Junior doctors left without consultant supervision, report reveals

4 Comments

PERFORMANCE: Training offered to junior doctors by Great Ormond Street Hospital for Children Foundation Trust has been criticised after an investigation found that trainees were running specialist clinics without consultant supervision.

The probe, carried out by a regional branch of Health Education England in April, found junior radiology staff conducting ultrasound scans on intensive care units and wards with “no direct supervision”.

The investigation team, assembled by the north central and east London branch of HEE, also pinpointed a lack of formal training across all the trust’s specialties and a “culture of pervasive bullying” of trainees by nurses on the paediatric intensive care unit.

Some trainees in oncology and infectious diseases were left with “little or no outpatients experience” and were at risk of failing their annual review of competence progression - a test all junior doctors must pass before progressing to the next stage of training.

Several serious incidents involving trainees had not been flagged up to the branch, the team claimed.

Their report warned the trust it faced suspension of some of its training posts unless it took action.

A spokeswoman for the FT said clinics had lacked consultant supervision in “a small number of specialities and on a limited number of occasions”.

“We agree with the junior doctors that this should not happen and we are now ensuring that all clinics are supervised. We have also set up a system for monitoring compliance,” she said.

Great Ormond Street had already taken a number of actions to address the research team’s concerns, including appointing a director of medical education.

It had introduced a system to report serious incidents to the HEE branch, and was working with some specialties to ensure trainees had adequate outpatients experience to meet their training requirements, the spokeswoman said.

The branch is due to visit the trust again in October.

In a report to the trust’s co-medical director, Catherine Cale, said: “A clear theme has emerged that our junior medical workforce do not perceive that education is valued and prioritised in the organisation, and that their skills, training needs and contribution - both actual and potential - is not being recognised.”

A trust spokeswoman said: “The trust values the contribution made by all its workforce including its junior doctors and recognises the need for good education and training opportunities.

“Prior to receiving the report, the trust recognised that it needed to improve the focus on education amongst its clinical staff and created a dedicated director of medical education post to facilitate this - it was previously part of the medical director role.

“All recommendations that required immediate attention have been implemented.”

A spokesman for the junior doctors’ representative committee at the trust said: “Our findings are being actively addressed through constructive dialogue with the trust and our local education and training board.

“This is an example of junior doctors acting as a vehicle for positive change within our organisation for the benefit of our patients and their families.”

This story was updated on 7/82013 at 1209 to change “psychiatric” intensive care unit to “paediatric” intensive care unit