The Royal College of Physicians (RCP) has published a new briefing report calling for urgent, system-wide action to stabilise and support Northern Ireland’s physician workforce, warning that without reform the health service risks losing a generation of future doctors.
The new report draws on evidence from a high-level roundtable convened by the RCP in November 2025, bringing together doctors, system leaders and policymakers from across Northern Ireland. It highlights four critical areas requiring immediate action: workforce pressures and morale, training bottlenecks, system pressures including corridor care and the need to value and invest in clinical leadership.
The RCP says that rising demand, rota gaps and growing patient acuity have left many services under severe strain. Resident doctors and consultant physicians described unsafe workloads, erosion of goodwill and growing exhaustion, while specialist, specialty and associate specialist (SAS) and locally employed doctors reported inconsistent career progression and a lack of recognition despite their expanding role in delivering frontline care.
Clinicians further described the ethical and emotional toll of delivering care in overcrowded hospitals, where prolonged delays to discharge and insufficient community capacity have normalised corridor care. The report argues that these pressures cannot be solved by hospitals alone and calls for a renewed focus on generalist practice, multidisciplinary working and community-based models of care.
Alongside these system challenges, the RCP highlights the critical importance of investing in clinical leadership. Doctors across all career stages reported taking on leadership responsibilities without protected time, training or recognition, undermining both morale and service improvement.
The RCP is calling for a series of practical reforms, including:
- expansion of training places and redesign of recruitment processes to reflect medical school growth and better support retention in Northern Ireland
- support resident doctors with better supervision, fair access to training and flexible, modern career pathways including non-traditional and portfolio roles
- the development of structured career pathways and leadership opportunities for SAS and locally employed doctors
- action to tackle corridor care through system-wide discharge planning, intermediate care and the expansion of ambulatory and community care
- greater support for generalist practice and value-based care
- meaningful investment in clinical leadership development across all career grades.