UK Surgical Workforce Census Report
Advancing the Surgical Workforce: 2023 UK Surgical Workforce Census Report
In 2023, we surveyed the UK surgical workforce to identify the key challenges facing surgical teams and to inform workforce planning. Respondents included consultants, surgeons in training, Specialist, Associate Specialist and Specialty (SAS) surgeons, Locally Employed Doctors in surgery (LEDs) and members of the extended surgical team (EST).
Advancing the Surgical Workforce reveals a number of interesting insights and paints a picture of a surgical workforce working long hours and in stressful environments. Too many staff are trying to navigate a system which frustrates the delivery of surgical services rather than enabling them.. Surgical trainees in particular are increasingly being affected by these pressures.
We have made a number of recommendations and are committed to championing improvements to the working lives of our members and the surgical profession. We’re not just endorsing change, we’re actively shaping it. Read the full report for details.
Key findings
- Access to theatres is a major challenge: 56% of respondents cited that access to theatres was a major challenge and this was specifically cited by 61% of all surgical trainees.
- Retaining the surgical workforce: 50% of respondents across all career grades indicated that they have considered leaving the workforce in the past year.
- Respondents feel their workloads are unmanageable: 61% of respondents cited that burnout and stress are the main challenge in surgery - due to excessive workloads.
- Consultant surgeons are considering retirement: 64% of the 55-64 age group of consultant surgeons plan to retire in the next four years.
- Lack of time to train and mentor: Surgery remains a popular career choice, however, 52% of all surgical trainees reported a lack of adequate time for training.
- Conflicts between clinical and managerial priorities: 47% of respondents said they felt that ‘system challenges’ had an impact on their ability to deliver their work.
- Working beyond contracted hours: 67% of consultants always or frequently work beyond their contracted hours
- Annual leave: 42% of respondents did not take their annual leave entitlements in the last year.
Download the report to read the findings in full.
What are the solutions?
We’ve made several recommendations which will provide the basis for future comparative work to support the working lives of surgeons and the wider surgical team. Recommendations include:
Increasing productivity to reduce waiting lists
- There is an urgent need for increased theatre capacity by ensuring existing theatre spaces are used to their maximum capacity, including increased numbers of surgical hubs and ring-fencing beds for elective surgery.
- The consultant surgeon workforce needs to increase according to specialty demand year on year. There must also be a significant increase in theatre staff numbers.
Ensuring a sustainable surgical workforce
- We will work with NHS trust organisations and health boards to develop a national focus on policies and guidance to positively impact the wellbeing of surgeons. This includes tackling bullying and harassment, sexual misconduct, and enabling flexible working.
- Improvements to the working environment are needed, such as providing places to rest, availability of hot meals, and dedicated places for personal study.
- We recommend increasing training numbers across all surgical specialties and prioritising training opportunities for those in designated training programmes to meet future service requirements and reflect the demand for flexible working.
Changing the way the whole surgical team works
- We will work with NHS trust organisations and health boards to develop and implement national job planning guidance to reflect career stage.
- We will further promote the integration of SAS surgeons and LEDs within the surgical team, ensuring their inclusion in service planning, education and leadership opportunities.
Read all the recommendations in the full report.
Demographics and other data
Who makes up the UK surgical workforce?
There were 6,348 responses from different members of the surgical team, which is approximately 25% of the current workforce. Of the responses to the census:
- 54% were consultants, 25% were trainees, 10% were SAS surgeons, 5% were LEDs and 6% were part of the extended surgical team (EST)
- Women make up 33%, 67% men, and other genders represent less than 1%
- There is a greater proportion of ethnic minority surgeons in the trainee population than in the consultant population, overall, 57% described themselves as from a white background
Working conditions and wellbeing
- Nearly half (49%) of respondents cited working conditions as their main challenge
- 55% cited pay and pensions as a major challenge
- 24% of respondents cited bullying and harassment as a main challenge. This increased to 35% for SAS surgeons and LEDs
Less than full time (LTFT) training and working
- 11% of the surgical team work less than full time, with the highest proportions by career grade happening among consultants (12% work LTFT) and higher surgical trainees (10% work LTFT)
- The top two reasons cited for working LTFT were work life balances and family commitments
Workload and productivity
- 67% of consultants cited always or frequently working above their contracted hours
- Access to theatre/operating lists, adequate support staff and admin support were listed as the top three responses to the question, “What would increase your productivity?”
Surgical trainees
- 28% of higher surgical trainees and 45% of core trainees have considered leaving the profession
- Overall, 71% of trainees would recommend training in their specialty; lack of training opportunities and lack of work-life balance were cited as the most common reasons they wouldn’t recommend training.
SAS surgeons and LEDs
- SAS surgeons and LEDs describe similar experiences, citing limited inclusion, training and education and career development which have had a detrimental effect on their job satisfaction
- Among the main challenges, ‘culture and environment’ was cited more frequently by SAS surgeons compared to other groups
- 74% of SAS surgeons have an on call commitment
You can download the full census report, with a full breakdown of all the information above, plus detailed specialty specific data.
Share this report with your MP to help us communicate the importance of supporting service development, training and future investment in surgical services.
Questions? Get in touch by emailing census@rcseng.ac.uk.
View previous Surgical Workforce Census reports.