Date Published: 2 June 2010

NHS at risk of stagnating as BMA survey shows cuts to consultants' time to develop services

Health News from the United Kingdom (UK).

According to the British Medical Association (BMA), innovation in the NHS is at risk of being stifled as hospitals cut the amount of time senior doctors can devote to new services.

Under their standard contract, NHS consultants should have ten hours a week available for Supporting Professional Activities (SPAs), such as the introduction of new services, research, clinical governance, and training junior doctors.

However, interim findings from a UK-wide survey of over 2,000 NHS consultants, published today at the BMA's Consultants Conference, indicate widespread cuts to the time available for such activities.

Over a fifth (21%) said the number of SPAs in their job plan had been reduced since they transferred to the new consultant contract in 2004, or since they started. Only 7% said the number of SPAs had increased. More than one in seven (15.1%) said their employer had reduced the standard number of SPAs for all consultants, and almost a quarter (23.8%) said their employer had reduced SPAs for newly appointed consultants.

Dr Mark Porter, Chairman of the BMA's Consultants Committee, says:

Pretty much every clinical service that a hospital provides has been planned during this time. If hospitals cut it, they risk stifling innovation and allowing the NHS to stagnate. This is being driven by the financial pressures we all face, but it's a false economy, because the new services consultants develop often save the NHS money.

Nearly two thirds (65.4%) said the decrease to their SPA time was employer-driven. Areas identified as having already been affected by reductions, or at risk of being affected in future, included the training of junior doctors and continuing professional development. Of those respondents who reported that their SPAs had not changed, more than nine in ten (91.1%) said they would not be willing to accept a decrease in future.

The survey also shows that:

  • Consultants are contracted to work an average 44 hours a week, but work on average an additional 4 hours
  • Over a quarter (25.5%) of consultants report increased out of hours work over the past year
  • Consultants now spend on average 12.1% of their working time out of hours an increase from 9.3% in 2008
  • Of those consultants who reported changing their working patterns over the past year, 61.4% reported doing so because of decreased availability of middle grade doctors, and 48.5% said it was to improve the standard of patient care


Dr Porter added:

In many specialties, consultants are taking on a greater front-line role in response to the needs of patients. The challenge for the NHS is to make sure that this time is used for consultant-level patient care and not just to replace other doctors in shorter supply.

The survey also shows that eight in ten (80.7%) consultants have a strong or very strong desire to practise medicine.

Source: British Medical Association.

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