Why do vacancy rates matter?

by David Farren

The under reporting of consultant vacancies paints a confusing picture of the state of the health service 

Location: Northern Ireland
Last reviewed: 10 February 2022

Every quarter the Department releases vacancy rates. Sometimes the media report on it, other times they don’t, but almost every time I am left slightly puzzled as the rates reported never seem to match my experience of vacancies on the ground.

The ongoing high rates of vacancies in our health service are a huge concern for doctors. Earlier this year the BMA made some FoI (Freedom of Information) requests to examine the issue in more depth. They found the Department of Health’s definition of a consultant vacancy likely excludes a number of posts not filled by a permanent consultant and this could lead to an under-reporting of consultant vacancies.

FoI requests that we submitted show that the total number of posts in 2021 not filled by a permanent consultant were 291.62, compared to the reported vacancy total [at the time of the FoI] of 126.

This is a difference of 131%, with the number of posts not filled by a permanent consultant more than double the reported vacancy total across Northern Ireland.

In addition, HSC trusts and organisations appear to each define a consultant vacancy differently, and none correspond directly to the definition used by the Department of Health. This could mean that reported figures do not capture vacancy figures consistently, nor accurately. For example, the Belfast Trust told us that they define a vacancy as, a vacancy is any position that is currently with the recruitment team and being actively recruited to'.

But the definition from the Department of Health excludes a number of posts, and so will not often capture the true extent of existing vacancies. For example, it would not capture roles not under active recruitment, such as those newly created posts not yet advertised, or existing posts where someone has left, and recruitment has not yet started.

This means that there is not a clear and accurate picture of gaps within the consultant workforce in Northern Ireland, and this puts increasing pressure on the existing workforce who need to maintain a safe level of service, often taking on additional shifts or duties to fill gaps. This also means that appropriate, longer-term workforce planning cannot take place either at individual Trust level, nor indeed on a Northern Ireland wide basis.

We need clear, accessible consultant vacancy data to be routinely collated and published at Trust level, as well on a whole of Northern Ireland basis, and this is something the consultants committee in Northern Ireland will now work to achieve.

David Farren is chair of the BMA Northern Ireland consultants committee