Update
New government urged to stop cutting funding for doctors’ training
Junior doctors have called on the new coalition government to stop the erosion of doctors’ training and safeguard the quality of the NHS medical workforce.
The quality of doctors the NHS produces depends on the quality of training provided. Alarmingly, our training is now under threat
In a speech to the BMA’s annual conference of junior doctors, Dr Shree Datta, Chair of the BMA’s Junior Doctors Committee, said: "The NHS prides itself, quite rightly, on its highly-trained staff, but the quality of doctors it produces depends on the quality of training provided. Alarmingly, our training is now under threat on many fronts.”
Dr Datta highlighted research showing that four in ten junior doctors are working on understaffed rotas and that they are increasingly working more anti-social hours, in which training opportunities are scarce. She added: “Almost half of UK doctors surveyed by the BMA are missing out on essential training.
Working extra shifts to prop up understaffed rotas means less time to learn new procedures, less time to practise our skills, less time to learn and less time to become better doctors. Without proper training, junior doctors will not be able to gather the skills, experience and knowledge needed to be the GPs and consultants of tomorrow.
“The Mid Staffs Inquiry emphasised the important role of education and training in the hospital workplace and it is clear that the training of junior doctors is not an optional extra. A cavalier attitude towards our training cannot and will not be tolerated. We are the future of the NHS and it is imperative that our concerns are addressed if we are to provide care of the highest quality to patients in the future.”
At the conference, the delegates voted on motions calling on the Secretary of State for Health to shadow a junior doctor on an out-of-hours shift, and a motion calling for improvement to workplace inductions so that junior doctors are not left responsible for large numbers of patients in unfamiliar hospital departments.
Dr Datta said: “There is a clear and urgent need to review the medical workforce so that the number of medical graduates closely matches the number of specialty training places and the need for consultant and GP posts. If junior doctors do not have a realistic chance of becoming a consultant or GP, we risk wasting precious NHS funding and creating a generation of frustrated under-employed doctors.”
Interruptions make for poorer care
Hospital doctors who are frequently interrupted while working spend less time on tasks and fail to return to almost a fifth of their jobs in hand, according to research in the journal Quality and Safety in Healthcare.
Australian researchers carried out a time and motion study of an emergency department in a 400-bed teaching hospital, observing 40 doctors over different weekday sessions, totalling a period of 210 hours. They found that, on average, doctors were interrupted 6.6 times an hour and 11% of all tasks were interrupted.
These interruptions – such as a doctor being asked a question by a colleague while they were trying to write a prescription – meant that doctors, when they did return to the job in hand, tended to spend less time on it than if they had carried out the task with no pause.
The authors conclude: “Our results support the hypothesis that the highly interruptive nature of busy clinical environments may have a negative effect on patient safety. Task shortening may occur because interrupted tasks are truncated to 'catch up’ for lost time, which may have significant implications for patient safety.”
- Source: Quality and Safety in Healthcare (June, 2010)
Remedy takes fight to the High Court
Remedy UK’s battle to take the people who approved the flawed medical training application system (MTAS) through disciplinary procedures was heard in May. The case brought to the GMC, which Remedy UK thinks should investigate the senior medical officials who instigated the system, was heard on 11-12 May at the High Court in London.
Remedy asked the GMC to consider whether those responsible for MTAS should face a disciplinary hearing. The GMC declined to refer the matter to their case examiners. Remedy said they received a letter from the GMC, which said Sir Liam Donaldson’s involvement with MTAS could not render him unfit to practise “whatever the conduct”. Remedy says that this conflicts with their guidance for doctors in management, which states that: “You remain accountable to the GMC for your decisions.”
Remedy released a video summarising the case in 72 seconds; watch it here.