RIG Locums is a leading supplier of locum doctors to the NHS. In this article we reveal the doctors that are most in demand this year, using our industry insights to explain why.
10. Oncology Doctors
With the number of new cases of cancer on a steady increase, the demand for oncology doctors, consultants and surgeons is on the rise.
Whilst the percentage of new cancer cases hasn’t seen much change over the last decade, the increasing population has meant that the number of new incidents has risen by 50,000 over the last decade. This increase is also attributable to the ageing population with 50% of cancers diagnosed in patients over the age of 65.
Furthermore, Macmillan Cancer Support warns that the number of people living with cancer and its after-effects is predicted to increase from 2 to 4 million by 2030, placing further strain on oncology doctors and departments.
9. Gastroenterology
From the front line, RIG Locums is seeing a shortfall in gastroenterology doctors due to the mounting pressure on gastroenterology departments.
A number of factors appear to be at play. Most recently, added pressure has stemmed from the recent introduction of the Bowel Cancer Screening Programme (BCP), which looks to reduce the number of bowel cancer deaths by 16% by offering free bowel cancer screening to patients over the age of 55 without referral from a GP. This has seen the number of new bowel cancer cases rise considerably.
Additionally, there has been an over 50% increase in the number of alcohol-related admissions over the last 10 years. This has a direct impact on gastroenterology departments with increased cases of stomach and colon cancer, peptic ulcers and gastritis.
This increased pressure on gastroenterology doctors is also seeing more consultants move abroad to countries such as Australia, Canada & Dubai once they have completed their training, compounding the shortage.
8. Child Psychiatry Doctors
The new digital era and raised awareness of child abuse following high profile sexual abuse scandals are all contributing factors in the increased number of child psychiatry department admissions.
Internet bullying has become increasingly prevalent among school children and according to a recent report from the NSPCC, nearly one in five children have had undesirable experiences online last year which included bullying and cyber-stalking. This has put more pressure on parents and schools to deal with mental health problems, and therefore more cases have been referred to child psychiatry doctors.
The recent widely publicised child sexual abuse scandals involving celebrities have increased awareness of the problem and encouraged more children to come forward about child abuse. The NSPCC reports the alarming statistic that 1 in 20 children have been sexually abused, and there were 18,915 sexual crimes against children reported between 2012 and 2013.
As well as creating greater demand for child psychiatry doctors, these contributing factors are creating a shortage of beds available in specialist children’s units with a surge of 350 under-18s being admitted to NHS adult wards in just nine months between 2013 and 2014.
7. Ophthalmology Doctors
In seventh place, are ophthalmology doctors. With a shortage sweeping Europe, the UK is in the worst position with only two ophthalmologists per 100,000 population compared to Greece which is at the top of the pile with 14 ophthalmologists per 100,000 population.
Dr. Beaconsfield, president of the UEMS ophthalmology section, comments in Healio about trends in shortages across Europe:
“Generally speaking, if you put the number of ophthalmologists against the ability to spend on health care, you see that where there are insufficient ophthalmologists there is also insufficient money to invest in more.”
The shortage of ophthalmology doctors is compounded by a number of factors. Firstly, age-related macular degeneration affects 3.3% of the over 65 population, and with this population increasing by over 26% to 10.8 million over the last three decades, this has seen the number of cases rise by the same proportion. Furthermore, this percentage is expected to double by 2030.
Other age-related eye conditions such as presbyopia and glaucoma are also seeing a proportionate rise in new cases.
Diabetes is another significant factor contributing to the demand for ophthalmology doctors. Poor diet and lifestyle is seeing an increased number of type 2 diabetes cases in younger generations, of which 50-80% of cases lead to retinopathy within 20 years of diagnosis.
6. Paediatric Doctors
According to the latest children’s doctors census undertaken by the Royal College of Paediatrics and Child Health, there is a UK-wide shortage of paediatric consultants.
The findings revealed that between 2009-2011:
- The number of paediatric consultants has grown at an annual rate of 2.3%, which is too slow to meet demand with 86 permanent vacancies
- The number of specialty and associate sepcialist doctors has seen a 17% decrease
- There are too many paediatric in-patient units, with only 7 closures out of a recommended 48, as advised by the Facing the Future report released by the college
- There is risk to the research and innovation work carried out by the NHS, with a reduction in academic paediatricians by 11%
Dr. Hilary Cass, president of the Royal College of Paediatrics and Child Health, commented:
“The problem is three-fold. Firstly there are not enough senior doctors available to maintain the safety of current paediatric care; we need a 50% increase in the consultant workforce if we’re to have a round-the clock consultant presence. Secondly, expertise is spread too thinly – we have too many small units and not enough specialist centres. If we had staff and resources concentrated in fewer specialist centres, treatment would be better coordinated and of a higher standard. And finally, there are too many trainees for long term sustainability of the paediatric workforce if the current rate of recruitment into training is maintained – when they qualify to be consultants there won’t be enough posts for them to fill.“
5. Haematology Doctors
The surge in the number of haematology consultants at the beginning of the last decade has not been maintained, according to the latest census by the Royal College of physicians – leading to a significant shortage. Haematology consultants have also been flagged on the Migration Advisory Committee’s shortage occupation list as a concern over the next year.
The problem appears to stem from a lack of medical students and junior doctors choosing haematology as a pathway, often because the specialty is perceived as complex and obscure.
4. Radiology Doctors
Radiologists play an integral part in the diagnosis and management of diseases, with clinical radiology becoming one of the fastest expanding specialties over the last few years.
The Royal College of Radiologists’ 2011 census reports a significant increase in workloads, with over a third more requests for MRs, CTs and interventional radiology since 2008.
Advances in technology have played a key part in the demand for radiology doctors with better quality imaging meaning that doctors are able to rely on scans for a more accurate diagnosis. For example, complex imaging is now used in most cancer pathways for initial diagnosis and to monitor the success of treatments.
However, despite the number of consultants rising, it hasn’t been at a fast enough rate to meet the shortfall.
3. Dermatology Doctors
According to the Royal College of Physicians, 54% of the UK population is affected by skin conditions and 24% see their GP about skin disease each year. In 2009-2010, this resulted in 2.47 million consultations and these numbers set to increase even further over the next two decades.
The increased prevalence of malignant melanoma and atopic eczema appears much to blame. Cases of malignant melanoma have increased by 400% in the UK over the last 30 years and new cases in young people between ages of 15 to 34 are expected to increase by a further 70% over the next 15 years. Atopic eczema now affects 15-20% of children and 2-3% of children, the increase often cited as environmental and lifestyle changes.
With only 650 consultant dermatologists in the UK, the number is not rising enough to meet demand so it is no wonder that dermatology doctors rank at number three in our Most Sought After Doctors in 2014 list.
2. Elderly Care Doctors
Elderly care is the specialty most impacted by the UK’s ageing population. Growing numbers of people between the ages of 65 and 84 are expected to reach 39%, over the next 18 years. This increases to a whopping 106% percent for people over the age of 85. With many of these suffering from long-term ailments such as kidney problems, heart issues and diabetes, pressure is mounting on elderly care departments.
In addition to the increasing need for elderly care, Jasmine Bindley, elderly care recruitment specialist at RIG Locums, warns that there are less new doctors being attracted to the specialty:
“From the ground we’re seeing less new doctors being attracted to elderly care. The specialty just doesn’t seem as appealing or challenging compared to other specialisms.
We find that a significant proportion of doctors that move into elderly care are nearing the end of their career. Many of our doctors often delay retirement to move into a specialty such as elderly care. They often find it difficult to give up practicing entirely when they are so passionate about their profession and it has been such an intrinsic part of their lives. Elderly care presents a good opportunity to continue practicing in a flexible and less pressurised environment.
However, there is a very real danger that when these doctors retire, there will be a lack of experienced consultant in elderly care; there will be a skills gap due to less junior doctors moving into the specialty.“
1. Accident & Emergency Doctors
As you may have guessed, the title of “most sought after doctor” in 2014, goes to A&E doctors.
The national shortage has been widely reported, with A&E departments even being compared to “war zones”. The Commons health select committee has highlighted that over 80% of A&E units are unable to provide coverage by an on-duty consultant for the 16 hours a day required to guarantee the best patient care.
Despite the government’s ongoing ‘Choose Well’ campaign to prevent unnecessary emergency department attendances, the A&E doctor shortage is down to a number of other factors.
Firstly, there aren’t enough new doctors being attracted to the specialty in the first place due to the extremely demanding and stressful nature of the job. Dr. Saleyha Ahsan writes in the Guardian about her experience working in an A&E department;
“Most junior doctors who spend six months in A&E leave at the end of their assignment with a lot of experience, but they are relieved to be going and they won’t be coming back.”
Another issue is that there are a high proportion of consultants leaving the UK once they have completed their training. The CEM report “Stretched to the limit”, issued the following warning:
“Evidence confirms that burnout among physicians in emergency medicine occurs at the highest rate of all medical specialities. There is also a very worrying trend developing of consultants seeking to move abroad after having been trained in the NHS.”
The report found that 21 consultants had left the UK in 2013, with a total of 78 leaving since 2008. The CfWI’s report, “Shape of the medical workforce” also warned that there were a lack of consultants being recruited, and if the situation isn’t changed, the NHS could be spending as much as £6bn on consultant salaries by 2020.
Restrictions on working hours and the working time rest policy have also acted as a catalyst, with the consultants that are available being limited to a certain number of hours.
All in all, the A&E doctors’ crisis looks unlikely to be resolved any time soon, until reforms are put in place. However RIG Locums has found that the crisis has given more oversees doctors an opportunity to get a foot in the door of the UK medical system by starting out in Accident & Emergency Departments, where the demand for doctors is at its highest.
Sources Consulted
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Cancer Research UK. UK incidence statistics. Trends over time.http://info.cancerresearchuk.org/cancerstats/types/skin/incidence/#Trends (accessed April 2014)
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Royal College of Radiologists 2011 Workforce Census. https://www.rcr.ac.uk/docs/radiology/pdf/BFCR(12)14_census.pdf
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Royal College of Paediatrics and Child Health Article: http://www.rcpch.ac.uk/news/shortage-consultants-and-too-many-units-reveals-latest-census-children’s-doctor
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European Union of Medical Specialists. http://admin.uems.net/uploadedfiles/1306.pdf.
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Healio Online. http://www.healio.com/ophthalmology/news/print/ocular-surgery-news-europe-edition/%7B79ae2e17-4fd1-43e8-9593-91488c969ed3%7D/growing-demand-for-eye-care-services-may-highlight-shortage-of-ophthalmologists-in-europe
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Augood C, Fletcher A, Bentham G, et al. Methods for a population-based study of the prevalence of and risk factors for age-related maculopathy and macular degeneration in elderly European populations: the EUREYE study. Ophthalmic Epidemiol. 2004;11(2):117-129.
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ONS National Cancer Statistics for 2013
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Health and Social Care Information Centre. http://www.hscic.gov.uk/catalogue/PUB10932/alc-eng-2013-rep.pdf