Registrars' workload concerns.

Registrars, doctors one rank below consultants, state they are struggling to provide safe care because of heavy workloads.

Research by the Royal College of Physicians (RCP) has found that over a third of all hospital registrars find their workload “unmanageable” and over half said it was “heavy”. This is in contrast with GPs where only 5% of those questioned thought that their workload was heavy.

Registrars questioned stated that in some cases they were at 200% capacity. One stated “I had 30 patients to review. It was a ridiculous number. I was unsafe…I think medicine is unsafe at the moment.”

NHS Employers, who represent hospitals on employment issues state that many registrars are overworked because consultants refuse to work anti-social hours.

Chief Executive of NHS Employers Dean Royles said.” If consultant-level doctors in all medical fields embraced out-of-hours shifts, it would go a long way to ensuring that there are enough experienced doctors available at all times”.

The problem is compounded by a wide variation in the number of consultants in hospitals in different parts of the UK. London has almost twice as many consultants per head of population as the East MIdlands. The RCP suggests that London's figures are appropriate but that the rest of the country needs to catch up.

There is also heavy variation in the type of specialist consultants which are available from region to region. The North-East for example has enough hepatology consultants but too few specialising in kidney medicine.

There are also fears that elderly care will suffer due to general lack of specialist consultants. Only 50% of consultant posts in geriatric medicine were filled in 2011 due to too few doctors applying.

Royles went on to state “changes to hospital doctors’ working patterns were more important than simply demanding more and more doctors.