Consultants say they are under intense pressure

The Royal College of Physicians (RCP) found 78% planned to retire before the age of 65.

They blame long working hours and increased work pressure.

The RCP has calculated that if all these doctors retired at 62 it would be equivalent to every large UK hospital losing between 1.5 and two physicians.

A separate survey by the Royal College of Nursing has found that almost a third of nurses are planning to leave their current job in the next two years.

We need to change the working environment and workload to encourage this experienced and committed workforce to stay in the NHS Dr Alistair McIntyre

The RCP census, involving more than 5,000 consultant physicians, found the biggest problem facing consultants nearing the end of their careers was the heavy burden of emergency on-call work.

This issue alone, the survey found, could persuade many to quit.

But it said that the NHS had the potential to keep these consultants by changing their working patterns to reduce the long and pressurised hours they work.

Teaching aim

The RCP said that consultants nearing the end of their careers were keen to stay on to do speciality work, management and postgraduate education.

They were particularly keen to pass on their skills and knowledge to future generations.

Allowing consultants to concentrate on these areas could prevent an "early exodus" from the NHS, the report said.

The census results have been passed on to the Department of Health.

The number of NHS consultants is rising and we will ensure these increases continue to reduce the workload on those already employed in the NHS Lord Warner

The RCP said it hoped to work with them to achieve a "more appropriate career pattern".

The research also found that physicians were still working long hours.

More than four out of 10 (41.8%) said they were working more than 60 hours a week, while 23.3% worked more than 50 hours.

The census found that the average working week for consultants who had some NHS component in their contract, including part-time doctors, was 59.3 hours a week.

Under the European Working Time Directive, doctors are not supposed to work more than 48 hours a week.

The RCP said to reduce hours to conform with the directive - without loss of service to the NHS - would need a 28.2% expansion in consultant whole-time equivalents.

Change needed

Dr Alistair McIntyre, director of the RCP medical workforce unit, said: "The time has come to take a long hard look at the way consultants work as they progress through their careers.

"We need to change the working environment and workload to encourage this experienced and committed workforce to stay in the NHS."

Health Minister Lord Warner said significant steps had been taken to ensure the NHS retains senior consultants.

He said a new contract encouraged doctors to work for longer in order to gain a higher final salary and enhanced pension benefits.

He said there were currently 9,200 more consultants working in the NHS than in 1997.

"The number of NHS consultants is rising and we will ensure these increases continue to reduce the workload on those already employed in the NHS."

The RCN survey, of 4,795 nurses, found 71% believed they could be paid more for less effort if they left nursing, compared to 60% in 1995.