Closing the gap: the distribution of postgraduate medical specialty training posts to narrow health inequalities
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NHS England United Kingdom
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A739
In England, postgraduate specialty training posts have often been distributed based on historical arrangements, meaning posts are not always best aligned with patient needs. This has resulted in an imbalance in specialty training posts. In addition, we know that around 80’ of specialty trainees completing their training settle within 50 miles of where they trained, meaning there is a resultant shortage of specialist senior clinicians across the country. This imbalance of specialists contributes to health and healthcare inequalities. In 2018, Health Education England (HEE) and NHS England (NHSE) collaboratively commenced a programme to work towards an equitable distribution of specialty training places across the country. This will result in a fairly distributed medical workforce for the future which will in turn take a step towards addressing health inequalities. The programme will both redistribute current posts as well as allocate any new posts to underserved areas. The redistribution is based on both HEE and NHSE workforce, current and projected healthcare demand, and regional deprivation modelling. However, “receiving” regions must also be able to accommodate these additional trainees, such as providing adequate supervision. The programme was implemented in August 2022 in three specialties – cardiology, haematology, and obstetrics and gynaecology. There is a plan to redistribute most of the remaining specialties starting in the next 7 years in 3 phases. The workshop’s purpose is to specifically discuss the programme as a form of healthcare public health policy and its resultant impact on reducing health and healthcare inequalities.

The aim of this workshop will be to collaborate regarding the Distribution of Postgraduate Medical Specialty Training programme, with a focus on reducing health inequalities. The objectives to meet this aim are: To describe the drivers and background of the programme, including the evidence base informing the programme,To describe the modelling methodology of deciding how to redistribute specialty posts, which focus on the relationship of workforce, current, projected, and changing patterns in healthcare demand, and regional deprivation,To discuss with international partners if there are similar initiatives in different parts of the world, learning from best practice and lessons learnt, particularly in attracting and retaining the workforce in hard to recruit areas such as remote, rural and coastal locations.To discuss the intended impact on reducing healthcare inequalities in the context of other factors also contributing to unequal health, andTo develop key parameters to measure the success of the intended outcome of reducing health inequalities. COMPONENT PARTS: This workshop will consist of: Background to the programme and methodology – 20 minutesGroup discussion on international initiatives – 10 minutesRound tables on intended impacts on inequalities and key parameters to measure success – 20 minutesSharing of ideas and debrief - 10 minutes