Our workforce challenges

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Overnight anaesthetic cover

Our biggest problem is making sure that we have a resident anaesthetist (a doctor available in the hospital overnight).

This cover was previously provided by trainee doctors but since we are no longer allowed to have trainees covering the overnight period at the Friargae Hospital, we have had to rely on locum doctors (temporary doctors).

This role is needed on the hospital site to allow emergency services to remain there and is supported overnight by a consultant anaesthetist on call from home.

We need a team of sever doctors to provide this rota 24 hours a day, seven days a week, and despite our best efforts to recruit, we currently have five vacancies that are filled by locum doctors. This is more expensive than employing permanent doctors and is not sustainable in the long term.

On average, our anaesthetists see three emergency patients a week in the overnight period (from 6pm to 8am).

Critical care

We need a team of eight consultant anaesthetists to provide 24/7 cover (which includes the overnight anaesthetics on call rota). Previously four of these consultants provided specialist intensivist knowledge and covered the critical care unit during the day. Only two of the four are still in post.

This specialist knowledge is required daily to support the unit, so additional support is currently being provided by consultants from the James Cook site, which also has anaesthetic and intensivist vacancies.This increases pressures on the James Cook site which needs to cover a greater number of rotas across a range of specialities (i.e. trauma, consultant led maternity and paediatrics).

Despite extensive efforts to recruit, we have only managed to attract one new anaesthetist to cover the Friarage Hospital critical care unit and most vacancies are being filled by locum doctors.

We currently have four consultant anaesthetist vacancies out of a complement of eight posts.

Accident and Emergency

We also have recruitment difficulties in A&E and again are relying on locum doctors. To provide a 24/7 rota we need seven A&E doctors. Four are permanent and we are using locum doctors to fill the other three posts.

This makes sure there is a doctor available in the department 24/7, supported by an emergency medicine consultant on site from 8am to 6[m, Monday to Friday, and available by phone outside these hours.

The number of patients attending A&E at the Friarage has reduced to around 60 a day. This is because medical advances and national policy mean seriously ill patients now to directly to a specialist centre and there are also more services in the community for people who are unwell.

The department sees on average 4 patients an hour between 8am-8pm and, on average, one patient an hour from 8pm to 8am. Three quarters of those attending A&E have minor injuries and minor illnesses.