Clinical virology workforce
The UK Clinical Virology Network (CVN) and the Royal College of Pathologists worked together in 2021 to survey the current clinical virology workforce, aiming to define the current workforce, identify any workforce shortfall or imbalances and support workforce planning proposals. When designing this survey, there was the intention to capture microbiologists’ recognised contribution to clinical virology provision.
Virologists are interested in clinical as well as laboratory-based activities. They are responsible for diagnosing viral infections, providing advice on the treatment and management of people with viral infections, and supporting investigations of viral outbreaks in the community and in hospitals. Medically qualified virologists may also be trained in the management of infectious diseases and their work may extend into seeing patients in clinics, hospital wards and the community. They may undertake specialist clinics for patients with HIV or hepatitis B and C.
The provision of a clinical virology service is a mixed picture; for example, medical virologists may be involved in test development and clinical scientists may provide clinical advice. Not all hospitals have laboratories or staff dedicated to virology; most hospitals have medical microbiology laboratories that are able to carry out standard diagnostic tests for viral infections. These laboratories are run by microbiologists, doctors, and scientists, and refer samples to specialised virology laboratories for more sophisticated virological diagnosis. The nature of the workload of virology laboratories means that they are all specialised services.
However, some laboratories – especially those that are part of the UK Health Security Agency, Public Health Scotland, Public Health Wales and the Health and Social Care Public Health Agency in Northern Ireland – have additional responsibilities and capabilities, including genome sequencing of viruses and diagnosis of high consequence infectious disease agents, such as Ebola virus. Some of these laboratories have an international responsibility. For example, the reference laboratory in London is a World Health Organization (WHO) global specialised measles and rubella laboratory and contains WHO-accredited national laboratories for influenza and poliovirus.
The importance of defining the current workforce and describing the essential role of clinical virologists was underscored by a survey response rate of 98%.
The UK clinical virology service has been delivered by a relatively small workforce, both outside and during the pandemic. However, there is predicted to be a reduction in the senior workforce and persistence of unmet need, coinciding with the stated intention of the UK government to expand capability in this area.
The following findings emerged from the data:
Currently there are 77 medical consultants in post (58 full time and 19 part time) with 20 clinical scientist consultants of whom 5 are part time. At the time of surveying, 25 consultant level posts were vacant i.e. 25%.
Survey respondents indicated that demands on their service warranted additional clinical virology posts, but funding had not been allocated. This is of particular concern as Covid-19, bird flu, monkey pox and potential zoonoses are all competing for their attention currently.
There are insufficient consultant clinical scientist positions available for clinical scientist trainees completing the Higher Specialist Scientist Training (HSST) programme. Increasing the number of clinical scientist roles is a potential solution in helping to tackle the workforce shortage.