Workforce and job planning

Physician workforce

The number of clinical neurophysiologists recorded in the 2016–17 census of consultants and higher specialty trainees in the UK is:  

Role

Total

Proportion working less than full time (LTFT)

Consultant

151

37%

Higher specialty trainee

29

17%*

*HST LTFT percentages are calculated from JRCPTB data to give overall figures which may differ from those in the census

These figures relate to physicians who work substantively for the NHS.

Regional variance

London has one clinical neurophysiology consultant to fewer than 300,000 patients, while the North West, South East Coast and East Midlands have one to (in excess of) 700,000 patients.

Due to increasing demand, in many parts of the country referral-to-treatment targets are only met by utilising waiting list initiatives or by employing private agencies to supplement local provision.

Training and recruitment

The specialty enjoys good recruitment but there are insufficient training posts to meet current and future predicted demand, with over 50% of advertised consultant posts unfilled. Health Education England (HEE) is currently reviewing the commissioning of training in certain small specialties, including clinical neurophysiology.


Job planning

The job plan below is an example included as guidance and not intended to be prescriptive. Activities will vary according to population served, demographics and location. For further information, see the BMA/NHS Employers guidance from 2011.  

Table 1: Consultant work programme for clinical neurophysiology

Activity

Workload (patients per PA)

Programmed activities (PAs)

Direct clinical care

Outpatient EMG clinics

4–6 (depending on complexity)

2–5

 

Inpatient EMG

3–4 studies in the department, fewer if on ward

Up to 1

 

Supervision and reporting of HCS NCS clinics

8–10 (4–5 per HCS clinic)

0–2

 

Reporting routine EEG

10–15 (depending on complexity)

1–3

 

Performing and reporting specialised tests eg video-telemetry or visual electrophysiology

1–5

0–3 (may be more in specialist centres)

 

Intra-operative procedures, eg evoked potential monitoring, intracranial recording/functional mapping

0.5–1

0–4

 

Multidisciplinary team meetings

 

Up to 2

Total number of direct clinical care PAs

 

7.5 on average

Supporting professional activities (SPAs)

CPD/appraisal/revalidation

1.5

Teaching/training

0–1

Service development, clinical governance, audit

0–1  

Research

0–1

Total number of SPAs

2.5 on average

Other NHS duties

By local agreement

External duties

eg for deaneries, royal colleges, Department of Health

By local agreement

Inpatient video EEG telemetry, particularly if intracranial, may require consultants to be on call. When this is the case they may also provide other services. In many smaller units there is no on-call commitment. 


Clinics

Follow-up appointments are rarely needed for the investigations that form the bulk of clinical neurophysiology work, although patients may need more than one test for various reasons. Botulinum toxin injections usually need to be repeated for indefinite periods at intervals such as 3 months. These are not strictly speaking follow-up visits as they form part of ongoing treatment.

30/06/2017