Staff ‘belittled’ for contacting senior doctors, NHSE finds

The General Medical Council put University Hospital Southampton Foundation Trust’s general surgery training under enhanced monitoring at the end of 2023 following a referral and quality management visit by NHS England South East, Workforce Training and Education – Wessex.

The NHSE team’s visit and subsequent report said doctors in training had claimed senior staff were “not contactable” out of hours and there was “difficulty” in securing senior clinical advice, particularly on Sundays. 

The report added foundation year doctors were “discouraged” from contacting senior staff out of hours by “inappropriate” and “belittling” comments and behaviours, such as being told not to ask for help “unless your patient is dying”.

Foundation doctors also reported starting rotation on call and conducting ward rounds without appropriate supervision.

While the GMC open case is centred on patient safety concerns relating to supervising trainee doctors, the workforce and training directorate report also raised concerns about bullying, inappropriate sexual comments made by consultants, and a feeling that foundation doctors were unable to speak up.

GMC medical director and director for education and standards Colin Melville confirmed the trust’s training in general surgery was under enhanced monitoring due to “concerns regarding potential patient safety risks, appropriate out-of-hours supervision for doctors in training and undermining behaviour”, adding the GMC would work closely with the regional NHSE team. 

UHS chief medical officer Paul Grundy said the trust’s senior staff “acknowledge the issues” and are “committed to improving the experience” of its trainee doctors. 

He added: “Work is under way to ensure we offer a safe, equitable and inclusive workplace, where everyone has the opportunity and support to learn and develop their skills.”

Since the report, UHS has appointed a lead consultant to oversee rota management, ensuring additional consultants are available on-site at weekends, and changed its escalation protocols. Mr Grundy said the trust was also “working with our surgical consultants to review all aspects of leadership, both in reporting up and down within the department and across the organisation, and looking at how we develop and improve a shared sense of culture and team working”.

He added: “We are also engaging in a dedicated programme of work towards the [British Medical Association] joint pledge on ending sexism in medicine. Feedback is being regularly sought from all relevant staff, who are being actively encouraged to report and call out any unacceptable behaviours.”

UHS is one of 19 NHS organisations in England with an open GMC enhanced monitoring case.

Earlier this month, NHSE intervened and relocated 11 surgical foundation year trainees from a London hospital, which is under enhanced monitoring due to a “culture of fear”, bullying, and a lack of support.