RCoA response to the Queen’s Speech

Published: 20/12/2019

Professor Ravi Mahajan, President of the Royal College of Anaesthetists said:

“The Prime Minister’s commitment to a guaranteed NHS funding settlement and to addressing retention and recruitment is vital to the delivery of the NHS Long-Term Plan. 

“In recent years services provided by the NHS under anaesthesia and surgical care have focused on immediate, acute demand compromising the long-term sustainability of the NHS and increasing pressure on our hard working NHS staff. That’s why the College welcomes the Government prioritising the prevention of ill health.

“However individual interventions alone won’t achieve the changes so desperately needed at a population level. If our new Government is serious about prevention it must ensure The Prevention Green Paper does not become the ‘local authorities’ plan’ and the NHS Long-Term Plan the ‘NHS’s plan’. It needs a system level approach to prevention across the NHS.

“We need to see a commitment to a shared, collaborative and multidisciplinary system, with clear accountability mechanisms. It is essential that legislative barriers be removed and funding incentives re-aligned to enable Integrated Care Systems to take their work to the next stage – and a new funding settlement must be delivered for local public health teams.

“We also urgently need a new operating model for our workforce that will shift the dial towards a more compassionate, fairer, culture – and address the emergency of staff retention. 

"Alongside welcoming the Government’s work around prevention and its manifesto promise to improve performance to reduce the current record levels of waiting times, we strongly call upon it to address the ever-growing number of vacancies across the NHS workforce. The improvement of patient care and the services provided go hand-in-hand with NHS staffing levels. With an average seven per cent gap in consultant anaesthetist numbers across the UK (up from 4.4 per cent in 2015)1, 19.8 per cent of SAS and trust-grade anaesthetic posts empty2 and low figures for new doctors choosing to take up anaesthesia, we strongly urge Government to support the recruitment and retention of the NHS workforce. While the implementation of the NHS visa system is a welcome move, there are significant financial barriers in place which will continue to restrict the ability for international healthcare workers to join the NHS in order to help plug these gaps.

“Approximately 10 million patients undergo surgery every year in the UK. For most, it is successful in terms of the procedure itself and the care before and afterwards. However with the population changing, so must our services. There are 250,000 patients at higher risk from surgery and this is set to rise, due to the increasing number of patients with multiple long term conditions. We believe that collaborative and efficient perioperative care3 is a route to effective and sustainable prevention of ill health.”


  1. Royal College of Anaesthetists’ response to the NHS Confederation consultation: Defining the role of integrated care systems in workforce development http://bit.ly/2Z3NL9T
  2. Views from the frontline of anaesthesia – supporting the development of the People Plan http://bit.ly/ViewsFromTheFrontline
  3. http://bit.ly/WhatisPerioperativeCare