Everything you need to stay up to date on patient safety and workforce, plus my take on the most important under the radar stories. Contact me in confidence. Shaun Lintern, patient safety senior correspondent.
Crucial warning from trainee doctors
The General Medical Council’s national training environments survey, published this week, laid bare some key issues that individual trusts need to acknowledge and tackle.
Last year’s damaging dispute between the government and junior doctors left a lot of blood on the floor – but as Sir David Dalton made clear at the height of his involvement in the contract negotiations, the seeds for the row went deeper: in how junior doctors are treated by the health service.
Some of this is on display in the survey, which was answered by 53,000 trainee doctors and 24,000 trainers – a decent sample size that cannot be ignored.
Almost 80 per cent of the consultants and trainers who took part in the survey said they had to work beyond their rostered hours every week with as many as a third doing so daily. This isn’t an uncommon finding among surveys of NHS staff and many trust leaders know the service effectively functions on the goodwill of staff and their discretionary effort.
While more than three-quarters of trainees described the quality of teaching they received “good” or “very good”, there were also warnings. The GMC said a “worrying number” of junior doctors raised concerns about their heavy workload and a lack of sleep while on duty. Doctors reported missing education and training because of service pressures. Poorly designed rotas were also highlighted.
A quarter of junior doctors said they felt short of sleep on a daily or weekly basis and 40 per cent described the intensity of their work as “heavy” or “very heavy”.
The GMC highlighted a correlation between bullying and undermining of doctors in training by their superiors and difficulties retaining doctors as part of the workforce.
These sort of responses show (again) why the junior doctors dispute was almost always going to happen. The NHS for a long time has taken them for granted.
It is welcome to see Health Education England taking steps to try and improve the working lives of junior doctors but it needs communicate this to every trainee. During the contract row, HEE made use of mass emails to trainees – perhaps it should consider this now in relation to its new work.
Doctors are not unique in having complaints about how they are treated. Nurse surveys show similar, if not worse, fears over safety and workloads and feeling undervalued.
This is not about pay – though it is a factor – it is about how senior managers treat their staff; consultant behaviour to their trainees and trainee registrars’ treatment of foundation year doctors; and the senior nurse who doesn’t reflect on the concerns of their staff about lack of numbers, training or support.
The NHS is one of the world’s biggest employers and healthcare will be a labour intensive industry for a long time.
Recognising the need to be a good employer is crucial to how the NHS will cope with the tsunami of pressures coming its way from an ageing population and those with long term conditions.