Skip to main content

Patient safety put at risk by long hours for Junior Doctors

Many junior doctors are still working excessive hours, due to increasing pressures and staff shortages, and are worried this is putting patient safety at risk, a IPSOS Mori report for the BMA has shown.

Ahead of potential negotiations with NHS Employers on a new contract for doctors and dentists in training, the BMA analysed feedback from over 1,600 junior doctors and final years medical students on the employment and training issues most important to them.

Despite the European Working Time Directive bringing in an average 48-hour working week, the reality is that some junior doctors are working up to 100 hours a week to meet demand, with many worrying for their own and their patients’ safety as tiredness impacts on their ability to work and make decisions safely. 

This comes amidst increasing concerns about patient safety in the NHS. Comments by the doctors in training reveal the problem:

“My average working week may have complied [with the ETWD] but on occasion, especially on nights, I would have worked over 100 hours in one week which was not safe by the end.” (Junior Doctor, Scotland)

“Current hours are bad enough, especially since we have to stay late unpaid most days to finish ward work due to poor staffing. We need the same hours but more staff, not less staff more hours. (Junior Doctor, Wales)

Serious levels of understaffing are also resulting in junior doctors working unrecorded and unpaid extra hours in order to meet patient demand and to ensure extra work is not dumped onto colleagues.

“The fact is we feel obligated to stay to finish our jobs so that patient care doesn’t suffer and we also don’t want to ‘dump’ jobs onto our colleagues working the evening and night shifts.” (Junior Doctor, England)

A large number of junior doctors have also expressed concern at the impact of long hours or long stretches of consecutive shifts on their home lives, with the unpredictability of training rotations, lack of flexible leave and insufficient time to recuperate following unsociable hours all affecting morale.

“I should not have to work 12 day stretches, or 12 hour shifts; it’s not safe and means no quality of life outside work.” (Junior Doctor, England)

Commenting on the feedback, Dr Ben Molyneux, Chair of the BMA’s Junior Doctors Committee said:

“It is of great concern that junior doctors are being forced to work excessive hours and are often under intolerable pressure in order to ensure patient safety. There have been radical changes to the way we work since the current junior doctors contract was introduced 13 years ago. The feedback highlights that despite working time regulations, juniors are still working long shifts night after night as well as extra, unrecorded hours.

“We also need to address quality-of-life issues, such as getting decent notice of where and when we will be working and the use of fixed leave. Two weeks before the annual August changeover of jobs, thousands of junior doctors still don’t know basic details such as what they will be working or how much they will be paid. Some don’t even know where they will be working in a fortnight.

“The Keogh Review highlighted that despite the lack of support and value placed on junior doctors, they remain the best champions for their patients and this must not be lost to the growing sense of frustration they feel.

“We will now work towards negotiating with NHS Employers for terms and conditions that address junior doctors’ concerns and recognise the vital role they play in the NHS.”

It seems absurd that we can put tachographs into lorries to ensure drivers don't drive beyond legal specifications, and yet we can't regulate the hours worked by junior doctors. Staff shortages and lack of funding are taking their toll on patient safety. 

Comments

Popular posts from this blog

Prioritising people in nursing care.

There has been in recent years concern that care in the NHS has not been sufficiently 'patient centred', or responsive to the needs of the patient on a case basis. It has been felt in care that it as been the patient who has had to adapt to the regime of care, rather than the other way around. Putting patients at the centre of care means being responsive to their needs and supporting them through the process of health care delivery.  Patients should not become identikit sausages in a production line. The nurses body, the Nursing and Midwifery Council has responded to this challenge with a revised code of practice reflection get changes in health and social care since the previous code was published in 2008. The Code describes the professional standards of practice and behaviour for nurses and midwives. Four themes describe what nurses and midwives are expected to do: prioritise people practise effectively preserve safety, and promote professionalism and trust. The

Half measures on heat pumps

Through the "Heat and Buildings Strategy", the UK government has set out its plan to incentivise people to install low-carbon heating systems in what it calls a simple, fair, and cheap way as they come to replace their old boilers over the coming decade.  New grants of £5,000 will be available from April next year to encourage homeowners to install more efficient, low carbon heating systems – like heat pumps that do not emit carbon when used – through a new £450 million 3-year Boiler Upgrade Scheme. However, it has been widely criticised as inadequate and a strategy without a strategy.  Essentially, it will benefit those who can afford more readily to replace their boiler.   Undoubtedly, the grants will be welcome to those who plan to replace their boilers in the next three years, and it might encourage others to do so, but for too many households, it leaves them between a rock and a hard place.  There are no plans to phase out gas boilers in existing homes.  Yet, that is wha

No real commitment on climate

Actions, they say, speak louder than words.  So, when we look at the UK government's actions, we can only conclude they don't mean what they say about the environment and climate change.  Despite their claims to be leading the charge on reducing emissions, the UK government is still looking to approve new oil fields.  The Prime Minister, Boris Johnson,  has announced his support for developing the Cambo oil field and 16 other climate-destroying oil projects. Cambo is an oil field in the North Sea, west of Shetland. A company called Siccar Point has applied for a permit to drill at least 170 million barrels of oil there. If it's allowed to go ahead, it will result in the emissions equivalent of 18 coal plants running for a year.  What? Yes, 18 coal plants a year!  Today, as I write, Greenpeace is demonstrating in Downing Street against this project.  I suppose it will get the usual government dismissal and complaints about inconveniencing others.  Well, we know it won't