Excessive Consultant workload is affecting patient care according to the IHCA
An Irish Hospital Consultant Association (IHCA) survey has confirmed that the excessive Consultant workload in public hospitals is impacting already on patient care, with 6 in every 10 Consultants confirming that their current workload is having a negative impact on the provision of care to their patients. These IHCA survey results provide important insights into why 25% of the 2,830 doctors who left the Medical Council’s Register between 2015 and 2017 were in the Specialist Division, as confirmed in the Council’s Medical Workforce Intelligence Report published on 11th April 2019. The overall conclusion is that excessive workload levels and unfilled consultant posts are impacting adversely on the continuity and quality of patient care in hospitals.
The Irish Hospital Consultants Association (IHCA) today released results of a recent survey of more than 900 members which confirm that the current consultant recruitment and retention crisis is severely damaging access to care for patients.
IHCA President, Dr Donal O’Hanlon, said that more than half (54%) of respondents agreed that due to excessive workload the number of inpatients that they are expected to provide care to is more than the recommended norm for their specialty, with this exceeding two thirds of the respondents (67%) for outpatient care. In the key diagnostic services, half of respondents confirm that the number of patient scans they are required to report on is in excess of recommended norms.
“Ireland has one of the lowest number of hospital consultants in the OECD, at approximately half the OECD average. It is abundantly clear that our acute hospital and mental health services will increasingly fail our patients due to the 500 approved permanent consultant posts that cannot be filled because the Government has not restored pay parity for Consultants appointed since 2012 unlike other public servants,” said the IHCA President. “As a consequence of the vacant posts, the vast majority of Consultants are working in excess of their contracted hours, with over three quarters doing so ‘often’ or ‘very often’”.
The results confirm that 90% of respondents describe their current workload as unmanageable, and for a third of Consultants their workload has increased over the past year. Over the past 12 months more than three quarters of all Consultants (77%) have been required to work additional hours on weekends and public holidays in addition to their normal working week. More than a quarter (28%) have been working 5 hours or more per day on those weekends and public holidays, as well as being called into their hospitals throughout the rest of the day and night to provide emergency care to patients.
“With such workload pressures and the high number of vacant posts it is not surprising that 70% of Consultants say that their level of morale has unimproved over the past year,” said Dr O’Hanlon. “A majority of Consultants (55%) also indicate that they have felt unwell as a result of work-related stress in the past 12 months.”
Dr O’Hanlon said that in sectors where excessive working hours are a serious safety issue, such as the airline industry, strict regulations and appropriate staff numbers are in place, as the impact of fatigue and excessive workload is a recognised safety concern. “The health service needs to ensure that its Consultant staff are not overburdened and overstretched by the growing demand for care combined with the inability to fill consultant posts because of a failed Government policy that is driving our much needed specialists abroad,” said the IHCA President.
The vast majority of the survey respondents (87%) confirm that the standard of patient care has deteriorated due to a lack of suitably qualified Consultants to fill vacant posts in public hospitals. Almost all (95%) identify the ongoing pay discrimination against new hospital Consultants as the root cause of the failure to fill one in five permanent Consultant posts in our public hospitals.
“The most recent National Patient Experience Survey confirms that 84% of patients rate their hospital experience as good or very good. Access to that care is the main problem faced by patients. The large shortage of Consultants in our public hospitals is a significant factor which is contributing to growing and unacceptable waiting lists for outpatient Consultant appointments and inpatient care and procedures,” added Dr O’Hanlon.
Sample of anonymised comments from individual Consultants on workload pressures:
“I have had to scale back my working hours to 50-60 hours a week since I became a new mother. I could not sustain the 70-80 plus hours I had been working as I cannot sustain that service and still be a good mother.”
“The new entrant discrimination is having a devastating impact on morale, adding additional stress on existing consultants and having adverse consequences for care. It needs to be addressed immediately.”
“We are too overstretched yet we are expected to cover for absent colleagues when they are on leave as the hospital will not provide locum cover. This results in leave not being taken out of guilt for the colleague who is asked to cover the workload of 2 consultants.”
For further information contact:
James Dunny, FleishmanHillard 086 388 3903