A snapshot summary of consultant cover and current working practices in Intensive Care Medicine across the United Kingdom.

Abstract

A challenge lies ahead in ensuring that consultant workforce planning within Intensive Care Medicine meets changing and expanding health care needs at a time of financial constraint. During the development of an enlarging consultant intensivist workforce, it is important to explore existing practices to ensure subsequent contracts provide optimal work intensity and on-call frequency as well as appropriate SPA time for clinical governance and professional development. We conducted a survey across 14 deaneries, 43 ICUs and 398 consultant job plans to compare current working practices and set these against new guidelines and standards. It demonstrated that 93% of consultants work 10 PAs or more, with an average of 5.14 Direct Clinical Care PAs in Intensive Care and an average of 2.14 SPAs. Seven of 43 ICUs had consultant-to-patient ratios greater than 1:8 and 33 ICUs had insufficient resident cover overnight, highlighting challenges with trainee staffing and anticipated service reconfiguration.