Why are there local shortfalls in anaesthesia consultant staffing? A case study of operational workforce planning

Anecdotally, many hospitals experience shortfalls in anaesthetic consultant staffing. This paper aims to investigate whether these subjective experiences are confirmed objectively.

The paper hypothesises that a simple model that estimated service delivery capability using consultant entitlements to annual and other types of leave would not (null hypothesis) accurately predict the magnitude of any shortfall that existed. It also hypothesises that excessive leave-taking was an important cause of any shortfall. A comparison is made between the model predictions for total leave taken and service delivery with results from a real data set from a large university teaching hospital's department of anaesthetics.

The model prediction for leave (median total 45 days absence in a year per consultant, range (30-59)) closely matched the reality (median 41 days (tenth-ninetieth deciles 30-69)). Consequently, both model predictions and the real data for annual elective service delivery agreed: median 228 sessions (193-266) vs 232 (183-266) per consultant respectively. Taking into account likely service delivery by trainees (2,304-4,140 elective sessions in total annually) the predicted shortfall of 2,220 sessions was very close to the true elective service shortfall of 2,148 sessions for the department as a whole over the year.

Rejecting the null hypothesis, it is concluded that a simple model that estimates elective service delivery using leave entitlements as the main factor can accurately predict actual service capability for a department. There is no evidence that excessive leave-taking occurs.

The paper computes an estimate that 2.2-2.6 consultants per functional operating theatre are necessary to ensure that staffing matches the elective workload.