The state of the consultant geriatrician workforce: An analysis of the RCP census
This report analyses data from the UK 2022 census of consultant physicians, conducted by the Royal College of Physicians London on behalf of the Federation of the Royal Colleges of Physicians of the UK. The latest RCP census was published in 2023 and is based on data collected in 2022.
Foreword
The BGS has long advocated for a better staffed healthcare workforce to care for the needs of the UK’s rapidly ageing population. Workforce pressures are nothing new and it is well known that the NHS is experiencing severe staff shortages. As a result, healthcare workers report feeling exhausted. These challenges are exacerbated by the failure to resolve long-standing industrial disputes. There is a long way to go to solve these problems. Concerted action is needed to recruit more healthcare professionals into the specialty of geriatric medicine, especially to rural and coastal areas where the populations are likely to age faster, and to retain and support existing staff.
This report analyses data from the UK 2022 census of consultant physicians conducted by the Royal College of Physicians (RCP) on behalf of the RCP London, the Royal College of Physicians of Edinburgh (RCPE), and the Royal College of Physicians and Surgeons of Glasgow (RCPSG). The census was published in 2023, using data that was collected in 2022. The BGS would like to express thanks to the RCP who work to conduct this annual census. The data is a valuable resource that allows us to keep track of the current state of the consultant workforce caring for the older population. Of course, consultant geriatricians are just a small part of the multidisciplinary workforce that provide healthcare to older people. The BGS will continue to seek data on the wider workforce in our endeavour to represent the whole multidisciplinary team. Our recent report, The state of the older people’s healthcare workforce: A report from the BGS membership survey, captures some of this evidence from our wider membership but more high level data is needed.1
Nine months on from the publication of The Case for More Geriatricians: Strengthening the workforce to care for an ageing population,3 the new census data highlights that there is still a long way to go to meet our calls and make up for the shortfall in consultant geriatricians. The current shortage is only expected to worsen, with just under a half of geriatricians expected to retire in the next decade and more people needing healthcare in their later years. The report also highlights that there is an uneven geographical distribution of geriatricians in the UK, with urban areas typically being better served despite the ageing population more likely to be found in rural and coastal areas. On the ground, most geriatricians report substantial staff shortages and do not feel in control of their workload. These frustrations echo the findings of our recent membership survey which painted a bleak picture of the wider workforce and highlighted that staff shortages have a big impact on mental and emotional wellbeing of healthcare professionals.1
Despite frustrations, most consultant geriatricians are happy with the specialty of geriatric medicine, and we know many of our members find their roles rewarding. This sentiment needs to be captured in a recruitment drive, starting to build increased training numbers. We are excited by our own upcoming #ChooseGeriatrics BGS campaign which will promote the specialty to medical students and the wider multidisciplinary team, making the case for the older people’s healthcare workforce. More information on this campaign will be publicised soon and we would value support from BGS members and others.
As the biggest users of the health and social care system, older people’s needs must be at the centre of workforce planning. The upcoming general election is a vital opportunity for political parties to consider the needs of an ageing population and the workforce supporting it. Health policies must address current staff shortages and put geriatricians where they are needed most. This is vital so that, across the country, older people can receive high-quality, personalised care, now and in the future.
Professor Adam Gordon
BGS President
Dr Amit Arora
BGS Vice President for Workforce
Key messages
- For the first time since 2016, geriatric medicine is the biggest medical specialty.
- There are 2,328 consultant geriatricians in the UK. For every 697 individuals aged 85 and over in the UK, there is one consultant geriatrician. This does not meet the UK-wide target of one consultant geriatrician per every 500 people aged 85 and over that the BGS recommends. At least 1,786 additional geriatricians are needed by 2030 to make up for this shortfall. If including intended retirement plans, this number increases to 2,566.
- There is an uneven distribution of geriatricians across the country, with urban areas, particularly London, typically being better served. This is despite non-metropolitan areas being more likely to have ageing populations.
- More female consultant geriatricians work less than full time or flexibly than their male counterparts.
- A higher proportion of consultant geriatricians care for patients on virtual wards compared to other specialties.
- More consultant geriatricians have a work commitment to Acute Internal Medicine and General Internal Medicine compared to other specialties.
- Most consultant geriatricians do not feel in control of their workload.
- Most consultant geriatricians reported a substantial level of rota gaps and vacancies in their department, and this appears to be a bigger problem than other specialties. The majority of geriatricians felt this impacted patient care.
- Leadership roles significantly contribute to job satisfaction, but this is often not recognised in appraisals.
- Just under half (44%) of consultant geriatricians will reach their intended retirement age in the next ten years, equating to 1,025 consultants who will need to be replaced.
Introduction
The NHS workforce is in crisis and there are not enough healthcare professionals to care for an ageing population. As the biggest users of the health and social care system, older individuals are not receiving the high-quality, personalised care they need. In September 2022, the BGS published The geriatric medicine workforce 2022, which analysed data from the RCP census of consultant physicians conducted in 2020.2 Key findings showed that geriatric medicine was the second largest medical specialty; consultant geriatricians were more likely to work in the community than consultants of other specialties; geriatricians are more likely to care for non-specialty inpatients and participate in the unselected acute take; and vacancies appeared to be a bigger problem than for other specialties. Following on from this, in May 2023, the BGS published The case for more geriatricians: Strengthening the workforce to care for an ageing population.3 Using data from the 2021 RCP census and population projections, the report highlighted that more geriatricians are urgently needed to support the older population.
Data collected through the UK 2022 Census of Consultant Physicians was published in June 2023 by the Royal College of Physicians London (RCP).4 The RCP reiterates the need for long-term strategic planning to grow the medical workforce as a whole and for robust retention policies to reduce staff pressures. This BGS report brings the geriatric medicine workforce data up to date using the data from the 2022 RCP census and exploring the potential impact on healthcare for older people.
About the census
The annual UK census of consultant physicians is conducted by the Medical Workforce Unit (MWU) of the RCP on behalf of the RCP, the Royal College of Physicians of Edinburgh (RCPE) and the Royal College of Physicians and Surgeons of Glasgow (RCPSG). The census collects data about the consultant physician workforce across the four nations of the UK. The collected data gives a sense of the number of consultants, demographics, work commitments and patterns, job satisfaction, retirement intention and employment prospects.5
The most recent census data was published in June 2023 and represents data collected in 2022 from consultant physicians working across all specialties. The RCP defines consultant physicians as senior hospital doctors who focus “on the non-surgical treatment of patients’ conditions, such as outpatient care and diagnostic investigation” across 30 specialties.3 As of June 2023, there were 23,937 consultant physicians on the General Medical Council (GMC) register, with 21,182 of them practising in the NHS. The census was sent electronically to 19,187 NHS consultant physicians and 5,244 (27%) responded. After excluding those that were no longer working, 4,774 responses to the survey were from practising consultant NHS physicians. The response rate across the UK was similar, ranging between 25 and 31%, with the highest percentage of respondents from Scotland.
The RCP has published an overview of the key findings of the 2022 census, which highlights key insights into the workforce as a whole.3 The data indicates that most consultants have unmanageable workloads and it is common to work beyond contracted hours. Compounding this issue, consultant posts are not being filled and there are frequent gaps in the trainee rota which impacts patient care. There is also a growing trend in less-than full-time and flexible working. However, despite workforce issues, most consultants felt valued and would recommend their workplace. To allow for public interrogation of the data, the RCP have published an interactive census data toolkit which allows the data to be analysed by specialty, location, demographics, and work commitments. This has allowed the BGS to analyse the data of those specialising in geriatric medicine, helped by the inclusion of new specialty-specific questions which the BGS agreed on with the RCP. For the purposes of this report, we have analysed data of the consultant respondents who consider ‘geriatric medicine’ to be their main specialty. It must be acknowledged that this may not include consultants who may have trained in geriatric medicine but predominantly identify with a different specialty, such as stroke medicine or general internal or acute medicine. It must also be recognised that other specialties look after a large proportion of the older patient population but will not consider geriatric medicine to be their main specialty. Furthermore, consultant geriatricians work in a wider multidisciplinary team consisting of geriatric medicine trainees, SAS grade doctors, Locally Employed Doctors (LEDs), nurses, allied health professionals, physician associates, specialist pharmacists, and more. Therefore, the data of this report analyses only a sub-section of the wider workforce looking after the healthcare needs of older individuals where the data exists. Comparisons are made throughout this report to the overall consultant workforce and to the second biggest specialty, consultant cardiologists.
About the respondents
Data from the General Medical Council indicates there were 2,328 registered consultant NHS physicians in the UK in 2022 whose main specialty was geriatric medicine, with 657 responding to the RCP census survey (31% response rate). Based on self-reported data collected by the BGS, an estimated 1,767 of these are members of the BGS. Of the RCP census respondents, 525 were based in England, 16 in Northern Ireland, 87 in Scotland, and 29 in Wales (see Figure 1a & 1b). This report analyses some of the data at a country level. However, the low level of responses from Northern Ireland and Wales may be too small to draw meaningful conclusions regarding country trends. For the first time since the 2015-16 census, geriatric medicine was the biggest specialty, with 160 more consultants than cardiology, the next biggest specialty. This is a changing trend as cardiology has been the biggest specialty since 2016-17, with geriatric medicine coming in second. Since 2021, there has been an increase of 378 consultant geriatricians included in the census data.
The consultant geriatrician population has a higher proportion of women working in the specialty compared to the overall consultant workforce. Just under half (47%) of consultant geriatricians were female and 53% were male, compared to 41% of females in the overall consultant workforce and only 18% of consultant cardiologists being female. Most consultant geriatricians were aged between 40 and 54 (56%). This is consistent with the average age of all consultants. The next biggest age groups were those over the age of 60 (15%) and those between the ages of 35 and 39 (10%) (see Figure 2).
Ethnicity and citizenship
Most consultant geriatricians identify as white, with 53% noting they were white English, Welsh, Scottish, Northern Irish or British. The second biggest ethnicity was Asian or Asian British (29%). A small proportion (3%) of consultant geriatricians identify as Black or Black British, consistent with the wider consultant workforce (see Figure 3). Compared to consultant cardiologists, geriatrics appears to be slightly more inclusive of the Black population, with only 1% identifying as Black or Black British in the specialty of cardiology. The 2021 census of England and Wales shows that 81.7% of residents identify as white, 9.3% identify as Asian, and 2.5% identify as Black.6 In Scotland, the 2011 census illustrates that 96% identify as white, 2.7% identify as Asian, and 0.7% identify as African Caribbean or Black.7
Over a quarter (31%) of consultant geriatricians qualified outside of the UK, which is consistent with all consultants, with 32% of all consultants having graduated overseas. Most geriatricians qualified in England, followed by Scotland, India, Pakistan, Northern Ireland, Wales, Italy, Ireland, Greece and Germany. Most consultant geriatricians (95%) were UK citizens, compared to 93% of all consultants.
How many consultant geriatricians are there and where are they based?
In The case for more geriatricians: Strengthening the workforce to care for an ageing population, the BGS not only highlighted the overall shortage of geriatricians in the country, but also noted that the ratio of geriatricians to older people is uneven across the country.2 While quantitatively comparing the number of geriatricians in different locations may not take into account the uniqueness of some areas, for example, smaller populations in rural and remote locations, it allows for a top level understanding of where geriatricians are based in the UK. To meet the needs of the older population, the BGS has advocated for a UK-wide target of one consultant geriatrician per every 500 people aged 85 and over.2
Data from the RCP census indicated that there were 2,328 substantive consultant geriatricians in the UK in 2022, with an estimated number of 2,019 full time equivalent (FTE) consultant geriatricians. That means, comparing population estimates8,9,10 to the total headcount of geriatricians (not FTE roles), there is one consultant geriatrician per 697 people aged 85 and over in the UK. This is not meeting BGS’s suggested target. Geographical variation means that some areas are better served than others. Wessex is the least served region with 1,257 individuals aged 85 and over per geriatrician. The RCP data shows that 38% of Wessex consists of rural and hubtown populations (towns with populations between 10,000 and 30,000), and it also has a coastal population.11 In contrast, London is the best served area, with one consultant geriatrician per 428 individuals aged 85 and over. The Chief Medical Officer’s Annual Report 2023 highlighted that urban areas are not where the growth in older people is occurring, with more non-metropolitan areas experiencing a growth in this population group.12 A proportion of older people move away from urban areas before they reach older age and therefore, rural, semi-rural and coastal areas have growing older populations. This indicates that a particular focus is needed to increase the numbers of geriatricians in these rural and coastal areas, to meet current and future demands. However, the data also indicates that not all rural areas are less well served, with West Scotland having relatively more geriatricians than some other areas, despite having a rural and hubtown population of 53%. More analysis is needed to examine the potential reasons behind this variation. A full breakdown of each region can be found in Table 1 (see Appendix).
Last year, the BGS highlighted that an additional 1,218 consultant geriatricians were needed to level up to the national benchmark of one consultant geriatrician per 500 people aged 85 and over based on census data from 2021 and an additional 1,846 needed by 2030.2 The new RCP census data indicates that the new number of consultant geriatricians that would have been needed for 2022 was at least 917. By 2030, it is estimated that at least 1,786 additional geriatricians are needed (starting from the total headcount of geriatricians in 2022), not taking into account retirement. It is important to note that these figures are for the total headcount of consultant geriatricians in the UK, inclusive of part-time consultants. This reinforces our calls for government to urgently act on recruitment, retention, training and support as outlined in The case for more geriatricians: Strengthening the workforce to care for an ageing population.5
Working arrangements
The majority of consultant geriatricians - 85% - work for the NHS; 9% work academically (with or without an NHS contract); 2% work jointly for the NHS and another organisation; and 5% work for other organisations. Other organisations included local authorities, charities, hospices, and HM Forces. In comparison to all consultants, it was more common for geriatricians to work for the NHS and less common for them to work academically. Amongst all consultants, 78% worked for the NHS and 15% worked academically. Consistent with all consultants, 31% of consultant geriatricians work less than full time or flexibly comprise. Of the female geriatricians, 47% work less than full than full time or flexibly whilst 14% of male geriatricians work this way.
The majority of consultant geriatricians (94%) provided care for hospital inpatients, which is higher than the average for all consultants at 79%. A higher proportion of geriatricians also delivered care for patients on virtual wards, with 19% delivering care in this way compared to 9% of all consultants. Of those, 49% work on a virtual ward weekly, 24% work on them daily, 21% work on them monthly, and 7% once or twice a year.
Most consultant geriatricians (98%) have a Certificate of Completion of Training (CCT) in Geriatric medicine and a further CCT in Acute Internal Medicine (AIM) or General Internal Medicine (GIM). This is significantly higher than the average of all consultants, with 62% on average having a CCT in AIM and GIM, and 50% of consultant cardiologists. As a result, 71% of consultant geriatricians had a work commitment to AIM or GIM which is considerably higher than the average of 45% for all consultants and 24% of consultant cardiologists. Additionally, 59% of consultant geriatricians reported that they participated in the acute medical take, which is higher than the average of all consultants at 35% and consultant cardiologists at 11%.
Most consultant geriatricians (82%) participate in out of hours on call work, with 34% participating in specialty only calls and 23% participating in the acute take only. This is slightly higher than average, with 72% of all consultants participating in out of hours on call work. Consultant geriatricians tend to partake in less specialty-only out of hours work compared to other specialties. Most consultant geriatricians (84%) routinely work some hours above their contracted Programmed Activities (PAs). The majority of respondents (64%) reported that their patient-facing clinical workload was a contributing factor to working above contracted hours, most (56%) also highlighted that their administrative clinical workload played a role, and just under half (45%) highlighted vacancies and covering for colleagues was a factor. This is similar to other specialties. However, most consultants spend more overtime on administration duties and geriatricians spend more overtime on patient-facing activities. This is probably a result of geriatricians spending more time on the acute medical take. Over half of consultant geriatricians would like to work fewer PAs in the future, consistent with the wider consultant workforce’s views.
Reflective of the whole consultant workforce, just under half of consultant geriatricians (43%) did not take their full leave entitlement in the last year. Of those, 55% had 10-20% of their leave remaining. The primary reason why leave was not taken was due to an inability to find cover for clinical service, followed by consultants being too busy to organise cover and being unable to take time from non-clinical roles. Nearly half - 42% - were contacted by work about clinical matters while on leave, and 38% were contacted by work about non-clinical matters while on leave. The majority of consultant geriatricians took Continuing Professional Development (CPD), or study leave in the last year, with the majority taking 3-5 days, which is similar to the average.
Most consultant geriatricians felt that they were supported to work from home, with 75% reporting sufficient equipment to effectively work remotely. The majority of consultants (86%) have remote working IT equipment provided by their workplace and 78% also reported using personal electronic devices to do work. The type of work most done remotely was CPD (78%), followed by administration related to patient care (61%), education (47%), and appraisals (42%).
Job satisfaction and wellbeing
Consistent with the wider consultant workforce, the majority of consultant geriatricians do not feel in control of their workload, with only 35% feeling they can manage the expected amount of work. However, a stark comparison can be made to consultants who mainly work in general internal medicine, with 52% of them feeling in control of their workload. Of the geriatricians, 42% of male consultants and 28% of female consultants felt in control of their workloads. A significantly lower proportion of consultants from Northern Ireland felt in control of their workload, at 7%, compared to other UK nations, which ranged from 31 to 37%. The age group which felt the least in control of their workloads were the 40–49 year olds. Just under half of geriatricians felt that they worked excessive hours, consistent with the wider consultant workforce.
Just under a quarter (23%) of consultant geriatricians felt that they were at risk of burnout, which is slightly higher than the average of all consultants at 19% and consultant cardiologists at 17%. The burnout percentage is higher in the male workforce, at 25%, compared to the female workforce, at 21%. Northern Ireland had a slightly higher percentage of consultant geriatricians at risk of burning out (27%) compared to other nations, which ranged from 19% to 25%.
Most consultant geriatricians are happy with the specialty, with 83% saying they are always or often satisfied with geriatric medicine. For those taking on commitments in general internal medicine, only 44% were satisfied with this. Most consultant geriatricians (75%) felt they were valued by their colleagues, and 79% felt they were valued by their patients. Additionally, 84% of geriatricians would recommend their organisation to outside consultants and trainees, 85% would recommend to a SAS doctor, and 80% would recommend to their friends and relatives as a patient.
Staff in core clinical team
The proportion of consultant geriatricians working with a Physician Associate - 38% - is higher than the average for all consultants at 28% and for consultant cardiologists at 27%. A small proportion (9%) of consultant geriatricians reported having time in their job plan to support Physician Associates. Geriatricians had mixed opinions regarding the use of Physician Associates in clinical settings. Just under half of consultants considered that the Physician Associates in their departments impacted on access to training opportunities for junior doctors. However, most recognised the benefits, which included providing continuity of care for patients, having a reliable junior presence in the department during trainee doctor changeover or on call periods, supporting medical staffing on wards and improving wellbeing and morale among doctors by sharing workload. Healthcare for older people is delivered by multidisciplinary teams and consultant geriatricians work with a range of healthcare professionals. The data highlights that the most reported other healthcare professionals in the core clinical team were physiotherapists, followed by occupational therapists, pharmacists, clinical nurse specialists, and discharge coordinators.
Rota gaps, vacancies, and locums
Most consultant geriatricians (83%) reported trainee rota gaps daily or weekly, which is higher than the average of all consultants at 69% and consultant cardiologists at 64%. Most consultants (69%) reported that a locum was working in their department, with an average of 2.3 full time equivalent locums in each department. This is higher than the average of all consultants, with 52% of all consultants reporting they work with a locum and 59% of consultant cardiologists. Most consultant geriatricians (81%) also reported a substantive consultant vacancy in their department, with an average of 2.6 full time equivalent consultant vacancies. This is considerably higher than the average of all consultants, with 58% of all consultants reporting vacancies and 40% of consultant cardiologists.
Northern Ireland has the highest average number of full-time equivalent vacancies in comparison to other UK nations but also compared to other specialties in the country. When looking across all specialties in Northern Ireland, there is a higher number of FTE locums than FTE vacancies, indicating that the gaps are being filled. However, in geriatric medicine, the average number of FTE vacancies is higher than the number of FTE locums. In Wales, the number of FTE vacancies in geriatric medicine is higher than the national average but they do have a higher number of FTE locums, which is higher than the national average amongst all specialties and geriatric medicine in other nations. Most consultant geriatricians (86%) feel that rota gaps have an impact on patient care, which is higher than the average of all consultants at 73%. Geriatricians felt that the biggest impact on patient care was the increased length of stay, followed by care of patients out of hours, assessment of patients in the emergency department, and delays in diagnosis.
Consultant geriatricians noted that the main barriers to recruitment were that the candidates did not find the post attractive and that they lacked support from their organisation to agree funding. Additionally, we know from a recent BGS membership survey that many roles are not advertised as there is no expectation to fill them due to a lack of candidates.1 However, the RCP census data tells us that in 22% of consultant vacancies, other healthcare professionals were appointed instead. In most cases, this was an SAS doctor (58%), followed by Advanced Clinical Practitioners (26%), clinical nurse specialists (20%), and physician associates (18%).
Leadership and appraisal
Almost half of consultant geriatricians (42%) were in a leadership role and most felt they were supported by management and specialty colleagues. Most leadership roles were specialty leads in their organisation (40%), followed by undefined leadership roles (26%), and educational leadership roles (25%). Leadership opportunities resulted in higher enjoyment rates, with 76% of consultant geriatricians reporting that they enjoyed their job more due to leadership roles. For those over the age of 60, this increased to 92%. Despite this, only 55% felt that leadership roles were recognised in appraisals and only 52% reported time in their job plan for leadership, consistent with the wider consultant workforce. Just under half of consultant geriatricians reported that the time taken to undertake leadership responsibilities adversely affected their ability to deliver clinical care and a quarter reported that leadership duties adversely affected wellbeing.
Retirement
Almost half of consultant geriatricians (47%) are expected to reach the age of 60 in the next decade. Additionally, 30% of geriatricians are expected to reach the age of 65, and 24% of geriatricians are expected to be 67. The average intended retirement age was reported as 62, and 44% of consultants are expected to reach this age in the next ten years. This equates to 1,025 consultants leaving the workforce who will need to be replaced. This is consistent with the wider medical workforce, with 44% of all consultants expected to reach the average intended retirement age in the next decade and 46% of consultant cardiologists. Of note, this data was collected prior to the government announcement of partial retirement in October 2023 which may have an impact on the planned retirement levels.13 Considering the substantial rota gaps and vacancies and the increasing demands of an ageing population, high retirement levels will deepen workforce problems and have a detrimental impact on the quality of healthcare for older people.
Reflections
The RCP census data provides valuable insights on consultant physicians in the UK, allowing us to gather evidence on the consultant geriatrician workforce and its ability to meet the needs of an ageing population. The analysis helps the BGS to understand the priorities for workforce recruitment and development and to target its advocacy.
The data analysed in this report reiterates the BGS’s calls for more geriatricians. It is clear that there is a workforce crisis in the UK and there are not enough healthcare professionals specialising in geriatric medicine to meet the needs of the population. The report highlights substantial rota gaps and vacancies, which appear to be worse than other specialties. Compounding this issue, a large proportion of geriatricians are due to retire in the next decade. With the population continuing to age and older people being the largest population group using the healthcare system, it is vital that these workforce issues are addressed to enable older individuals to access the healthcare they need. The BGS estimates that at least 1,786 additional consultant geriatricians are needed by 2030 to rectify the current shortage. With 780 geriatricians reaching their intended retirement age by 2030, this number increases to 2,566. Considering it takes an average of 16 years to train a consultant geriatrician, urgent action is needed to empower the current workforce to care for the older population. The BGS will continue to call for the government to act to make up for the shortfall in consultant geriatricians, as highlighted in The case for more geriatricians: Strengthening the workforce to care for an ageing population.5 In particular, an urgent expansion of National Training Numbers in geriatric medicine is needed so that a UK-wide target of one consultant per every 500 people aged 85 and over is met. This will require a national recruitment drive in geriatric medicine, highlighting the importance of the specialty, and it should be complemented by an expansion of roles and numbers in the wider multidisciplinary team. An urgent increase in the number of ST4 geriatric medicine posts is also needed to support the expansion of training numbers.
Different parts of UK are ageing faster than others, with rural and coastal areas ageing much faster than urban and city areas. While some rural areas, such as West Scotland, are well served by consultant geriatricians, it is more typical for urban areas, particularly London, to be better served. Considering the geography of older age is increasingly skewed away from large urban areas, it appears that the current concentration of consultant geriatricians does not match the demand for healthcare in areas where older people live. More work is needed to explore the uneven geographical spread of geriatricians and how this mismatch can be addressed. Specifically, more data analysis is needed at a local level, below that of sub-regions. This will also allow for the number of additional training posts required on a deanery-by-deanery basis to be established, to better calculate the shortfall in geriatricians.
Conclusion
As the population of the UK continues to age, it is vital that the current crisis facing the older people’s healthcare workforce is addressed. The RCP census data provides valuable evidence regarding the current state of the consultant workforce. However, consultant geriatricians are just one part of the multidisciplinary team caring for older people. While focusing on the needs of consultant geriatricians is an important starting point, the same analysis needs to be done for the wider workforce, such as specialist nurses, allied health professionals, physician associates, specialist pharmacists, and others. More data is required about the wider multidisciplinary team to understand current and future workforce needs. The BGS will continue to endeavour to collect and analyse this. In the meantime, we urge prompt action to address the shortfall in the specialist workforce caring for older people in order to start to narrow the gap. The BGS will act on this through our upcoming campaign #ChooseGeriatrics which will promote the specialty of geriatric medicine to medical students and the wider multidisciplinary team.
References
[1] British Geriatrics Society, 2024. The state of the older people’s healthcare workforce: A report from the BGS membership survey. Available at: https://www.bgs.org.uk/BGSworkforce (accessed 12 February 2024).
[2] British Geriatrics Society, 2022. The geriatric medicine workforce 2022. Available at: https://www.bgs.org.uk/GMworkforce22 (accessed 19 January 2024).
[3] British Geriatrics Society, 2023. The case for more geriatricians: Strengthening the workforce to care for an ageing population. Available at: https://www.bgs.org.uk/MoreGeriatricians (accessed 19 January 2024).
[4] Royal College of Physicians, 2023. The UK 2022 census of consultant physicians. Available at: https://www.rcplondon.ac.uk/projects/outputs/uk-2022-census-consultant-physicians (accessed 19 January 2024).
[5] Royal College of Physicians. Census of consultant physicians and higher specialty trainees in the UK. Available at: https://www.rcplondon.ac.uk/projects/census-consultant-physicians-and-higher-specialty-trainees-uk (accessed 19 January 2024).
[6] Office for National Statistics, 2022. Ethnic group, England and Wales: Census 2022. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/ethnicity/bulletins/ethnicgroupenglandandwales/census2021 (accessed 19 January 2024).
[7] Scotland’s Census, 2011. Ethnicity. Available at: https://www.scotlandscensus.gov.uk/census-results/at-a-glance/ethnicity/ (accessed 29 January 2024).
[8] Office for National Statistics, 2022. Population and household estimates, England and Wales: Census 2021. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationandhouseholdestimatesenglandandwalescensus2021 (accessed 31 January 2024).
[9] Scotland’s Census, 2023. Scotland's Census 2022 - Rounded population estimates – data. Available at: https://www.scotlandscensus.gov.uk/documents/scotland-s-census-2022-rounded-population-estimates-data/ (accessed 31 January 2024).
[10] Northern Ireland Statistics and Research Agency, 2022. Census 2021 main statistics demography tables – age and sex. Available at: https://www.nisra.gov.uk/publications/census-2021-main-statistics-demography-tables-age-and-sex (accessed 31 January 2024)
[11] Department for Environment, Food, and Rural Affairs, 2015. Defining rural areas using the rural urban classification. Available at: https://www.gov.uk/government/statistics/defining-rural-areas (accessed 31 January 2024).
[12] Department of Health and Social Care, 2023. Chief Medical Officer’s annual report 2023: health in an ageing society. Available at: https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2023-health-in-an-ageing-society (accessed 19 January 2024).
[13] NHS Business Services Authority, 2023. Partial retirement. Available: https://www.nhsbsa.nhs.uk/member-hub/partial-retirement (accessed 8 February 2024).
Contributors
- Dr Marsali Anderson, Junior Doctor, NHS Greater Glasgow & Clyde
- Dr Katherine Chin, Research and Teaching Integrated CARE Fellow, Guy’s and St Thomas’ NHS Foundation Trust.
- Dr Amanda Koh, Junior Doctor, London North West University Healthcare Trust
- Dr Sangam Malani, Specialty Trainee, Imperial College Healthcare NHS Trust
- Dr Zuleikha Mistry, Junior Doctor, Chesterfield Royal Hospital NHS Foundation Trust
- Dr Matthew Roycroft, Consultant Physician, The Rotherham NHS Foundation Trust
Appendix
|
Region |
Number of geriatricians (total headcount in 2022)3 |
Population ≥ 85 years7 8 9 |
Population ≥ 85 years per geriatrician |
Rural and hubtown populations (% of settlements with populations ≤ 30,000) 3 |
|---|---|---|---|---|
|
Wessex |
69 |
86,800 |
1257 |
38% |
|
West Midlands |
154 |
146,700 |
952 |
32% |
|
East England |
184 |
170,000 |
923 |
48% |
|
East Midlands |
145 |
118,700 |
818 |
39% |
|
Yorkshire and the Humber |
171 |
132,000 |
771 |
27% |
|
Thames Valley |
74 |
56,800 |
767 |
49% |
|
Northern England |
108 |
81,200 |
751 |
35% |
|
Kent, Surrey and Sussex |
189 |
139,300 |
737 |
27% |
|
South West |
209 |
146,300 |
700 |
55% |
|
South Scotland |
69 |
45,600 |
660 |
21% |
|
North Scotland |
26 |
16,700 |
642 |
45% |
|
Wales |
134 |
82,500 |
615 |
- |
|
Northern Ireland |
65 |
39,391 |
606 |
19% |
|
North West England |
262 |
155,200 |
592 |
7% |
|
East Scotland |
15 |
8600 |
573 |
24% |
|
West Scotland |
99 |
50,900 |
514 |
53% |
|
London |
320 |
137,200 |
428.7 |
0% |