year.
In addition to clinical time spent with patients, these programmed activities have to include “supported programmed activities” (SPAs), meant for professional and service development.
The Academy of Medical Royal Colleges says doctors need at least 1.5 SPAs to support their ongoing revalidation4. RCR figures show that one-in-six clinical oncologists did not hit that minimum in 2017, raising questions around whether a lack of up-to-date expertise could be putting patients at risk.
Consultant jobs are sitting vacant for long periods. In 2017, 64 clinical oncology jobs5 were unfilled at any one time, a third of which were vacant for a year or more.
An extra 144 clinical oncologists were needed across UK hospitals just to cover the increased contractual workload and unfilled consultant jobs in 2017.
To make matters worse, trainee shortages and doctors retiring early are putting further pressure on services. RCR figures show only two-thirds of the new clinical oncologists needed joins the workforce each year6, and last year saw many clinical oncologists retiring earlier than in previous years.
The RCR estimates that by 2022, the NHS will need a minimum of 1,102 full-time clinical oncology consultants to look after cancer patients. However, based on current trends, there will only be 855, meaning the UK will be 22 per cent down on the number of consultants it needs.
Now, more than ever, Government bodies, including Health Education England and its counterparts in the devolved nations, must urgently invest in training and retaining clinical oncologists.
Dr David Bloomfield, the RCR’s Medical Director of Professional Practice in Clinical Oncology and lead author of the workforce report, said:
“The Prime Minister recently made a very public promise to invest in the NHS workforce and provide a comprehensive 10-year plan for the health service that will transform cancer care. To make good on both commitments, we must see a boost in the clinical oncologist workforce and its integral support services and equipment.
“Clinical oncologists are the UK’s experts trained in all non-surgical cancer treatments – and we do not have enough of them.
“Projections show that by 2022 the workforce will be more than 20 per cent short-staffed and it is cancer patients who will suffer, with less clinical oncologists’ time and care to go around.
“People with cancer are living longer thanks to better diagnosis and treatment, however, half of us are predicted to get cancer at some point in our lives. For treatment to keep up with cancer rates, we need more trainee clinical oncologists – to do that Government must fund more training places for UK hospitals.
“On average it takes seven years for a qualified doctor to specialise as a clinical oncologist, so in the short-term we will need more than new trainees to relieve the pressure on cancer services. Right now, we need a concerted effort by officials and NHS managers to keep our best doctors in practice.”
Download the workforce report in full.
References
1. A clinical oncologist is a doctor who is specially trained in prescribing both radiotherapy and systemic therapies: chemotherapy, hormone therapy, immunotherapy and the use of radioactive isotopes to treat patients with cancer.
2. The RCR has been conducting an annual clinical oncology workforce report since 2008. Data for 2017 was collected between October and December 2017 as part of an online survey of hospital heads of service. Information was returned for each of the UK’s 62 cancer centres.
3. Cancer Research UK statistics for new cancer cases per annum.
4. The Academy of Medical Royal Colleges’ Advice on SPA’s in Consultant Job Planning guidance
5. The overall figure of 64 posts includes both full-time and part time posts advertised.
6. RCR workforce figures show 42 clinical oncology trainees became consultants in 2017, however, there were 64 vacant consultant posts.