Junior doctor employers under scrutiny to help deal with low morale

The relationship between junior doctors and their employers will come under scrutiny as one of the main focuses of a new independent review of their training and employment experiences in the NHS.

The review, led by Academy of Medical Royal Colleges chair Professor Dame Sue Bailey, will also look at the relationship between the trainee workforce and their senior medical colleagues, who are often vital to help junior doctors develop their careers.

First announced last week, the review is designed to better understand the longstanding issue of low morale, which has been brought to the forefront recently as a fundamental issue in the junior doctor contract dispute.

Junior doctors’ placements can sometimes be as short as four months, for example, often leading to a breakdown in relationships between hospitals and their doctors.

The NHS Staff Survey, for example, of which the results will be published next week, found that junior doctors are less likely than any other staff group to feel valued by the hospital they work for.

They are also less likely to understand how their role fits into the wider organisation and how they can personally contribute to work improvement.

Dame Sue will also look at the competing demands between NHS service requirements and training and education, with junior doctors “too often” missing training opportunities or not receiving support around exam time because of pressures within the health service.

Competing demands between service requirements and supporting doctors to progress in their careers will also be explored, with doctors not always getting their first choice of speciality due to oversubscription or shortages.

She will work alongside representatives from other organisations in this review, including royal colleges, Health Education England (HEE), NHS England, NHS Employers and junior doctors themselves.

The last two groups may be of particular use in identifying issues faced by junior doctors in the working environments and facilities in which they are placed – as well as highlighting incidents of bullying and understanding the existing flexibility around annual leave and notice periods ahead of future placements.

Dame Sue added: “This work is crucial to improve working life for junior doctors and, as we know, improving the morale of staff will improve the quality of patient care. That is why this is such an important task and so, I am sure, all parties will be fully committed to ensuring we are successful.

“I particularly want to hear about the concerns of junior doctors directly so we can, as a whole NHS community, significantly improve the morale and wellbeing of trainees. We will work openly to ensure all views are heard, understood and then acted upon.”

The review was a request from Sir David Dalton, the chief executive of Salford Royal who was appointed by the government to lead negotiations on the controversial junior doctor contract.

While he did not manage to solve the issue, with the BMA still reporting issues around pay, Sir David said it was vital to address the longstanding concerns and “high level of discontent that has been fermenting for some years” in the trainee workforce.

While health secretary Jeremy Hunt MP has made it clear that the department will impose the contract, expected sometime this month, regardless of remaining sticking points, he said it is “paramount that we address the deep-seated issues” relating to their morale, wellbeing and quality of life.

The review team will make recommendations to the Department of Health, NHS Employers and HEE by the end of the year.

Also ongoing is a petition calling for a vote of no confidence in Hunt which claims he is “destroying all staff morale in the NHS and will cause recruitment issues”, according to signees. While a separate petition of this kind was already debated last year, this one gathered over 100,000 signatures – the threshold needed to trigger a Parliamentary debate – in just 24 hours.

The petition has now collected over 280,000 signatures since its creation late last week. Petitioners are still waiting on a government response and fixed debate date.

(Top image c. Frank Augstein, AP/Press Association Images)


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