BSH review of the UK haematology clinical work force 2019
5th March 2020
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The BSH review of the UK haematology clinical work force 2019 is the most comprehensive review of the UK Haematology Workforce undertaken by the British Society for Haematology since the last review was undertaken by RCPath in 2008.
The BSH commissioned this research, managed by the External Affairs Committee under the leadership of Professor Beverley Hunt OBE (Guy’s and St Thomas’ NHS Foundation Trust) to better understand our members, and other haematology professionals, and how they work within the NHS. The last major study of the UK haematology workforce, published with the RCPath, dated from 2008 and focused on consultant haematologists. We felt that a great deal of water had passed under the bridge since then in terms of treatment and how the workforce has changed and as such we wanted to look at other members of the modern clinical MDT as well as consultants. This is particularly important in 2020 as NHS England and its partners develop a long term health and care workforce plan – the People Plan - for England.
This research project was undertaken by the BSH in partnership with APCO Insight, an advisory and advocacy communications consultancy with a strong track record of working with the haematology community.
Freedom of Information (FoI) requests were sent out via email in March 2019 to 176 NHS trusts across the UK. They were asked for details relating to workforce and staffing including:
- The number of haematology staff by function and job role
- Vacancies within the haematology department by function and job role
- The number of staff within five years of retirement by function and job role
- Contextual information, e.g. the number of dedicated haematology beds
- Total sick leave days taken by clinical haematology staff, including those taken due to stress
- Involvement in multi-disciplinary teams
- The number of times job planning, mandatory training and continuing professional development sessions were missed due to work overload.
Trusts were also asked to indicate what they consider to be the most pressing issues facing haematology departments and why. This was to help provide greater insight into the challenges faced by teams. Of the 176 Trusts that were sent FoI requests:
- 79 responded
- A further 47 confirmed they did not have a haematology department
- 50 did not respond
In addition to the FoI requests, qualitative research was carried out in the form of interviews with haematology staff. Interviewees came from a range of roles and across the UK. The interviews explored the FoI results, the reasons behind them and the possible consequences for both the workforce and for patients.
The BSH remained in close contact with the Royal College of Pathologists who recently carried out its own review focusing on the UK haematology laboratory workforce over a similar period. We welcome the results of that report and echo and support their key findings.
The research findings revealed that clinical haematologists, nurses, laboratory scientists, pharmacists and specialist managers are under increasing pressure to deliver for patients in the NHS as the burden of doing more with less staff is impacting rates of work related stress, sickness and absence:
- Unfilled vacancies in the Haematology workforce remain significant: Even a stable workforce is insufficient given the increasing incidence of haematological conditions, combined with the complexity of newer treatments. Many Trusts are having to resort to employing expensive locums to ensure essential services can be delivered in the face of long term vacancies.
- Reduced numbers of trainees to fill consultant haematologists post: The number of Medical Trainees / Foundation Year doctors being recruited to haematology training posts has dropped dramatically. Averaged out across Trusts, the number has fallen more than a third (36%) over the past two years.
- Vacancies likely to rise as current workforce approaches retirement: Overall, the haematology workforce across the UK appears stable in terms of numbers. However, more than one in ten consultants are due to retire within the next few years, which could trigger a further decline in numbers if nothing is done to address the urgent recruitment crisis in the profession.
- Low morale, sickness and absences are affecting the haematology workforce, as they are across the NHS. Between October 2017 and October 2018, the average number of sick days per haematology department was 796 across staff including consultants, nurses and lab scientists.
- More than a quarter (27%) of those absences were taken by employees suffering from stress or mental illness. The workload burden is a likely factor in employees suffering physical and mental health problems.
- Haematology is already adapting to the changing nature of advanced medicine: The introduction of cutting-edge treatments is truly exciting; however, this rising number of complex treatments available requires more intensive long term care that was not previously planned for. This has added additional pressure to services already under strain.
Ensuring a sufficient haematology workforce is in place is fundamental not just for safeguarding for the future, but to ensure a functioning health care system today. This research will inform the Society on the particular needs of and challenges faced by today’s multidisciplinary haematology professionals and will inform the next phase of the Society’s strategic planning. Ultimately this knowledge will lay a strong foundation on which the organisation can build its plans to become more of a voice for the profession and to represent the interests of its members.