UK neurosurgical workforce planning. What changes have occurred in the consultant body 2014-2018?

Introduction: The British Neurosurgery Trainee Association aimed to investigate the amount of trainees qualifying through the British national training scheme and the rate at which potential consultant posts became available from 2014 to 2018.Methodology: A survey was sent to representatives from each neurosurgical unit and deanery across the United Kingdom to ask about the changes in consultant numbers and those who had attained CCT (Completion of Certificate of Training) over 5 years.Results: At the end of 2018, there were 416.5 full-time equivalent consultants in neurosurgical posts, 388.5 in substantive posts; a median of 11 per unit. The rate of vacating substantive posts was 3.04% per year, with 60% doing so due to retirement. There were 119 substantive appointments, 74 of which were expansion posts (an expansion rate of 4.31% per year). 66% of the appointments went to those with a British CCT. 107 trainees achieved CCT over the 5 years. Five separate scenarios are presented to show the potential variation in the future. If current trends continue there will be 666 consultants by 2031 and 102 too few UK-trained trainees to fill consultant posts. If expansion slows to 467 consultants by 2031, there will potentially be 211 post-CCT trainees more than available consultant posts.Conclusion: There is a wide range of outcomes for workforce planning, greatly impacted upon by retirement rates and consultant body expansion; therefore, a workforce planning committee has been created to monitor and respond to the ongoing situation, with representation from the SBNS, BNTA and SAC.