OTH-3 The state of the gastroenterology and hepatology consultant workforce in 2020

IntroductionBritish Society of Gastroenterology (BSG) Workforce reports have identified widespread consultant vacancies, excessive workloads and insufficient training posts to meet current and future service demand. The COVID-19 pandemic has put further strain on an already overstretched and often demoralised workforce.MethodsThe Medical Workforce Unit of the Royal College of Physicians (RCP) undertakes an annual census of consultants each October. Data for gastroenterologists and hepatologists from the 2019 census, January 2020 RCP consultant wellbeing survey and the General Medicine Council (GMC) between 2012 and 2020 were examined.ResultsThe number of UK licensed gastroenterologists increased from 1,703 to 2,013 from 2014 to 2019. However, in recent years, fewer gastroenterologists have joined the GMC register annually (151 in 2014 and 115 in 2018). Consequently, 45% of advertised consultant posts in gastroenterology were unfilled and 8% of all posts filled by a locum in 2019, mostly due to a lack of applicants, with demand outstripping supply. There has also been a smaller increase (9% versus 14%) in gastroenterology trainee numbers compared to other medical specialties between 2012 and 2020. The average number of population per full time equivalent gastroenterologist in the UK is 43,913 but there are significant regional variations with some regions much more poorly served (Thames Valley 63,456, North Wales 59,444, Kent, Surrey and Sussex 50.974, and East of England 50,487).Gastroenterologists work a mean of 1PA unpaid in addition to contracted PAs. This leads to gastroenterologists saying they always, or most of the time in 59% work excessive hours and in 61% have an excessive workload. Gastroenterology is the major specialty at highest risk of burnout with lower (worse) mean mental wellbeing scores. Consequently, 51% of gastroenterologists reported that work affected their relationship with their partner and 53% with their children in the past year. 52% described their morale in 2019 as being worse than in 2018. 18% of gastroenterologists reported feeling bullied or harassment over the past year by managers or fellow consultants. Despite these issues, 87% of gastroenterologists reported they were always or often satisfied with specialty work, but only 21% with general internal medicine work.ConclusionsUnfilled consultant vacancies, high workloads, low wellbeing scores and morale were evident in gastroenterology and hepatology even before the COVID-19 pandemic. Gastroenterology is the major medical specialty at highest risk of burnout. At a time when the NHS workforce is under increasing pressure, these issues must be urgently addressed to improve the working lives of gastroenterologists and hepatologists.