NHS faces specialist surgeon shortage after abrupt training cuts

Getty/shapecharge

By Erin Dean

The NHS could face a shortage of surgeons for complex, high-risk procedures after funding for advanced training was abruptly withdrawn, surgical leaders have warned.

Funding has been pulled from training interface group (TIG) fellowships, creating a “direct risk to future patient care”, according to the Royal College of Surgeons (RCS) of England, the Association of Surgeons in Training and more than a dozen other surgical training organisations.

The fellowships have “for decades” provided training in seven areas where surgeons need expertise that crosses multiple disciplines, the organisations said in a letter to the Department of Health and Social Care (DHSC).

Last August, central funding and national support was withdrawn from the fellowships with “no warning or consultation”, the surgical organisations said.

This means no new surgeons will enter TIG training this August. Previously around 50 to 60 places were funded each year, the RCS told Doctors.net.uk.

Interdisciplinary training

These six-to-12-month programmes run by the Joint Committee on Surgical Training, covered areas including major trauma, complex hand disorders, head and neck surgical oncology and oncoplastic breast surgery.

Mohs skin cancer procedures, operations for spinal conditions and cleft lip and palate conditions were also included in the fellowships.

In a letter to Jo Lenaghan, DHSC interim director general for people, the surgical organisations warned that the ongoing loss of TIGs could lead to a shortage of suitably skilled surgeons in complex and interdisciplinary surgical services, making it increasingly difficult to maintain specialist services as senior doctors retire.

This “reduced workforce capacity” could disrupt access to timely and high-quality care for patients and increase dependence on international medical graduates.

It could also force UK trainees to seek essential experience abroad in a move that runs against “other policy initiatives seeking to improve job opportunities for UK medical school graduates”.

The training provided “structured, quality-assured national programmes”, the letter said.

“The erosion of national coordinated supra-specialist training poses a direct risk to future patient care,” it said.

Call for clarifications

The letter called for the DHSC to clarify national commissioning and funding arrangements for TIG fellowships in 2026-27.

The organisations asked for the impact assessments undertaken by the DHSC and NHS England on the impact of not providing the training.

They asked what alternative plans are in place to ensure surgeons have the necessary skills for such procedures.

The letter is also signed by the Association of Surgeons in Training and a range of trainee organisations. These include the Association of Otolaryngologists in Training, the British Neurosurgical Trainees’ Association, the British Orthopaedics Trainees Association and the Plastic Surgery Trainees Association, the National Trainee Committee for Cardiothoracic Surgery and Trainees in Paediatric Surgery.

The DHSC and NHS England have been contacted for comment.

‌
‌
‌
‌
‌
‌