Health Department
Human Resources Directorate

NHS MEL (2000)24

Dear Colleague

1. This circular advises Health Boards, NHS Trusts and the Scottish Council for Postgraduate Medical and Dental Education (SCPMDE) of the number of posts for doctors in higher specialist training in 2000-2001.

2. It also provides information on the numbers of trainees expected to be awarded CCSTs in the next few years.

3. Annex A provides information on the Specialist Registrar Establishment 2000.

4. Annex B contains 2 tables. Table 1 shows the Specialist Registrar Establishment 2000 and Table 2 the expected CCST dates of current Specialist and Senior Registrars.

5. Health Boards, NHS Trusts and Postgraduate Deans must ensure that posts have been approved as training posts by the appropriate Joint Committee on Higher Training before proceeding to fill them.

6. A request for information on consultant retirals and plans for consultant replacement and expansion over the next five years has recently been issued.

7. Health Boards, NHS Trusts and the SCPMDE should note the above and take action as appropriate.

Yours sincerely

GERRY MARR
Director of Human Resources

28^th April 2000
______________________________

Mr Lee Thorburn
Directorate of Human Resources
Room 142
St Andrew’s House
EDINBURGH EH1 3DG

Tel: 0131-244 2430
Fax: 0131-244 2837
_______________________

ANNEX A

The tables attached in Annex B set out the establishment and distribution by specialty and region of Specialist Registrars in Scotland in 2000-2001 (Table 1), and the projected CCST dates for current Specialist and Senior Registrars up to 2004 (Table 2).

These tables should be read in conjunction with the information set out below.

The Specialist Registrar indicative establishment figures for 2000 detailed in Table 1 are based on information from Health Boards, Trusts and their respective planning partners, on the projected need for consultants over the next 5 years in the different specialties. Changes in service configuration and technical advances in medicine were also amongst a number of other factors taken into consideration. The figures were also reached through discussion with representatives from a number of specialties, expectations about future trends and pressures, and Postgraduate Deans’ extensive knowledge of regional situations. The workforce situation throughout the UK was also taken into consideration.

These figures include the funded establishment posts in training rotations. A number of posts are fully funded by Universities or Industry or in collaboration with the SCPMDE. The overall Scottish numbers have been considered by the hospital sub-committee of the Scottish Advisory Group on the Medical Workforce (SACMW-HCHS), while the regional distribution of posts has been agreed by the SCPMDE and the Regional Postgraduate Deans.

The CCST dates in Table 2 include a number of Specialist and Senior Registrars who are currently "out of programme" in research or abroad, but are expected to return to take up NHS posts on completion of their training programmes.

The projections for CCST dates beyond 2002 should continue to be interpreted with caution; further appointments this year will add to the totals for 2003 and beyond, as will slippage of CCST dates from earlier years as individuals undertake research, spend time abroad or choose part-time working.

The figures in Annex B refer to whole-time equivalents and Postgraduate Deans have the ability to adjust these to take into account Specialist Registrars who are training on a part-time basis.

The development of effective medical workforce planning will require relevant and accurate information and the commitment of Health Boards and Trusts, as well as Postgraduate Deans, SCPMDE and the Management Executive. NHS MEL (1999) 89 issued on 29th December 1999 providing guidance on HIPs, TIPs and Corporate Contracts, reinforces the fundamental need for the NHS in Scotland to work in partnership, to build a strong, modern health service for the 21st century. In the light of this information, and as the effects of the Calman reforms are worked through, the numbers of Specialist Registrars are adjustable and will be regularly reviewed and revised in the light of changing service demand for consultant posts in Scotland.

Health Boards’ and Trusts’ projected requirements for consultants should reflect closely any service redesign planned in HIPs and TIPs, as well as consultant vacancies and retirement. The recently established Scottish Integrated Workforce Planning Group (SIWPG) has been set up as a need was identified for a more integrated approach to workforce planning, to ensure the NHS workforce is sufficiently flexible to react to change and new developments in service delivery. The group is expected to report its findings in Spring 2001, with a view to identifying models of best practice. As the HIPs process is a five year rolling programme, significant changes in the way we plan the NHS workforce may affect consultant requirement in the future and should be reflected in any data returns submitted to the Scottish Executive.

The request for returns on consultant requirements has recently been issued and is timed to coincide with the submission of the final HIPs – 31 March 2000. It had been the intention for this information to be submitted as part of the HIPs process this year but this has not been possible. It is envisaged that this information will be included in the HIPs submitted to the Executive at the end of March 2001. Further guidance will be issued in a subsequent Priorities and Planning Guidance Management Executive Letter.

Specialty

West

South East

East

North/
North East

Total

Change in
Establish-ment
figures

Medical Specialties

484

309

131

166

1100*

No change

Hospital Specialties

468

303

128

161

1069*

+1

Accident and Emergency Medicine

14

8

4

3

29

-1

Anaesthetics

55

32

15

16

118

-10

Clinical Laboratory Specialties

43

26

12

16

97

+2

Blood Transfusion

4**

-2

Chemical Pathology

5

2

2

1

10

-2

Clinical Genetics

6

2

0

3

11

+1

Haematology

8

6

3

3

20

-1

Histopathology

13

9

5

7

34

+4

Immunology

2

0

0

0

2

No change

Medical Microbiology and Virology

9

7

2

2

20

No change

Medical Specialties

134

96

40

46

316

+22

Dermatology

6

4

2

2

14

No change

53

39

16

21

129

No change

Genito-urinary Medicine

4

4

0

0

8

No change

Geriatrics

13

8

5

5

31

+3

Homeopathy

1

0

0

0

1

No change

Medical Oncology

6

7

2

2

17

+5

Neurology

Paediatric Cardiology

6

2

4

-

1

-

1

-

12

2

+1

Paediatrics

26

15

9

11

61

No change

Palliative Medicine

4

4

2

1

11

+4

Radiotherapy

11

8

2

2

23

+7

Rehabilitation Medicine

2

24

4

16

0

7

1

8

7

55

No change

-10

Psychiatry Specialties

2

54

2

38

1

20

1

22

6

134

+1

No change

Child and Adolescent Psychiatry

9

5

3

3

20

"

Forensic Psychiatry

3

3

3

1

10

"

General Psychiatry

27

20

11

12

70

"

Old Age Psychiatry

10

5

2

5

22

"

Psychiatry of Learning Disability

4

4

1

1

10

"

Psychotherapy

1

1

0

0

2

"

Radiology

37

21

5

13

76

+5

Diagnostic Radiology

36

21

5

13

75

+5

Nuclear Medicine

1

0

0

0

1

No change

Surgical Specialties

97

62

31

38

228

-5

Cardiothoracic surgery

6

2

0

2

10

+2

ENT Surgery

10

8

2

4

24

No change

General Surgery

26

17

9

12

64

"

Neurosurgery

6

2

1

1

10

"

Ophthalmology

13

7

5

6

31****

-2

Orthopaedic Surgery

20

11

9

10

50

-5

Plastic Surgery

6

4

1

1

12

No change

Paediatric Surgery

2

2

0

0

4

"

Urology

10

9

2

2

23

"

Other Specialties

4

3

1

2

10

+4

Neurophysiology

1

0

0

0

1

No change

Intensive Therapy

3

3

1

2

9

+4

16

7

3

5

31*****

-2

Specialty

2000

2001

2002

2003*

2004*

Totals

251

228

215

169

96

Accident and Emergency Medicine

4

8

5

7

3

Anaesthetics

36

38

28

27

2

Clinical Laboratory Specialties

Blood transfusion

1

1

0

0

0

Chemical Pathology

4

1

0

1

2

Clinical Genetics

2

1

2

2

0

Haematology

4

5

5

2

2

Histopathology

5

3

7

8

5

Immunology

Medical Microbiology and Virology

4

0

0

2

2

Medical Specialties

Dermatology

3

3

1

3

0

General Medicine (Group)

36

25

30

20

18

Genito-urinary Medicine

1

3

0

0

0

Geriatrics

10

9

4

6

4

Homeopathy

0

0

0

0

0

Medical Oncology

5

5

1

3

2

Neurology

2

2

5

0

0

Paediatrics

12

10

9

7

10

Palliative Medicine

1

2

4

1

0

Radiotherapy

3

3

4

4

2

Rehabilitation Medicine

0

1

2

1

0

Obstetrics and Gynaecology

20

10

11

10

11

Occupational Medicine

7

2

2

1

0

Child and Adolescent Psychiatry

2

9

1

2

1

Forensic Psychiatry

4

2

2

2

0

General Psychiatry

19

16

12

1

1

Old Age Psychiatry

5

5

6

0

0

Psychiatry of Learning Disability

1

1

2

3

1

Psychotherapy

1

0

0

0

0

Diagnostic Radiology

10

16

13

8

7

Nuclear Medicine

0

1

0

0

0

Surgical Specialties

Cardiothoracic Surgery

4

2

3

1

0

ENT Surgery

6

5

3

5

3

General Surgery

8

11

17

9

3

Neurosurgery

3

2

2

1

0

Ophthalmology

6

7

7

8

2

Orthopaedic Surgery

6

10

13

12

9

Plastic Surgery

3

1

4

4

0

Paediatric Surgery

2

0

1

1

0

Urology

6

3

3

2

1

Other Specialties

Neurophysiology

0

0

1

0

0

Intensive Therapy

0

0

0

0

0

Public Health Medicine

5

5

5

5

5