As representatives of junior doctors across a range of organisations, we, the Academy Trainee Doctors’ Group and the BMA Junior Doctors Committee are deeply concerned about the effect of increasing pressures on our health service, and the inevitable impact this is having on doctors training in the UK and the patients we care for.
The pressures in the NHS have been growing year on year. The crisis is no longer confined to winter, with figures from the BMA showing that the summer of 2018 was as bad as previous winters, leaving little capacity to deal with the inevitable surge in the coming months.
Throughout the year patients miss out on the high-quality care they deserve, and trainees routinely bear the brunt of staffing shortages, made worse by poor workforce planning and employment practices.
When long-term planning fails, attempts at short-term fixes appear, however these fixes must not exacerbate the problems they are trying to solve.
Increasingly, junior doctors are being moved from their approved speciality training jobs into service delivery roles to ease winter pressures. Yet moving trainees from a known training environment to deliver service elsewhere risks crucial training being missed or delayed, and widening gaps in the future senior workforce.
Without suitable safeguards in place, patients may be at risk – both those being treated by doctors working in unfamiliar settings and specialities, and those denied continuity of care because the junior doctor has been moved away. Additionally, junior doctors frequently tell us that an increasing lack of control over their working and training life is demoralising, and is driving them to leave the profession in the UK. Trainees must not be treated as a faceless resource to be moved on a whim when longer term planning fails.
The protection of quality training for junior doctors must remain a priority if we are to ensure a safe, high quality health service that meets the needs of patients.
All alternative options must be fully considered and implemented before junior doctors are moved. If they are moved, it must be:
Movement of trainees to meet service pressures must be recorded and data must be shared with training, representative, and regulatory bodies including HEE, the GMC, ATDG, the CQC, and the BMA.
Any decision to move junior doctors must be fully transparent and open to scrutiny. While we will always assist in emergencies and unpredictable crises, such moves should not be seen as an easy fix to plug gaps caused by long-term underfunding and poor planning.
Junior doctor training environments can be extremely demanding. As such, trusts must recognise that moving doctors out of their expected area of training will exacerbate existing workplace stress and anxiety levels, which have consistently been highlighted as reasons for poor wellbeing and staff retention.
If junior doctors are asked to move or cover different areas:
As the NHS braces itself for another winter for which it is underprepared, it is vital that we start to see long-term sustainable workforce and funding solutions.
Dr Alice Wort
Chair, Academy Trainee Doctors’ Group
Dr Jeeves Wijesuriya
Chair, BMA UK Junior Doctors Committee
© 2020 Academy of Medical Royal Colleges.