In a report, the PAC said attempts to improve NHS emergency admissions were being ‘completely stymied’ by a serious shortage of A&E consultants.
Nearly one fifth of A&E consultant posts were either vacant or filled by locums in 2012, the committee noted. It also highlighted the problem of training enough doctors to work in A&E.
‘Struggling hospitals, such as those placed in special measures, find it even harder to attract and retain consultants,’ said PAC chair Margaret Hodge.
‘There are currently no incentive payments to make working in these hospitals a more attractive prospect.
‘You could also make greater use in A&E of consultants from other departments, or mandate that all trainee consultants spend time in A&E, or make A&E positions more attractive through improved terms and conditions.’
Making these changes would require both the British Medical Association and NHS Employers to negotiate a more flexible consultant contract, the PAC said.
It also noted that, while hospitals, GPs and community health services, all had a role to play in helping reduce emergency admissions, there were no financial incentives in place to encourage this.
The PAC called on the Department of Health, NHS England and Monitor to review the overall system for funding urgent and emergency care to ensure incentives for all hospital and community services were coherent and aligned.
Responding to the report, Dr Paul Flynn, chair of the BMA’s consultants’ committee, said the high pressure and stress of working in A&E had contributed to a recruitment and retention crisis.
‘Consultants already work around the clock to provide emergency care for patients but, as the report makes clear, there simply aren't enough to meet rising demand,’ he said.
‘The government needs to urgently address issues such as workload pressures, resourcing and work-life balance if the NHS is to attract doctors in training and the consultant numbers that are needed, not least because spending large amounts on locum doctors is not financially sustainable in the long run.’
But health minister Dr Dan Poulter said the government did have a clear strategy to tackle the shortage of A&E consultants. He pointed out that there were 414 more doctors working in the specialty than there were in 2009.
'It takes six years to train an A&E consultant, and there is no easy fix, but our long-term plans are robust, increasing the number of training places by 75 next year, and planning for all trainee doctors to spend time in A&E,' hw said.
'We are also looking at making an A&E career more attractive as part of our negotiations on the consultant contract.'
