Full reports from the below and earlier censuses can be downloaded at the bottom of this page when applicable.
The pressure of the COVID-19 pandemic upon an already stretched workforce exposed concerns and exacerbated existing issues. Paediatric and child health services were affected by a number of factors, including redeployment of staff and space, cancellation of outpatient clinics and concerns about staff wellbeing.
- 2022 report pages
Demand on the paediatric workforce continued to escalate rapidly. Pandemic-driven staff shortages and increases of 30% in paediatric waiting lists exacerbated a service already heavily strained due to increasing chronic disease, delivery of new treatment options and changes in neonatology care provision. This is in addition to significant increases in emergency department attendances.
We had three key recommendations
- Each nation should develop a bespoke child health workforce strategy
- NHS organisations and senior leaders should support the wellbeing of the child health workforce and modern ways of working
- NHS organisations and senior leaders should ensure equality, diversity and inclusion (EDI) are integral to workforce planning.
In 2020 we had to halt the census due to the COVID-19 pandemic and shifting priorities. Monitoring the pandemic became paramount, and culminated in producing two reports on the Impact of COVID-19 on child health services.
Earlier during the year a focus report from 2017 data was released on vulnerable children and families.
- 2020 report pages
Workforce census: Focus on vulnerable children and families paediatric workforce (2020) - The vulnerable children and families lead roles are filled by paediatricians that deliver these responsibilities alongside other work, as part of their overall job plans. The challenges facing the paediatric workforce are therefore of high relevance to the vulnerable child and families workforce.
Impact of COVID-19 on child health services between April and July 2020 - In March 2020, it became clear that the NHS was facing an enormous challenge in responding to the novel coronavirus pandemic. This included child health services who had to respond rapidly with no precedence or rulebook.
Snapshot of general paediatric services and workforce in the UK - General paediatric services are the forefront of care for a seriously unwell child or baby. The majority of paediatric trainees qualify in general paediatrics, but only around 42% of paediatric consultants work in general paediatrics, with the remaining in subspecialty roles. Emergency paediatric admissions are increasing year-on-year, primarily driven by respiratory illnesses in the under 5s and neonatal issues.
Snapshot of neonatal services and workforce in the UK - Shortages in neonatal medical and nurse staffing have been highlighted in previous national reports including the NHS England (NHSE) and Department of Health and Social Care (DHSC) (2019) report, Implementing the Recommendations of the Neonatal Critical Care Transformation Review and the National Neonatal Audit Programme (NNAP) annual report (2019). These reports recommended neonatal networks and services should produce a gap analysis of medical and nurse staffing and that workforce transformation was needed, working closely with Health Education England (HEE) and the RCPCH.
Impact of COVID-19 on child health services between December 2020 and February 2021 - We launched the second phase to respond to the need for further data about the impact of the pandemic on paediatric services. This consisted of a snapshot questionnaire to clinical leads on Friday 4 December 2020, followed by a short, ten question weekly alert system for fourteen weeks starting on Friday 27 November 2020.
In 2019, using data from Census 2017 we published a series of additional reports focussed on specific areas such as devolved nations and SAS doctors, as well as an overview report with recommendations in five key areas:
- Planning the child health workforce
- Recruiting, training and retaining more paediatricians
- Incentivising the paediatric workforce
- Attracting more overseas-trained doctors and health professionals
- Planning for and expanding the non-medical workforce
- 2019 report pages
Workforce census: UK overview report (2019) - Overall, 84% of respondents in the UK said that paediatric training posts and gaps pose a significant risk to their service or to children, young people and their families.
There was recognition among respondents that pressures facing paediatrics are interlinked with problems and shortages across the NHS, especially Emergency Care, Child and Mental Health Services (CAMHS) and primary care.
Workforce census: Focus on SAS doctors (2019) - RCPCH census data clearly show that the SAS doctors in paediatrics are decreasing in number and increasing in age. This appears to run contrary to the national trend for other specialties, as the British Medical Association (BMA) stated in 2014 that “in recent years an increasing number of doctors have chosen to become SAS doctors rather than enter higher specialist training”.
Workforce census: Focus on Northern Ireland (2019) - There are five Health and Social Care Trusts in Northern Ireland delivering acute, community and specialist (including neonatal) care for children and young people across 11 hospitals5 . Northern Ireland has the highest proportion of the population under 18 of the UK nations, and 20.8% of the population are aged 0 to 15 years.
Workforce census: Focus on Scotland (2019) - Scotland has 11 Health Boards that provide paediatric services across the total 14 Health Boards, and NHS Scotland is responsible for workforce planning in this nation. Consultant growth in Scotland between 2015 and 2017 was 5%, lower than the England growth of 8.2% and the UK growth of 7.8%. Growth of consultant numbers in Scotland has slowed since 2015: between 2013 and 2015 WTE consultant growth in Scotland was 14.2%.
Workforce census: Focus on Wales (2019) - Wales has seven Health Boards providing a range of paediatric services. Tertiary paediatric services are primarily concentrated at University Hospital of Wales in Cardiff and Vale University Health Board (UHB), and acute services in across South Wales are generally in large urban centres. However, elsewhere (in West Wales for example), services are based in more rural and remote areas with access and staffing problems. All health boards provide community child health services.
In 2017, using data from Census 2015 we published the RCPCH Medical Workforce Census. This was the ninth biennial census produced by the RCPCH since 1999. It provided a snapshot of how trained and trainee paediatricians were working on 30 September 2015, and the structure of child health services in the UK.
Some key findings were:
- For the first time, there were more female paediatric consultants than male.
- ANPs were now employed in over 60% of hospitals.
- 31% of inpatient units and 41% of neonatal units had to close to new admissions due to shortages.
- Census 2015 (published 2017) reports
RCPCH 2015 Medical workforce census - For the first time, there are more female paediatric consultants than male. Across all grades, there are more women than men in the workforce; and 74% of paediatric trainees are female.
Workforce Census 2015: Focus on Scotland (2017) - In Scotland, we received full responses from 81.8% (9/11) of health boards providing child health services. Where no or partial response was received, we used alternative sources of data, including organisation websites, the GMC register and Specialist Info, to ensure basic information was known.
Additional Workforce Census 2015: Focus on Northern Ireland and Workforce Census 2015: Focus on Wales are available to download at the bottom of this page.
Earlier workforce reports undertaken between 1999 and 2013 can be consulted below in the downloads section in the form of executive summaries and key findings.