Update

Government calls loss of free accommodation ‘side effect’ of EWTD

The campaign to renew free accommodation for new doctors was delivered a heavy blow, when the government dismissed it as a “side effect” of the European Working Time Directive (EWTD). The EWTD determines that from August new doctors will not be included in “on call” rotas. As a result the government amended the Medical Act to remove the statutory requirement for FY1s to live at or near their workplace. The government stressed that it was now up to local trusts to decide whether to continue to offer free accommodation.

If a doctor is contractually required to live in hospital accommodation, then no charges should be made for the accommodation provided. The government receives pay advice on junior doctor’s pay from the Doctors’ and Dentists’ Review Body (DDRB). The DDRB commented that although the removal of free accommodation would increase costs in the short term, the potential for future earnings has been greatly enhanced by recent contractual changes. For 2008 the DDRB recommended an increase of 2.2%.

In response to the government’s decision demonstrations were held across the UK in May and there is talk of more in the future. The BMA attacked the government for not consulting the profession and described the decision as an “effective pay cut” which would leave all new doctors £4,800 p.a. worse off.

Read the government’s full report here: www.ome.uk.com.

 

New consent guidance for all doctors

New consent guidance published by the GMC, reflects a changing legal landscape that poses new challenges for doctors. For the first time issues such as risk and making decisions when a patient lacks capacity are covered in detail. However concerns have been raised that the new guidance may place doctors under additional time pressure. Dr Stephanie Bown, Director of Policy and Communications, said: “Doctors are under a duty to optimise each patient’s ability to make their own decisions, which when done properly, can be very time consuming – especially where the nature of the decision is complex or involves a number of options. Doctors are already working in a pressurised environment and this adds to it.

“In order for doctors to meet the standards expected from this guidance, we would like to see it reflected at an earlier stage of their training, so that they can be well prepared for the issues that will arise when dealing with patients whose capacity to make a decision may be impaired.”

The guidance will have a particular impact where doctors are treating patients with impaired or fluctuating decision-making abilities. The guidance:

  • Sets out the key principles of good decision-making, in all areas of medicine
  • Takes account of changes in the law (Mental Capacity Act)
  • Reflects the shift in attitudes towards more patient-centred care
  • Contains practical advice on sharing information and discussing treatment options
  • Includes guidance on how to approach discussions about risk.

The guidance came into force on 2 June 2008. Consent booklets can be downloaded from the GMC website: www.gmc-uk.org. The booklets include the significant cases that moulded the common law on consent, such as Chester v Afshar (2004) and Gillick v West Norfolk and Wisbech AHA (1986).

 

GMC moves to civil standard

From 31 May all doctors in fitness to practise proceedings will be judged on the civil standard of proof. MPS campaigned against this, as it is a lower standard than the criminal standard, arguing that there are more effective ways of ensuring robust regulation. Access the factsheet on GMC Fitness to Practise Procedures here.

 

Doctors blame poor training for prescription errors

Three-quarters of junior doctors say they have not been trained to prescribe drugs properly. In a survey of 2,400 juniors at Edinburgh University, more than half said their training did not adequately test their skills. The report can be read in full in the British Journal of Clinical Pharmacology.

 

Tags