WORKFORCE: A review of medical education and training for junior doctors in London has raised concerns over the quality of supervision at some hospitals, and in one instance uncovered the use of operating theatres for intensive care.
A regional inspection programme by the General Medical Council found the standard of medical training was good overall but there were examples of poor supervision of foundation doctors, with trainees reporting difficulty getting advice from senior staff.
The GMC, in a report on the inspections published last month, said some “found themselves isolated, exposed and dealing with clinical situations beyond their competence.”
During a visit to Charing Cross Hospital, run by Imperial College Healthcare Trust, the GMC found operating theatres were being used as overflow intensive care beds with poor handover between intensive care staff and trainee doctors.
The report by the GMC said the situation was caused by high numbers of patients and said it was a “symptom of a healthcare system working close to full capacity”.
Across the city junior doctors also reported difficulties completing their workplace assessments and complying with the regulated limit on their working time.
The GMC highlighted that handover procedures were inconsistent.
Inspectors for the GMC found some hospitals were overcrowded with trainees and the quality of clinical placements was variable and depended on the enthusiasm of teachers and trainers.
Only at one trust, St George’s Healthcare NHS Trust, the GMC found time set aside for education was built into job plans.
The GMC carried out visits across the capital between October and December 2012 and included 10 education providers, five medical schools, and the London Deanery.
At Northwick Park Hospital, part of North West London Hospitals Trust, inspectors found concerns about the supervision of trainee doctors with junior medics “routinely asked to make decisions beyond their competence”. The GMC also highlighted pressure on staffing levels here.
At the Royal London Hospital, part of Barts Health Trust, the GMC said trainee doctors struggled to get senior support, particularly during out of hours.
Around 12,000 students and doctors, 20 per cent of all medical trainees and students, are based in London.
Niall Dickson, chief executive of the GMC, said: “We will work with NHS trusts, senior doctors and others at a local level to ensure they are meeting our standards.
“Inadequate clinical supervision is not just a London issue – doctors in training in other parts of the UK have reported similar issues.”