Transcript RCP presentation-Free movement of doctors in the EU

Free Movement of Doctors in
the EU
The UK Consultant Physician Perspective
Issues
• The different settings
• The need for an EU supported workforce
• Specific issues in hospital care
The settings
Out of hours GP care
• High profile
• Often employ non-UK professionals
• Local NHS provider responsible for assuring
professional competencies (including language)
• Responsible for large numbers of hospital admissions
Foundation year 1
•
•
•
•
Free movement from EU
Need for shadowing
Gaps left if doctors fail to perform
How comparable are basic medical qualifications
across EU?
Locum hospital jobs
• Large demand for locums
• Often short notice
• Evidence of concerns about competencies of external
locums
• No consistent method to assess/assure
competencies
• EWTD has limited internal locums
Consultants
• Specialist qualifications vary across EU
• EU focus on length of training not competencies
• UK specialists often have different skill mix to EU
specialists, e.g. in acute medicine
• UK seen as attractive place to work as a specialist
The need for an EU supported workforce
• Vacancy rates in junior doctors
• Difficult to fill specialist posts in particular areas of
the UK
• The right of free movement across borders
Vacancy rates
F1
F2
CT
ST
SAS
836
561
903
1292
412
Post vacant
1.0%
3.0%
5.0%
8.6%
5.2%
Sick leave
1.5%
3.5%
2.2%
2.6%
2.3%
Annual leave
10.7%
10.4%
13.1%
8.6%
4.1%
Study leave
0.6%
3.3%
4.4%
6.0%
1.6%
Compensatory rest
7.1%
11.6%
11.7%
7.2%
2.4%
On MAU
10.1%
15.0%
13.2%
12.3%
3.0%
On base ward or in clinic
68.9%
53.3%
50.4%
54.7%
81.3%
Number of posts in survey
Sickness rates
T otal epis odes of s ic k leave taken
40
Episodes
35
30
8/2006 - 8/2007
25
8/2007 -8/2008
20
15
10
5
0
HO
S HO
T ra ining g ra de
EG
TraRining
Hard-to-fill specialties
Northern
South
Western
Peninsula
West
Midlands
Yorkshire
1.0
0.8
1.0
2.3
1.6
6.4
-
3.0
-
5.5
5.0
4.0
6.8
-
2.0
-
1.8
-
Endocrinology
2.1
2.5
2.0
2.0
1.0
2.8
3.0
Genito-urinary medicine
0
3.4
-
-
-
0
1.0
Gastroenterology
2.3
5.1
2.5
4.4
1.5
4.8
-
Medical microbiology
-
1.9
-
-
-
-
1.0
Nuclear Medicine
-
0.8
-
-
-
0
-
Rehabilitation Medicine
0
2.0
-
0
0
0.3
0.3
Renal Medicine
1.5
2.7
2.0
1.0
-
4.0
4.0
Respiratory Medicine
3.0
2.9
6.0
2.3
-
4.0
3.3
Rheumatology
-
4.3
-
2.0
0
1.7
2.8
Mersey
London &
KSS
Trent
Acute medicine
-
0.9
Cardiology
7.5
Dermatology
How often do you use locums?
Strongly
agree
Agree
Neutral
Disagree
Strongly
disagree
Internal locum cover is easy to
organise
1.6%
6.3%
12.7%
46.0%
33.3%
External locum cover is easy to
organise
1.6%
4.8%
6.5%
30.6%
56.5%
Internal locums are usually
reliable
25.8%
71.0%
3.2%
0%
0%
External locums are usually
reliable
1.6%
19.4%
45.2%
30.6%
3.2%
Internal locums are usually high
quality
23.8%
57.1%
17.5%
1.6%
0%
External locums are usually high
quality
0%
9.7%
41.9%
40.3%
8.1%
Patient care is usually worse
when internal locums are
employed
1.6%
3.2%
9.5%
66.7%
19.0%
Patient care is usually worse
when external locums are
employed
9.7%
33.9%
43.5%
12.9%
0%
Specific concerns for hospital care
• Ensuring adequate competencies and language skills
for locums and specialists
• Revalidation
• Costs of skills/language assessments for hospitals
under current economic pressures
• Optimising out-of-hours care to limit the number of
inappropriate hospital admissions
Language – who is responsible for checking?
" Persons benefiting from the recognition of
professional qualifications shall have a knowledge of
languages necessary for practising the profession in
the host member state"
2005/36/EC Article 53
The HPRO card
Questions