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RCS England - comment on NHS England & NHS Improvement Letter

05 May 2022

NHS England and NHS Improvement has today published a letter which it sent out to NHS hospitals, outlining plans to ‘enable the workforce for elective recovery’.  Commenting on this, Professor Neil Mortensen, President of the Royal College of Surgeons of England, said:

“We support NHS England’s plans to encourage senior doctors and surgeons who are approaching retirement to stay on, to help tackle the backlog in planned treatment.  Patients deserve timely treatment and we must do everything we can to return to the 18 week standard. 

“Consistent guidance is required across the NHS to allow senior surgeons to retire and return to appropriate roles.  For example, older consultant surgeons may be able to perform planned operations in surgical hubs, without being part of on-call rotas.1  Currently, there is a huge amount of variability across trusts, with some not allowing it at all, and others offering one-year rolling contracts which do not bring stability to the workforce. 

“On the issue of reducing the cap on working hours for consultants, it’s very important that surgeons’ time is used efficiently. Any increase in the number of scheduled hours in their job plans, must be voluntary.  Some staff may be willing to work 12 PAs instead of 10, but we must avoid staff burnout for those who are worn down by the experience of working through the longest pandemic in living memory.  And we must make good use of the extra time available from those who do opt to work more hours.  That means good access to surgical hubs and improving patient flow, so that more operations get done.

“Today’s letter from NHS England also outlines plans for hospitals to be encouraged to undertake simple, low risk elective procedures in ‘enhanced procedure rooms’2 rather than surgical theatres.  We support this in principle because it should free up much needed theatre space for more complex operations. However, the biggest challenge remains the availability of staff.  There are 110,000 vacancies in the NHS and this is adding pressures to an already overstretched workforce. We agree absolutely that training and service needs must be equally prioritised, and educational recovery linked to elective recovery.  We need to make sure there are enough staff now and in the future to care for our patients. This means both support for surgical trainees, and a credible long-term workforce plan from government.”


Notes to editors


2.The type of procedures that could take place in enhanced procedure rooms include carpal tunnel decompression, injections into joints to manage pain and some urological procedures such as cystoscopies.

3. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

4.For more information, please contact the Press Office:

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