Special measures trust at risk of losing trainees

Health Education England and the General Medical Council have warned Isle of Wight Trust the trainees could be removed if urgent action is not taken to provide additional out-of-hours doctors.

The trust was unable to give HSJ an exact number for how many trainees could be lost. However, a spokesman said it will likely be fewer than 12 and added a recruitment plan was in place. 

GMC and HEE have monitored acute medicine training at the trust since 2018, after serious concerns were raised about the safety of learning environments for patients and doctors.

A series of requirements were placed on the trust by the regulator to address issues around bed management, gaps in the workforce, effective and efficient handover and doctor training.

A 2018 GMC report raised concerns rota gaps at consultant level were affecting the level of safe clinical supervision provided to junior clinicians.

Following a further inspection in October, GMC officials wrote to trust bosses updating them on their concerns and the decision to keep the current special measures rating relating to clinical supervision and handover.

Action plan

The trust’s December board papers said: “Although improvements made since the previous visit were acknowledged there still remained a number of concerns which were highlighted in a letter to the CEO by [postgraduate dean for HEE Wessex] Dr Paul Sadler.

“An action plan has been produced and submitted to the HEE on 28 November 2019.

“The action plan outlines [a] firm commitment to commence immediate appointment of extra doctors to provide a second decision maker on call overnight and weekends to meet the acknowledged excess workload for the current medical specialist trainee doctors.

“This is targeted to be fully in place by 31 January 2020, but will be implemented sooner if at all possible.”

‘Urgent action’

The trust added that a plan has been developed to make sure all roles are covered should trainees be removed, while recruiting qualified doctors from overseas is being considered to address the long-term recruitment challenges.

The trust spokesman said: “We are taking urgent action to address the concerns raised by the GMC and HEE including bringing in additional medical cover out-of-hours.

“Recruiting doctors to work in our services has been a challenge for some time and has no doubt added to the pressure felt by our trainees.

“To address the longer term recruitment challenge, we are focusing on a number of roles that have proven particularly hard to recruit to and we are exploring all options including recruiting qualified doctors from overseas to strengthen our medical workforce throughout the trust.

“Our trainee doctors are an important and valued part of our workforce and we will do absolutely everything we can to make sure that they are supported, can learn and ultimately thrive during their time at our trust.”

Isle of Wight was placed in special measures in April 2017 after it was rated “inadequate” by the Care Quality Commission due to “significant” concerns over patient safety.

The CQC upgraded the hospital to “requires improvement” in September this year but it remains in special measures.