RCoA evidence submission to the 10 Year Workforce Plan

The Royal College of Anaesthetists has made a submission to the government’s call for evidence to inform development of the 10 Year Workforce Plan.

Our submission emphasises the essential work of anaesthetists and the urgent need for the government to deliver on its commitment to reduce patient waiting times by addressing the shortage of anaesthetists. 

Key points from our evidence submission: 

• Anaesthetists are key to delivering the government’s ambition of a 2% year-on-year productivity 

We estimate that addressing the current shortfall of 1,766 anaesthetists in England could enable an additional 1.3 million operations and procedures to go ahead each year.​ This covers not only elective operations, but also anaesthetic procedures in urgent and emergency care, maternity, and general pain relief services.  

Over four in 10 clinical leaders (43%) who responded to the RCoA 2025 census reported operations being postponed on a daily or weekly basis due to anaesthetic workforce shortages. Only 11% reported no delays.

Almost seven in ten (68%) of clinical leaders say that increasing the number of anaesthetists would do more than any other measure to reduce waiting lists, ahead of factors such as ward space (50%) or operating theatres (42%).

• Capacity exists for more training, but investment is needed 

There is a shortage of anaesthetists, but there is no shortage in the number of doctors wanting to train to be anaesthetists. There is a huge bottleneck between foundation and core training. In 2025, there was a competition ratio of 12.6:1 for core (CT1) anaesthetic training posts, almost doubling from the previous year (6.5:1 in 2024).​ 

There is capacity in the system to train more anaesthetists. Our 2025 census results suggest capacity for 178 additional CT1 anaesthetics posts per year, and 206 additional ST4 posts across the UK. 

• The three shifts 

The 10 Year Health Plan for England sets out the government’s ambition to reinvent the NHS. Key to this are three shifts: hospital to community, analogue to digital, and sickness to prevention. Anaesthetists are essential to the successful delivery of these changes. 

• From sickness to prevention 

Anaesthetists have been driving secondary prevention initiatives such as early screening of surgical patients. This involves assessing their health status and unhealthy behaviours as soon as they join the waiting list, converting the waiting list into a ‘preparation list’.  

Anaesthetists deliver positive health messages and help to coordinate a range of services to optimise patients’ health, improving patient outcomes and supporting long-term behaviour change. 

• From hospital to community

Improving perioperative care is essential to deliver this shift. Interventions before and after surgery are helping to reduce the demand for hospital services and provide care in the community.   

Anaesthetists are key to coordinating this by identifying patients who require support through early screening and referring them to appropriate services. As such, patients can be supported in their own communities to prepare for surgery and improve their outcomes in a convenient setting that fits around their lives.  

• From analogue to digital

Perioperative care teams across the UK have already started developing and implementing digital innovations that can be scaled to deliver the shift from analogue to digital. For example, utilising digital platforms for early screening to bring together patients’ health information as soon as they join the waiting list.  

As leaders of perioperative care teams, anaesthetists are vital to integrate and scale new technologies such as this into clinical pathways.

Dr Claire Shannon, President of the Royal College of Anaesthetists, said:

"Anaesthetists are critical to delivering the 10 Year Health Plan’s productivity targets and three shifts. Our members enable almost every operation that takes place, as well as playing a leading role in perioperative care. 

“But these ambitions cannot be realised without investment in anaesthetic training places. Patients are paying the price for the shortage of anaesthetists and the 10 Year Workforce Plan must address that."