Cardiology

This summary sheet contains

recommendations informed by the facts
collated by the CfWI in close collaboration
with specialty stakeholders. The
references in this summary sheet refer to
the reference section at the end of the
fact sheet for this specialty, available at
http://www.cfwi.org.uk/.

Medical Specialty Workforce Summary Sheet
Cardiology


CfWI | August 2011 1
Specialty group: General Medicine
Specialty: Cardiology

Recommendation

The CfWI recommends that no change is made to either the number
of training posts or the current geographical distribution of training
places over the next three years.
Although no geographical changes are recommended, stakeholders
need to be aware of geographical inequalities of accessibility to
consultants and trainees.
A further review of this specialty will take place in 2013 when
geographical allocation will be considered in more detail.

Introduction
The purpose of this document is to make recommendations to inform planning for future
medical training numbers in Cardiology in England over the next three years. When
formulating these recommendations, we considered factors such as demographics, lifestyle
issues and the views of key stakeholders.
The policies and issues affecting Cardiology include:
The Independent Public Service Pensions Commission: Final Report (2011)
recommends switching public sector pensions from existing final salary schemes to a
new career-average salary scheme, with existing members moving to the new scheme
for future accruals. At Budget 2011, the Government accepted Lord Hutton's
recommendations as a basis for consultation with public sector workers, unions and
others. Depending on its implementation, this may create an incentive for many
consultants of pensionable age to retire earlier that otherwise planned.
CfWI research and engagement with the specialty has identified the following issue:
Changing methods of investigation and treatment: Currently, consultant
cardiologists duties include carrying out invasive procedures, including fitting
pacemakers and diagnostic catheterisation. However, NHS Medical Careers (2011)
states that in future,

New imaging modalities such as magnetic resonance and CT scanning are likely
to complement and challenge the invasive investigations performed in the
cardiac catheter laboratory.
This has implications for the future working patterns of consultant cardiologists, who
will need to have expertise in using the new technologies. The changing prevalence of
Medical Specialty Workforce Summary Sheet
Cardiology


CfWI | August 2011 2
cardiological conditions and the changing practices in treatment and technology use
would need to be quantified in order to deduce resulting workforce demands.
The reported activity for Cardiology is expected to increase if the Hospital Episode Statistics
(HES) finished consultant episode (FCE) and outpatient figures are extrapolated.
Key findings
The most recent data from the NHS Information Centre for Health and Social Care (IC) census
(NHS IC, 2011a) records a headcount of 893 (862 full-time equivalent) consultants in
Cardiology employed in England on 30 September 2010.
College and/or
specialty association
views

It is possible that due to errors in coding of the medical workforce,
the IC figures may not capture all consultant cardiologists, thereby
underestimating the size of the workforce. The CfWI will in future
consider census data from the British Cardiovascular Society, which
is thought to be more accurate but is as yet unpublished.
The Royal College of Physicians (RCP) estimates that for England
there should be 2,5904,127 consultant cardiologists, which
equates to 1321 per 250,000 population.

Figure 1, based on data from the IC census, shows that the full-time equivalent (FTE)
consultant workforce has expanded by 22.3 per cent during the past five years.
If demand is modelled from a baseline of the consultant supply in 2010 and increases at the
rate of population growth, it will increase to about 789 FTE in 2020, and constantly remain
below the level of supply predicted for the consultant workforce. The supply of consultants
over the next ten years is forecast to increase to 1,574 FTE in 2020 (approximately 1,635
headcount), an average increase of 5.9 per cent annually. However, this does not reach the
RCP (2008) recommendation of 2,5904,127 (the mid-point in this range is modelled below).

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Cardiology


CfWI | August 2011 3
Figure 1: Historical workforce supply (FTE) and future consultant supply and estimation of the number of filled posts for
service delivery Cardiology

Source: Historical supply data is taken from the IC census, 30 September 1997 to 2010. Supply forecasts are based on NHS
Electronic Staff Records (ESR) data from November 2010, deanery monitoring data from 2009 and workforce assumptions.
Estimates of number of posts to achieve full service delivery use Office for National Statistics (ONS) population projections
(2010a) and RCP estimated number of posts to achieve full service delivery (2008).
Recommendations
The IC census data is likely to underestimate the size of the Cardiology consultant workforce.
However, the true figures are unlikely to suggest an oversupply of consultants, as the RCP
recommendation is rather higher than forecasts based on the IC census would reach by 2020.
The evidence available does not take account of changes to future service delivery models or
the impact of productivity and new ways of working, which are likely to impact on the future
consultant workforce.
Cardiology is currently undergoing changes in its methods of treatment and investigation. At
this stage, the workforce implications of these changes have not been quantified.
The CfWI therefore recommends that no change is made to either the number of training
posts or to their current geographical allocation.
A further review of this specialty will take place in 2013.
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estimation of the number of future filled posts for service delivery - Cardiology
Consultants (FTE) Historic Supply
Specialty Trainees
Staff, Specialty and Associate Specialist Grade (SSASG) Doctors
Royal College estimation of the future number of filled consultant posts to deliver service based on a fixed total
Consultants (FTE) CfWI Supply Forecast
Estimation of future number of consultant posts to deliver service due to population growth only (0.8% for 20+ yr olds)
Medical Specialty Workforce Fact Sheet
Cardiology


CfWI | August 2011 4

MEDICAL SPECIALTY WORKFORCE FACT SHEET
CARDIOLOGY

This fact sheet considers the factors influencing the future demands of the specialty (section 1) and the current and forecast workforce supply
(section 2). This information forms part of the body of evidence used to advise recommendations on future medical training numbers. Conclusions
and recommendations are in the accompanying summary sheet. The Centre for Workforce Intelligence (CfWI) welcomes contributions to both the
content and interpretations of this information. This fact sheet covers the following:
Section 1 - Considerations for future demands
Current training route
Specialty viewpoints
Policy drivers
Demographics
Health and lifestyle
Changes in activity

Section 2 Current and forecast supply
Existing workforce
Recruitment
Consultant projections
Related healthcare workforce



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Cardiology



CfWI | August 2011 5
CONSIDERATIONS FOR FUTURE DEMANDS
Current training route
Specialty training in Cardiology commences at ST3, after the trainee has successfully completed Core Medical Training (CMT).
Specialty viewpoints
1

Based on British Cardiovascular Society figures, the Royal College of Physicians (2008) estimates that for England there should be 2,5904,127
consultant cardiologists, which equates to 1321 for a 250,000 population. The NHS Information Centre (IC) census (NHS IC, 2011a) reports that
there are 893 headcount (HC) (862 full-time equivalent (FTE)) cardiology consultants in England as at September 2010. It is thought that due to
errors in coding of the medical workforce, the IC figures may not capture all consultant cardiologists, therefore underestimating the size of the
workforce.
Policy drivers
There are no new Government policies specific to Cardiology that will impact on future demand for consultants.


1
The CfWI conducted a series of stakeholder engagement meetings with representatives from each specialty. This report will use the term specialty representative to credit
information presented during these meetings. Although in some cases the source is not explicitly named, this information is available on a case by case basis. Please contact the
CfWI if more information is required.


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Cardiology



CfWI | August 2011 6
Demographics
The charts in Figure 1 display the population age distribution in England in 2011 and 203, based on Office for National Statistics (ONS, 2010)
forecasts for both males (left chart) and females (right chart). Hospital Episode Statistics (HES) data for inpatient finished consultant episodes
(FCEs) (NHS IC, 2011b) were analysed to identify the age range(s) which appear to use the specialty the most. The shaded bars show the subgroups
of the population which use the specialty more. The darkest shaded bars represent those that fall in the upper quartile (the top 25 per cent) of the
parts of the population that use the service the most, when compared with the equivalent age bands of the overall population. The unshaded bars
indicate the population percentage for that age group in 2031.

Figure 1 indicates that, based on FCE data, males aged 6084 and females aged 65 and over are the patients who use Cardiology services the most.
Additionally the data suggests that males aged 3559, males aged 84 and over and females aged 2064 also use the service, but to a lesser
degree. Patients outside these age ranges do not appear to use the service on a regular basis and account for only occasional use.
Figure 1 also indicates that the population in all age bands from 65 and over is predicted to grow over the next 20 years. This is likely to have a
disproportionate effect on demands for Cardiology in comparison with other specialties.
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Cardiology


CfWI | August 2011 7

Figure 1: 2031 population estimate and indication of age and gender of the 2011 population using Cardiology

Source: HES Data provides the specialty specific age range that is applicable to the population using Cardiology (NHS IC, 2011b). Population statistics updated July 2008 (ONS, 2010).
6% 5% 4% 3% 2% 1% 0%
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2011 Male population % & <1% service use
2011 Male population % & avg service use
2031 Male population % ONS forecast
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2011 Female population % & <1% service use
2011 Female population % & avg service use
2031 Female population % ONS forecast
Medical Specialty Workforce Fact Sheet
Cardiology


CfWI | August 2011 8

Health and lifestyle
Lifestyle Influences
The lifestyle and health of the population are major drivers for the cardiology workforce. Smoking and poor diet can cause many diseases that
require treatment by this specialty. The table in Annex 2 shows the trends for a select number of behaviours which are relevant to Cardiology
services.
Tobacco Smoke
Figure 2: Lung cancer incidence and smoking trends, Great Britain by sex 1948-2009 (Cancer Research UK, 2011c)
According to Cancer Research UK (2011a), the single greatest cause of
preventable illness and premature death in the UK is smoking. Smoking is seen
as a factor towards lung cancer, coronary heart disease and chronic obstructive
pulmonary disease (COPD) (NHS Choices, 2010a). Cancer Research UK (2011a)
reports that in 2009, approximately 10 million adults smoked cigarettes in
Britain, 22 per cent of men and 20 per cent of women. Cancer Research UKs
data indicates that although smoking prevalence has been gradually declining
since the early 1970s, the proportion of current cigarette smokers (21 per cent)
has not changed significantly in recent years (Figure 2). According to Action on
Smoking and Health, men were more likely than women to have given up
smoking cigarettes with 30 per cent male ex-smokers compared to 22 per cent
female ex-smokers (ASH, 2011).

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Year
Male smoking prevalence Female smoking prevalence
Male lung cancer incidence Female lung cancer incidence
Lung cancer incidence and smoking trends, Great Britain, by sex, 1948-2009
Smoking data weighted after 1998, source: GHS, ONS
Smoking data prior to 1974 from Wald and Nicolaides-
Bouman, 1991
Actual lung cancer incidence data 1975-2008 from CR-UK


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Cardiology



CfWI | August 2011 9
Figure 3: Prevalence of cigarette smoking by age, persons aged 16 and over, Great Britain 1974-2009 (Cancer Research UK, 2011c)
In Great Britain, 26 per cent of people in the 2024 age group are
recorded as smokers and this group has the highest rate of smoking
across all age groups. The prevalence of smoking is reducing with
age, with 14 per cent of people aged 60 and over recorded as
smokers (Figure 3) (Cancer Research UK, 2011a).
Various legislation measurements were launched to reduce
smoking. Smoking Kills a White Paper on tobacco (DH, 1998) and
Choosing Health: Making healthier choices easier (DH, 2004)
highlighted the need to reduce smoking rates. The Cancer Plan (DH,
2000) defined targets to reduce smoking rates among adults to 21
per cent or less and among manual groups to 26 per cent or less by
2010. These targets were reinforced in the Public Service
Agreement in 2004 and a comprehensive ban on smoking in all
enclosed public places was introduced in England from July 2007
(NHS Smokefree, 2007). Every year, there are 78 attempts to quit
smoking for every 100 smokers (counting multiple attempts by the same individual) (Aveyard and West, 2007). There are a range of possible
intervention techniques, both pharmaceutical and behavioural (NHS Choices, 2010b).
According to Cancer Research UK (2011b), if people made changes to their lifestyle, such as stopping smoking, moderating alcohol intake,
maintaining a healthy bodyweight and avoiding excessive sun exposure, up to half of all cancers in the UK could be prevented. A high-fibre, low-fat
diet with plenty of fruit and vegetables reduces the risk of cancer (Cancer Research UK (2011c).



0
10
20
30
40
50
60
1619 2024 2534 3549 5059 60+ All aged
16+
%

s
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Age group
Prevalence of cigarette smoking by age, persons aged 16 and over,
Great Britain, 1974-2009
1974
1986
1994
2004
2005
2007
2008
2009
Smoking data weighted after 1998


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Cardiology



CfWI | August 2011 10
Diabetes
People with diabetes are more likely to develop coronary heart disease compared with those without diabetes. The majority of people with
diabetes die from cardiovascular disease. Cardiovascular disease accounts for 44 per cent of fatalities in people with type 1 diabetes and 52 per
cent of fatalities in people with type 2 diabetes (Diabetes UK, 2010). Diabetes UK suggests that the number of adults diagnosed with diabetes in
the UK amounts to 2.6 million and approximately half a million people do not realise that they have diabetes. It is predicted that by 2025 the UK
diabetes population will reach more than four million people. Studies show that diabetes has the strongest association with obesity.
Hypertension
NHS Choices (2010c) indicates that 18 per cent of adult men and 13 per cent of adult women have high blood pressure but are not receiving
treatment for it. NHS Choices identify the following as risk factors for high blood pressure:
age
poor diet
lack of exercise
being overweight
excessive alcohol consumption.

Diet
The NHS IC (NHS IC, 2011c) reports that in 2008, 25 per cent of men, 29 per cent of women and around 20 per cent of children in aged 515
reported meeting the Governments 5 a day guidelines of consuming five or more portions of fruit and vegetables a day. NHS Choices lists a
healthy diet as a means of preventing coronary heart disease (NHS Choices, 2010d) and hypertension (NHS Choices, 2010c).





Medical Specialty Workforce Fact Sheet
Cardiology



CfWI | August 2011 11
Physical inactivity
A report published by the NHS IC (NHS IC, 2011c) indicates that lack of physical activity has decreased amongst both men and women since 1997,
with 39 per cent of men and 29 per cent of women meeting the recommended levels in 2008 (at least 30 minutes of moderate or greater intensity
activity, 5 times per week). In 2008, boys aged 215 were more likely than girls to meet the recommended levels of physical activity with 32 per
cent of boys taking part in 60 minutes or more of physical activity on each of the seven days in the preceding week to the survey compared with 24
per cent of girls. It can be assumed that physical inactivity will be decreasing in the future. NHS Choices lists physical activity as a means of
preventing coronary heart disease (NHS Choices, 2010b) and hypertension (NHS Choices, 2010c).

Alcohol
The National Audit Office (2008) reports that more than 10 million people (31 per cent of men and 20 per cent of women) are now regularly
drinking above the guidelines set by Government. The importance of tackling this problem has been reported particularly in the Choosing Health
White Paper (2004) and in Lord Darzis review of the future of the NHS, High Quality Care for All (DH, 2008). NHS Choices lists keeping alcohol
consumption within recommended levels as a means of preventing coronary heart disease (NHS Choices, 2010d) and hypertension (NHS Choices,
2010c).
Coronary heart disease
The NHS IC (NHS IC, 2007) summary of the National Coronary Angioplasty Audit states that coronary heart disease accounts for around one in five
deaths in men and one in six deaths in women. It is also estimated that there are over 1 million men and 840,000 women living in the UK who have
or have had angina (British Heart Foundation, as cited by NHS IC, 2007).
The British Medical Journal (BMJ, 2011) reports that Body Mass Index (BMI) in young adults and adolescents has been linked to heart disease,
predicting future risk in later life, after adjusting for age, family history, lifestyle and blood biomarkers. The BMJ notes that some BMI scores predict
a higher risk of heart disease currently fall within the normal BMI range (New England Journal of Medicine, as cited by BMJ, 2011).



Medical Specialty Workforce Fact Sheet
Cardiology



CfWI | August 2011 12
Congenital heart disease (CHD)
Patient UK (2011) states that:
The incidence of congenital heart disease in full term live born infants is between 4 and 9 per 1,000.
Each year there are about 1.5 million new cases worldwide.
It is the most common congenital condition diagnosed in newborns.
As more of these children survive into adulthood, there are more adults now requiring surgery for this condition. Although this is often carried out
by paediatric surgeons, ongoing care is required from consultant cardiologists with expertise in Adult CHD. The factors in this section will need to
be quantified, and the relative influences assessed before an overall level of demand can be gauged.
Changes in activity
Changing methods of investigation and treatment
Currently, consultant cardiologists duties include carrying out invasive procedures such as fitting pacemakers and diagnostic catheterisation.
However, NHS Medical Careers (2011) state that in future, new imaging modalities such as magnetic resonance and CT scanning are likely to
complement and challenge the invasive investigations performed in the cardiac catheter laboratory. This has implications for the future working
patterns of consultant cardiologists. The changing prevalence of cardiological conditions and the changing practices in treatment and technology
use would need to be quantified in order to deduce resulting workforce demands.



Medical Specialty Workforce Fact Sheet
Cardiology



CfWI | August 2011 13
Finished Consultant Episodes (FCEs)
Figure 4a shows Finished Consultant Episode (FCE) data for Cardiology up to 2009.
Figure 4a: FCEs per year for Cardiology

Source: (NHS IC, 2011b). The data shows annual number of FCEs. FCEs were recorded in the tax year in which they finished, the date on the graph indicates the starting year for each tax year.
It is assumed that the recording and definition of FCEs in this speciality has not changed significantly over this time period, and therefore the rise in
FCEs indicates an increase in activity in the speciality. The majority of cardiology FCEs are for outpatients. Figure 4b shows the trend in outpatient
attendances from 20032009; it also indicates a trend of an increase in activity.
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Finished Consultant Episodes for Cardiology
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Cardiology


CfWI | August 2011 14

Outpatient attendances
Figure 4b: All outpatient attendances per year for Cardiology

Source: (NHS IC, 2011d). OAs were recorded in the tax year in which they occurred, the date on the graph indicates the starting year for each tax year.
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Year starting
Outpatient attendances per year for Cardiology using specialty
codes 320.
First appointment Subsequent appointments All appointments


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Cardiology



CfWI | August 2011 15
CURRENT AND FORECAST SUPPLY
Existing Workforce
Supply and age profile
The most recent data from the Information Centre census (NHS IC, 2011a) records a headcount (HC) of 893 HC (862 FTE) consultants employed in
England as at 30 September 2010. The latest available data records 915 FTE consultants (955 HC), including 25 locums, as at February 2011
(extracted via iView from Electronic Staff Records (ESR), May 2011).
The age profile of the current consultant workforce as at September 2010 is shown in Figures 5a and b.
Figures 5a and b: (a) Consultant age profile (FTE), and (b) Consultant age profile (HC) Cardiology

Source: (NHS IC, 2011e).
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Consultant age profile (FTE) - Cardiology
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Consultant age profile (HC) - Cardiology


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Cardiology



CfWI | August 2011 16
The chart shows a plentiful supply of younger staff and a small proportion of staff working beyond typical retirement age. There appears to be no
impending retirement bulge in the near future.
The IC three-month vacancy rate for all general medicine consultants is 0.0 per cent as of March 2010 (the latest available data); the three-month
vacancy rate for cardiology consultants is higher at 0.5 per cent (NHS IC, 2011f).
Vacancies and locum staff
Data extracted via iView from ESR, December 2010 (ESR, 2010), records that 2.6 per cent of the practising consultant workforces are locums (25
locums out of a total of 930 consultants).
The NHS IC vacancy survey (NHS IC, 2011f) records a three-month vacancy rate of 0.5 per cent for cardiology consultants in England.
Geographical distribution
Tables 1a and b below show the geographical distribution of doctors and trainees in absolute values and in relation to the weighted capitation of
each Strategic Health Authority (SHA), a description of weighted capitation is given below*.
Tables 1a and b suggest that, out of the ten SHAs, NHS London is significantly over-capitated, i.e. the only area with a significantly greater
proportion of Englands doctors in training and consultant grade doctors than if provision were to follow weighted capitation. This indicates a
skewed geographical distribution of the workforce.
*The Department of Health uses a weighted capitation formula (WCAP) to distribute resources to primary care trusts (PCTs) based on the relative
health needs of each PCTs catchment area (DH, 2011a). If qualified doctors and trainees were equitably distributed according to the formula, all
other columns in Table 1b would be zero. Values greater than zero indicate that the SHA has more doctors than would be included by WCAP; values
less than zero indicate that the SHA has fewer doctors than would be included by WCAP. However, the CfWI recognises that weighted capitation
does not reflect that specialist services are not equally distributed throughout England. It is also important that all training posts are of high quality,
and high-quality training placements may not be equally available across England.
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Cardiology


CfWI | August 2011 17

Tables 1a and b: a) Actual number of doctors by grade and SHA, across ten SHAs for Cardiology, b) Number of FTE above or below that recommended by weighted capitation alone
Number of doctors (FTE) by grade and SHA,
shown for cardiology - Based on IC census data
for 2010 and deanery monitoring data for 2009
Number of doctors (FTE) over or under the
number recommended by weighted capitation
alone
Table (a) Table (b)
SHA Weighted
Capitation
Doctors
in
training
SSASG Consultant Doctors in
training
SSASG Consultant
North East
5.80%
34 4 56 0 -3 6
North West
15.00%
78 21 132 -10 2 3
Yorkshire & The Humber
10.70%
47 19 82 -16 4 -10
East Midlands
8.60%
32 9 63 -18 -3 -11
West Midlands
11.00%
50 21 87 -14 5 -8
East of England
10.30%
57 14 83 -3 -1 -6
London
14.20%
178 23 173 95 3 51
South East Coast
7.70%
29 7 51 -16 -4 -15
South Central
6.80%
42 5 52 2 -5 -7
South West
9.90%
38 18 84 -20 4 -1
Total
100.00%
585 142 862
Source: Weighted capitation (DH, 2011b), Consultant/SSASG numbers (NHS IC, 2011a) and deanery monitoring (NHS IC, 2009).
Note due to rounding sum of data may not match presented totals



Medical Specialty Workforce Fact Sheet
Cardiology



CfWI | August 2011 18
Recruitment
Table 2: 2010 Specialty recruitment for Cardiology at ST3, by Deanery
The level of recruitment to further medical training is shown in Table 2.
The table illustrates the situation at point of entry in 2010. The data
correspond to posts openly advertised.
The table shows a successful fill rate at ST3. The data implies an
uneven distribution geographically, with the East Midlands deanery
exhibiting a fill rate of less than 100 per cent of the available posts.
However, it is thought that all posts were filled in reality. Many
deaneries overfilled their positions possibly due to candidates
deferring entry.







Source: (DH, 2010).
Note: London recruitment includes recruitment to London, London/KSS and
London/KSS/EoE
Deanery Available
Posts
Accepted
Posts
Fill Rate
East Midlands 9 8 89%
East of England 5 6 120%
Kent, Surrey and Sussex 0 0 -
London 20 21 105%
Mersey 4 6 150%
North West 0 0 -
Northern 3 3 100%
Oxford 5 6 120%
Peninsula 4 5 125%
Severn 0 0 -
West Midlands 7 7 100%
Wessex 3 5 167%
Yorkshire and the Humber 5 10 200%
Total 65 77 118% (avg.)


Medical Specialty Workforce Fact Sheet
Cardiology



CfWI | August 2011 19
Consultant projections
The supply and forecast of doctors in Cardiology is shown in Figures 6a and b. Historical data is taken from the NHS Information Centre (IC) Medical
Census (19972010) (NHS IC, 2011a).
The objective of the medical workforce configuration data in Figures 6a and b is to show how the service has historically been delivered in
Cardiology, with a combination of consultants, staff, specialty and associate specialist grade (SSASG) doctors, and trainee doctors (who may be in
training towards another specialty, but are providing service in Cardiology). The figures are based on the latest data available (SSASG data dates
back to 2005).
Medical Specialty Workforce Fact Sheet
Cardiology


CfWI | August 2011 20

Figures 6a: Historical workforce supply (FTE) and future consultant supply and estimation of the number of filled posts for service delivery Cardiology
Figure 6a shows that the consultant workforce
expanded by 22.3 per cent during the past five years
based upon the information centre (IC, 2011a) census.
The trend is reflected by middle-grade medical staff
together with trainees (which are defined as those in
the SHO and registrar groups and therefore include
more than just doctors in training to CCT in
cardiology, but are forming part of the cardiology
service delivery). These staff groups now constitute
58.1 per cent of the medical cardiology workforce.
The supply of cardiology consultants over the next 10
years is forecast to increase to 1,574 FTE in 2020
(1,635 HC), an average increase of 5.9 per cent

Source: Historical Supply Data (NHS IC, 2011a), Supply forecast (ESR,
2010), (NHS IC, 2009) and workforce assumptions. Estimates of number
of posts to achieve full service delivery use population projections (ONS,
2010).
0
500
1000
1500
2000
2500
3000
3500
1
9
9
7
1
9
9
8
1
9
9
9
2
0
0
0
2
0
0
1
2
0
0
2
2
0
0
3
2
0
0
4
2
0
0
5
2
0
0
6
2
0
0
7
2
0
0
8
2
0
0
9
2
0
1
0
2
0
1
1
2
0
1
2
2
0
1
3
2
0
1
4
2
0
1
5
2
0
1
6
2
0
1
7
2
0
1
8
2
0
1
9
2
0
2
0
F
u
l
l

T
i
m
e

E
q
u
i
v
a
l
e
n
t

(
F
T
E
)
Year
Cumulative historical workforce supply (FTE) and future consultant supply &
estimation of the number of future filled posts for service delivery - Cardiology
Consultants (FTE) Historic Supply
Specialty Trainees
Staff, Specialty andAssociate Specialist Grade (SSASG) Doctors
Royal College estimation of the future number of filled consultant posts to deliver service based ona fixed total
Consultants (FTE) CfWI Supply Forecast
Estimation of future number of consultant posts to deliver service due to populationgrowthonly (0.8% for 20+ yr olds)
Medical Specialty Workforce Fact Sheet
Cardiology


CfWI | August 2011 21


Figure 6b: Historical workforce supply (HC) and future consultant supply and estimation of the number of filled posts for service delivery Cardiology
The supply forecast is based on the following
modelling assumptions*:
There is higher specialty training of 5 years (ST3
to ST7) after trainees complete core training (CT1-CT2)
in core medical training.
The total national training numbers (NTNs) in
training are split evenly across the higher specialty
training years, and NTNs are recycled upon trainees
gaining a CCT. All recycled NTNs are assumed to be
filled in the next application process.
Every new CCT holder is assumed to start work
as a consultant within the same year.
The only source of joiners to the consultant
workforce is through the training system. The
modelling of this route takes into account the age of
trainees, length of training, likely delays and attrition.
The only leavers modelled are permanent
leavers from the consultant workforce e.g. retirements.
A distribution of retirements is modelled which reflects
the variation in age of retirement between consultants.

*These assumptions were reached by analysing past
trends, and engaging with the specialty in order to
identify indications that trends may change in the
future.
0
500
1000
1500
2000
2500
3000
3500
1
9
9
7
1
9
9
8
1
9
9
9
2
0
0
0
2
0
0
1
2
0
0
2
2
0
0
3
2
0
0
4
2
0
0
5
2
0
0
6
2
0
0
7
2
0
0
8
2
0
0
9
2
0
1
0
2
0
1
1
2
0
1
2
2
0
1
3
2
0
1
4
2
0
1
5
2
0
1
6
2
0
1
7
2
0
1
8
2
0
1
9
2
0
2
0
H
e
a
d
c
o
u
n
t

(
H
C
)
Year
Cumulative historical workforce supply (HC) and future consultant supply &
estimation of the number of future filled posts for service delivery - Cardiology
Consultants (HC) Historic Supply
Specialty Trainees
Staff, Specialty andAssociate Specialist Grade (SSASG) Doctors
Royal College estimation of the future number of filled consultant posts to deliver service based ona fixed total
Consultants (HC) CfWI SupplyForecast
Estimation of future number of consultant posts to deliver service due to populationgrowthonly (0.8% for 20+ yr olds)


Medical Specialty Workforce Fact Sheet
Cardiology



CfWI | August 2011 22
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Cardiology



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