Training squeeze will result in poorer quality patient care, says BMA

Almost half of UK doctors surveyed by the BMA are missing out on essential training, since the implementation of the 48 hour week in August 2009, a BMA conference was told.

The conference, attended by junior doctors and key stakeholders, explores the impact the European Working Time Directive has had on training. The erosion of junior doctors’ training could seriously undermine the ability of the NHS to provide high quality patient care in the future, say BMA leaders.

The NHS is dependant on junior doctors to provide much of the medical care in hospitals, however they also need structured time to learn new skills.

Preliminary findings of a BMA survey which explores the impact of the EWTD on the working lives of junior doctors were discussed at the conference. Of the doctors who reported missing out on training opportunities, three-quarters had not been able to attend lectures and training days and six in ten had missed out on supervision and opportunities to complete new procedures. Two in five respondents have felt compelled to come into work in their own time to get the formal training needed to do their jobs.

Dr Shree Datta, Chair of the BMA's Junior Doctors Committee said: “We cannot afford to place the future of the NHS in jeopardy by compromising on the training of tomorrow’s consultants and GPs. It is not sustainable to run hospitals by creating an environment where doctors feel they have to come in during their free time to get training. The current system is jeopardising the quality of training given to junior doctors, a development that will inevitably result in poorer quality patient care.

“Hospitals must devise ways of providing structured training alongside the delivery of patient care. They need to work with their junior doctors to devise rotas that meet the needs of the patients but also the training requirements of juniors. We must to cut out unnecessary bureaucracy and inappropriate work to allow junior doctors get the training they need.”

The conference will also announce findings that cast doubt on government claims that 99% of doctors are compliant with the working time directive. According to the survey, half of all junior doctors are still working in excess of 56 hours a week and one in three are working in excess of 65 hours a week. Over half of juniors surveyed said they were under pressure to work additional hours that are not recorded.

Dr Datta added: “The government would have us believe that the 48-hour week has been successfully implemented in UK hospitals. Our survey reveals that compliance has only been achieved by pressurising junior doctors into working off the clock.”