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Emergency departments' workforce

Health Education England working with partners NHS Improvement, NHS England, and the Royal College of Emergency Medicine have published a plan that addresses staff shortages in emergency departments in England and makes recommendations for future planning.

Emergency departments are at the heart of our National Health Service, recording 23 million patients visits in 2016. It is evident that there is a need to recruit and retain more clinical staff and senior decision-makers to help address the reported pressures in A&E services. Improving staff numbers remains a priority.

We are working with partners to deliver on the Government’s commitment to provide the same quality of care in hospitals for urgent and emergency services, seven days a week by focussing on the recruitment, retention and development of the urgent and emergency care workforce. Read our plan, 'Securing the future workforce for emergency departments in England' to address clinical staff shortages and ensure we have sustainable staffing in our emergency departments.

Key points for Health Education England include:

- Recruiting an additional 100 doctors per year for four years into other training programs that develop skills in emergency medicine to help develop the mix of junior and middle grade expertise in emergency departments

- Investment in the growth of the advanced clinical practitioner (ACP) workforce, with funding for 42 ACPs across 14 trusts in 2017, rising to 84 ACPs in 2018

- A significant increase in the number of qualified Physician Associates through the training pipeline to 3,200 by 2019 with approximately 30% working in emergency departments

- HEE have been piloting less than full time training for all ST4 and above trainees in emergency medicine

- Raising awareness about the Certificate of Eligibility Specialist Registration Programme to support alternative routes to becoming an emergency departments consultant, through development events and best practice toolkit

- Investment in a leadership/personal development programme for every emergency departments trainee in England

- Following a successful pilot, the GMC has approved the incorporation of run-through training into the curriculum. 

Specialty Associate Specialist doctors are an important group of the urgent care workforce. HEE launched a number of initiatives to address some of the staffing challenges faced by Urgent and Emergency Care staff. One in particular was a pilot launched in the Midlands, to implement what became known as the Specialty Associate Specialist doctor’s development and retention toolkit - developed by the Derby NHS Foundation Trust - available at the bottom of the page.

The implementation of this toolkit at the Trust resulted in better recruitment and retention, a positive impact on the 4 hour performance target and lower spend on agency and wider financial savings. It provides tried and tested information regarding best practice including practical support for development towards successful entry on to the Certificate of Eligibility for Specialist Registration and is now available nationally for trusts to discuss, adapt and use to implement locally.

Elements of the toolkit can be edited for local use, using the 'edit text and edit' Adobe feature, or similar provider. To obtain a copy of the documents in an alternative format, email our urgent and emergency care team.

We are running a pilot that will look at whether we can provide higher specialty trainees in emergency medicine with greater flexibility in their working lives, by extending opportunities to train Less Than Full Time.