‘Systematic pressures’ affecting doctors’ training

Monday 8th July 2019

A third of trainee doctors across the UK do not know who they can approach with concerns about their wellbeing, a General Medical Council (GMC) survey has found.

Questions about workload, safety during travels to and from work, and relaxation facilities for doctors on shift are also raised in the survey of more than 75,000 doctors and trainers across the UK.

The GMC is warning ‘systemic pressures’ are affecting the quality of training doctors receive, while a ministerial taskforce is being convened by the Scottish Government to look at the findings.

More than 5,000 trainees and nearly 1,900 trainers in Scotland were asked about the quality of their educational experience and the support on offer.

Around half of Scots medical trainees say they miss out on training and educational opportunities because of staff shortages, the survey reveals.

A similar percentage only have access to ‘very poor/poor’ common room facilities or none at all.

The proportion of trainee doctors in Scotland working beyond their rostered hours every day was down on the previous year, although the percentage saying they did so at least once a week stood at 38%, broadly in line with the UK average.

On getting advance notice of their rota in their new roles, a similar figure say they received at least six weeks’ notice about the rota in their current role when they started, despite NHS Education for Scotland guidelines stating this should be the norm.

The equivalent figure for the UK as a whole was just under half.

A quarter of Scottish trainees say there is no mechanism for them to travel safely to and from work when working evening and night shifts.

It comes as NHS Lothian is being urged to resolve parking issues at St John’s hospital in Livingston, with a Labour MSP warning that changes are making staff members park offsite and walk through unlit areas.

Charlie Massey, GMC chief executive, said: “We’re pleased that trainees are continuing to see improvements to their working hours and to their training, showing that employers are working hard to tackle issues highlighted by the surveys.

“However, those efforts must continue if we are to support the excellent doctors we have.”

“...Doctors work long hours in highly pressured environments, and they need support. We are concerned about how work pressures impact on the mental health and wellbeing of doctors, which could ultimately impact patient care.

“We’ve commissioned a UK-wide review, chaired by Dame Denise Coia and Professor Michael West, to address this important issue.”

Professor Derek Bell of the Royal College of Physicians of Edinburgh believes part of the solution lies in tackling “significant gaps” in medical rotas that in some cases are compromising patient safety.

“We believe that medical rotas should be available at least six weeks in advance, to allow doctors to plan their professional and personal lives,” he says.

“It is important that medical rotas are designed to support the continuity of care, and where possible the continuity of multi-disciplinary teams. Those designing rotas must work closely with trainee doctors to improve the rota system.”

“Equally, there must be enough time in doctors’ job plans, to ensure that they have time to train junior doctors. This of course also requires the appropriate facilities too - including space on wards to conduct routine activities as well as having space for rest with good catering facilities.”

A Scottish Government spokesperson said: “Patient safety is our priority and we are reassured that the vast majority of doctors in training posts are satisfied with the overall quality of their training.

“Trainee doctors are our future GPs and consultant workforce, and we recognise we can do more to improve their working lives and experiences. Whilst, overall, the findings offer a positive picture of postgraduate medical education and training in Scotland, there are still areas where improvements can be made, including ensuring better access to WiFi across NHSScotland.

“We welcome the survey which helps enhance our understanding of the views and concerns of our trainees – and those who train them - and we will use the findings to keep making improvements to the quality of postgraduate medical education and training, and the wellbeing of all doctors working in NHS Scotland.  

“Overall, the findings offer a positive picture of postgraduate medical education and training in Scotland, but we recognise there are still areas where improvements can be made.

“We are already reviewing rest and catering facilities for junior doctors in partnership with the BMA and NHS employers.

“We are also convening a Ministerial-led working group which will look at what practical strategies can be put in place to ensure staff are able to work in an open, fair and supportive environment whatever their role and wherever they might be based, and are delighted that the GMC has agreed to work with us on this.                                                                                        

“We will continue our work with NHS Education for Scotland, NHS Boards, BMA Scotland and trainees themselves to ensure issues which are important to them can continue to be progressed efficiently.”