The NHS is unable to perform 1.5m operations a year because of a drastic shortage of anaesthetists, a report reveals.
More than 8 million patients are on waiting lists across England, Scotland, Wales and Northern Ireland. Many are in urgent need of a surgical procedure.
But an alarming lack of anaesthetists – specialist doctors who provide anaesthesia and pain relief before, during and after operations – is preventing the health service from performing about 4,000 procedures a day, the most comprehensive review of anaesthetic services has found.
The UK has 2,256 fewer anaesthetists than it needs, and the record shortfall is derailing NHS efforts to tackle the backlog of care, according to the 63-page report seen by the Guardian.
The crisis is leading to painful delays for thousands of patients, with many on waiting lists experiencing a decline in their physical and mental health, the report says.
As well as limiting NHS capacity, the shortage of anaesthetists is driving up costs, with hospitals having to divert funding to pay for agency locums and shifting staff to plug gaps.
The findings of the review, compiled by the Royal College of Anaesthetists, are being studied by officials in the Department of Health and Social Care, sources said.
Anaesthesia is the single largest hospital speciality in the NHS. Anaesthetists provide essential care in a range of health settings, such as operating theatres, maternity wards, intensive care units and pain services.
They are key to addressing the NHS waiting list crisis – and boosting NHS productivity – as most operations cannot take place without them, the report found.
The number of anaesthetists has grown slightly in recent years, but not by enough to meet demand.
There are 16% fewer anaesthetists than needed, with a shortfall of 2,256 posts across the UK. The largest gap is among consultants – the most senior grade of anaesthetist – according to the report. The consultant gap is about 1,640 or 73% of the total shortfall.
Anaesthetists quitting over stress and workload is a considerable problem. But the single biggest cause of the shortage is a lack of training places, the report says. Last year, there were 6,770 applications for just 539 core anaesthetic training positions.
The shortage is having a “severe impact” on NHS performance, the review found. Among clinical leaders interviewed for the report, 88% said surgeries were postponed due to a lack of anaesthetists, with 43% reporting this happening on a daily or weekly basis.
In total, 1,534,080 operations and procedures a year cannot take place because of the shortage of 2,256 anaesthetists, the report said.
Long waiting lists for surgery are bad for patients – 31% reported a decline in their mental health while waiting, and 36% reported a decline in physical health, according to the review.
Long waiting times are associated with additional use of healthcare services, increased likelihood that patients will seek financial compensation, and a greater risk that patients’ health deteriorates to the point that they can no longer work.
Dr Claire Shannon, the president of the Royal College of Anaesthetists, said: “Patients are still waiting too long for surgery, and the shortage of anaesthetists is a major factor. Despite modest increases, the gap between the anaesthetists we have and those we need continues to widen.
“This shortfall is delaying care for patients before, during and after surgery, placing growing pressure on our members and limiting the government’s long-term ambitions for the NHS.”
Urgent action was required, Shannon said. “The forthcoming 10-year workforce plan is a critical opportunity for the government to expand the number of training places for doctors to train as anaesthetists, retain our highly skilled workforce and deliver better care for patients.”
Jenny Westaway, the chair of PatientsVoices@RcoA, spoke of the impact the lack of anaesthetists was having on patients.
“The shortage of anaesthetists is causing real pain and distress to patients. We all know the toll it takes both physically and mentally to be waiting for a much-needed operation through our own experience or those of our loved ones,” she said.
The Department of Health and Social Care said the NHS had “record numbers of doctors”, including more than 14,800 full-time equivalent anaesthetists, 300 more than last year.
It said it was also “creating 4,500 additional training placements” as part of the deal agreed with resident doctors last month “and targeting those in areas where they are most needed”.
When asked how many of those 4,500 additional training placements would be for anaesthetists, a spokesperson said they were unable to say, and would set out which speciality areas would gain the extra posts “in due course”.
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