Metabolic medicine - Royal College of Physicians

Census of consultant
physicians in the UK 2011
Specialty report: metabolic
medicine

Specialty reports
Census of consultant physicians in the UK, 2011
Metabolic medicine
The speciality of chemical pathology with metabolic medicine (chemical pathology) has shown a decline
since 2010 and there is an ongoing apparent decrease in vacant consultant posts being advertised. This
is mostly due to impending changes to pathology service provision across England with the ongoing
planned merger of laboratories.
The clinical workload is growing due to:
• the increasing number of patients with inherited metabolic diseases (IMD) now
reaching adulthood
• certain diseases such as osteoporosis now being part of the GP Quality Outcomes
Framework
• increased general awareness of the other aspects of metabolic medicine.
There may be a future paradigm shift where metabolic physicians are appointed with a larger clinical
workload and, to a lesser extent, involved in the laboratory. More recently there has been an increase in
metabolic medicine CCT holders who practise predominantly as physicians, and without any laboratory
sessions (currently seven in total). There are suggestions that these posts will need to expand in number
by as many as 6‒10 posts during the next 10 years to maintain service provision for IMD patients.
Current trainee numbers for metabolic medicine and chemical pathology (without metabolic medicine)
and projected CCT date are as follows:
Table 1. Expected CCT dates of trainees
Expected CCT date
‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒ Number of trainees ‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒
With metabolic medicine
Without metabolic medicine
2012 4 6
2013 8 3
2014 6 3
2015 8 4
2016 12 2
2017 6 ‒
2018 6 ‒
>2018 ‒ 1
Summary 50 19
The potential impact on the future of the workforce of the privatisation of laboratory services, or hub
and spoke models, is unclear but it is unlikely that there will be an increase in posts (with a potential for
decline).
October 2012
Dr Peter Prinsloo
Consultant in chemical pathology and metabolic medicine
© Royal College of Physicians 2013 177

Census 2011
Return to
section start
Metabolic medicine
Expansion and demographics
Source: RCP consultant census – census date 30 September 2011
Consultant expansion
England Wales N Ireland Scotland
UK
(2011)
UK
(2010)
Expansion
since 2010
Metabolic medicine 19 1 1 1 22 22 0.0%
All specialties 9,858 573 314 1,065 11,810 11,225 5.2% 6.7
Retirement plans
Consultants reaching 65 2012 2013 2014 2015 2016 2017 Total
% of consultant
body
Metabolic medicine ‒ 2 ‒ ‒ ‒ 1 3 13.6
All specialties 135 174 190 198 220 262 1,179 10.0
Total number of consultants in metabolic medicine
England, Wales and Northern Ireland 1993–2001 / United Kingdom 2002–2011
26
Total number of consultants
24
22
20
18
16
14
12
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Census year
Consultant expansion in metabolic medicine vs all specialties
England, Wales and Northern Ireland 1994–2002 / United Kingdom 2003–2011
Annual consultant expansion (%)
40
35
30
25
20
15
10
5
0
-5
-10
-15
-20
-25
-30
Metabolic medicine
All specialties
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Census year
178
© Royal College of Physicians 2013

Return to
section start
Specialty reports
Metabolic medicine
Expansion and demographics
Source: RCP consultant census – census date 30 September 2011
Metabolic medicine consultant workforce by age and gender
Age
–––––––––––––––– Male ––––––––––––––––– –––––––––––––– Female –––––––––––––––––
% gender Number % age group % gender Number % age group
Total
34 and younger – – – – – – –
35–39 10.5 2 66.7 33.3 1 33.3 3
40–44 10.5 2 100.0 – – – 2
45–49 21.1 4 80.0 33.3 1 20.0 5
50–54 10.5 2 100.0 – – – 2
55–59 21.1 4 100.0 – – – 4
60–64 10.5 2 100.0 – – – 2
65 and older 10.5 2 66.7 33.3 1 33.3 3
Unknown 5.3 1 50.0 – – – 2
Total 19 3 22
Working patterns and contracts
Mean programmed activities (PAs) contracted per week
Specialty Responses
Total PAs Clinical PAs
Academic
PAs
Supporting
PAs
Other PAs
Metabolic medicine 7
9.9 6.9 1.6 1.4 0.0
All specialties 4,963
10.6 7.4 0.7 2.0 0.4
Mean programmed activities (PAs) worked per week
Specialty Responses
Total PAs Clinical PAs
Academic
PAs
Supporting
PAs
Other PAs
Metabolic medicine 6
13.1 8.3 2.4 2.4 0.1
All specialties 4,807
11.8 8.1 0.8 2.6 0.2
© Royal College of Physicians 2013 179

Census 2011
Return to
section start
Metabolic medicine
Working patterns and contracts
Source: RCP consultant census – census date 30 September 2011
Consultant workforce by specialty and category of post
Specialty
Responses
Pure NHS
Pure academic
Other (eg
charity)
Joint-academicother
Joint-NHSacademic
Joint-NHS-other
Number % Number % Number % Number % Number % Number %
Metabolic medicine
7 5 71.4 ‒ ‒ ‒ ‒ 2 28.6 ‒ ‒ ‒ ‒
All specialties 5,069 4,273 84.3 12 0.2 52 1.0 564 11.1 160 3.2 8 0.2
Breakdown of whole-time and less-than-whole-time working
Specialty
Responses
Whole-time
Less-than-whole-time
Number % Number
%
Metabolic medicine
All specialties
7 6 85.7 1 14.3
5,057 4,218 83.4 839 16.6
Mean programmed activities (PAs) worked per week – by gender
Gender Responses Fewer than 10 10–10.9 11–11.9 12–12.9 13–13.9 14–14.9
15 or
more
Female ‒ ‒ ‒ ‒ ‒ ‒ ‒ ‒
Male 6 ‒ ‒ 1 1
3 1 ‒
Mean programmed activities (PAs) worked per week – by gender
4
Female
Number of responses
3
2
Male
1
0
Fewer than 10 10–10.9 11–11.9 12–12.9 13–13.9 14–14.9 15 or more
PAs worked per week
180
© Royal College of Physicians 2013

Return to
section start
Specialty reports
Metabolic medicine
Population served by each whole-time equivalent (WTE) consultant
No RCP recommendation defined*
Source: RCP consultant census – census date 30 September 2011
Key and scale
Fewer than 1:1,500,000
1:1,500,001–1:1,700,000
1:1,700,001–1:2,000,000
1:2,000,001–1:3,000,000
1:3,000,001–1:4,000,000
1:4,000,001–1:5,000,000
Greater than 1:5,000,000
No dedicated specialty
consultants
Scotland
Northern Ireland
North East
Yorkshire and the Humber
North West (incl Isle of Man)
East Midlands
West Midlands
East of England
Wales
London
South Central
South East Coast
South West
© CALIPER 2011
*Although the RCP’s most recent vesrion of Consultant physicians working with patients contains a chapter for metabolic medicine, no
recommended ratio of WTE physician:population is defined therein. Royal College of Physicians. Consultant physicians working with
patients: the duties, responsibilities and practice of physicians in medicine, 5th edn. London: RCP, 2011
© Royal College of Physicians 2013 181