One in four senior anaesthetists reduce hours over pension tax concerns

Getty/nuttapong punna

By Daniel Pye

Senior anaesthetists are cutting up to 1.5 million hours of potential clinical time a year because of concerns over pension tax, a survey has found.

More than one in four (26%) consultant and specialty and specialist (SAS) anaesthetists across the UK reported reducing their hours due to the issue, the Royal College of Anaesthetists (RCoA) warned.

Anaesthetists who were reducing their hours said they would work an extra 2.5 additional programmed activities per week if pension tax wasn’t a worry - equating to around 460,000 additional patient cases per year.

Nearly half of consultant anaesthetists considering leaving the NHS said changes to this area would make them more likely to stay.

This makes it one of the most powerful levers for retaining senior doctors, the RCoA said in an NHS productivity report drawn from its 2025 Anaesthetic Workforce Census, which received 2,797 responses.

However the Department for Health and Social Care denied pension taxation affects overall consultant activity.

Tax rules in the NHS Pension Scheme has historically resulted in some doctors facing large and unpredictable tax bills, which has created uncertainty around the financial benefit of additional work, RCoA said.

Other findings include that almost all (89%) of anaesthetists find poor IT systems limit productivity.

More than half rated their computers ‘poor’ or ‘very poor’, and 44% reported difficulty in accessing patient information quickly and easily.

Paper records still used in many hospitals

Many clinical leaders (57%) also reported at least some paper records were still in use at their organisation.

However the role of anaesthetists in one growing form of care in the NHS has helped cut waiting lists, the report found.

Most anaesthetists (78%) play a key role in perioperative care, which the report stated is vital to improving patient outcomes and NHS productivity.

Perioperative care involves assessing a patient shortly before surgery for health problems and negative behaviours such as smoking – and offering targeted support such as prehabilitation before they go into theatre.

These interventions can cut surgical complications by half and shorten hospital stays by one or two days, turning waiting lists into preparation lists, the report stated.

Dr Claire Shannon, president of the RCoA, said: “Anaesthetists are losing valuable clinical time because outdated IT systems slow everyday work, while pension taxation is driving many senior doctors to reduce their hours, or consider leaving the NHS.  

“Investing in modern digital systems, reforming the pension taxation system, and strengthening perioperative care would allow anaesthetic teams to work more efficiently; retain experienced staff, help cut waiting lists and improve patient outcomes.”

A Department of Health and Social Care spokesperson said: “There is no clear evidence from national payroll data that pension taxation affects overall consultant activity.

“The NHS Pension Scheme continues to provide highly generous retirement benefits and includes flexibilities to help staff manage pension tax charges where these arise.

“We are also continuing to improve NHS IT systems through the rollout of electronic patient records and wider digital upgrades to help staff work more efficiently and improve patient care.”

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